手机App对2型糖尿病患者血糖控制和行为管理效果的Meta分析

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摘要目的采用Meta 分析方法，综合评价国外应用手机App 对2 型糖尿病患者进行血糖控制和行为管理的有效性。结果以英文关键词“type 2 diabetes/T2DM，mobile health/telehealth/mHealth/smartphone，App/application，selfmanagement”检索PubMed，Cochrane Library，Web of Science，OVID，MEDLINE，EMBASE，截止时间为2018年4月28日。采用Revman 5.3 进行统计分析。结果共纳入13 项研究，1217 例研究对象。Meta 分析结果显示，观察组手机App 干预后的糖化血红蛋白（HbA1c）水平明显改善（MD=-0.41，95%CI：-0.56～-0.25，P＜0.000 01）。手机App 对患者饮食管理有较好的作用（MD=1.58，95%CI：0.26～2.90，P=0.02），在患者运动管理和用药依从性方面，手机App的作用并不优于常规护理（MD=0.49，95%CI：-0.97～1.94，P=0.51；MD=-0.31，95%CI：-2.10～1.49，P=0.74）。亚组分析显示，干预3、6、9、12 个月时，观察组的HbA1c 水平均明显低于对照组（P＜0.05），不同干预持续时间比较，差异无统计学意义（P＞0.05）。结果手机App 干预能够有效改善2 型糖尿病患者的HbA1c 水平，但干预持续时间对血糖控制效果没有影响。手机App 可提高患者的饮食管理能力，但在运动和用药方面没有明显优势。

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	罗莎
	李军文
	曹璐璐
	文奕
	杨俊

关键词 ： 2 型糖尿病, 手机App, 健康教育, 血糖控制, Meta 分析

Abstract：Objective To comprehensively evaluate the effectiveness of applying mobile App on blood glucose control and behavior management in patients with type 2 diabetes in foreign countries by using Meta-analysis.Methods PubMed,Cochrane Library,Web of Science,OVID,MEDLINE,EMBASE with the keywords as “type 2 diabetes/T2DM,mobile health/telehealth/mHealth/smartphone,App/application,and self-management” were searched.The literature retrieving from these databases were limited to April 28,2018.Revman 5.3 software was used for statistical analysis.Results A total of 13 studies were included with the involvement of 1217 subjects.Meta-analysis showed that the hemoglobin A1c(HbA1c) level was significantly improved after the intervention of the mobile App in the observation group (MD=-0.41,95% CI： -0.56： -0.25,P＜0.000 01).Mobile App had a good effect on patient diet management (MD=1.58,95%CI：0.26-2.90,P=0.02).In terms of patient′s exercise management and medication compliance,the effect of the mobile App was not superior to regular care (MD=0.49,95%CI： -0.97-1.94,P=0.51;MD=-0.31,95%CI： -2.10-1.49,P=0.74).Subgroup analysis showed that the HbA1c levels in the observation group were significantly lower than those in the control group after 3,6,9,and 12-month intervention (P＜0.05),and there was no statistical difference between the different durations of intervention (P＞0.05).Conclusion Mobile App intervention can effectively improve glycosylated hemoglobin levels in patients with type 2 diabetes,but the duration of intervention has no effect on glycemic control.The mobile App improves patients′ diet management but has no obvious advantage in exercise and medication.

Key words： Type 2 diabetes Mobile App Health education Glycemic control Meta-analysis

基金资助:四川省卫生和计划生育委员会科研课题（普及应用项目）（18PJ260）

引用本文:

罗莎;李军文;曹璐璐;文奕;杨俊. 手机App对2型糖尿病患者血糖控制和行为管理效果的Meta分析[J]. 中国当代医药, 2019, 26(27): 12-16.
LUO Sha; LI Jun-wen; CAO Lu-lu; WEN Yi3;YANG Jun. Meta-analysis on the effect of blood glucose control and behavior management in patients with type 2 diabetes using mobile App. 中国当代医药, 2019, 26(27): 12-16.

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