目的 应用疾病管理理论与技术,观察中医特色疾病管理模式对抑郁症患者依从性的影响.方法 选取2010年5月~2010年8月到首都医科大学附属北京中医医院针灸科抑郁专台就诊的符合病例入选标准的60例抑郁患者作为观察对象,将入组患者分为管理组(30例)和对照组(30例).管理组患者接受中医特色疾病管理,包括综合抗抑郁治疗、抑郁症中医特色教育、定期复诊、评估.对照组患者以常规诊疗模式接受治疗及定期评估.两组观察评估时间均为24周.分别于治疗4、8、12、16、20、24周末观察依从性情况.结果 ①管理组较对照组复诊次数多、坚持治疗时间长(P < 0.01);②在24周的观察时间里,管理组较对照组服药依从性好,管理组按照医生建议服药例数均较对照组多(P < 0.05或P < 0.01);③管理组较对照组针灸治疗依从性好,管理组在前8周按要求完成针灸治疗的例数较对照组多(P < 0.01),在9～24周,管理组坚持针灸治疗的例数均多于对照组(P < 0.01).结论 中医特色疾病管理模式与常规诊疗模式比较其依从性优于常规诊疗模式.%Objective To observe the influence of the disease management of traditional Chinese medicine model on the the treatment compliance of patients with depression by applying the disease management theory and technology. Methods The patients that went to doctor in depression special clinic of acupuncture and moxibustion department in Beijing hospital of traditional Chinese medicine affiliated to capital medical university from May 2010 to August 2010 were incorporated as the observation object, they were divided into management group (30 cases) and control group (30 cases). The patients who assigned in management group accepted the disease management of traditional Chinese medicine model such as antide-pressant medicine treatment, education of traditional Chinese medicine model about depression, regular assessment and following. Conventional treatment model and treatments were used for the control group. The intervention of both group lasted for 24 weeks. The changes in measuring indicators including treatment compliance scale was observed in 4 weeks, Sweeks, 12weeks, 16 weeks, 20 weeks, 24 weeks after the intervention in order to observe the measuring indicators of the treatment compliance. Results (l)The management group had more return visit times and longer treatment time which compared with control group (P ＜ 0.01). (2;The management group had higher compliance of drug treatment, there were more patients taking medicine according to doctor than control group (P ＜ 0.05 or P ＜ 0.01).③The higher compliance of acupuncture treatment was showed in the management group, there were more patients accepting acupuncture treatment over 3 times every week than control group from 0 to 8 weeks (P ＜ 0.01). From 9 to 24 weeks, the persistent acupuncture treatment rate of the management group is higher than the control group (P ＜ 0.01). Conclusion The disease management of traditional Chinese medicine model was superior to the conventional treatment model in the treatment compliance.
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