目的探讨基于信息-动机-行为技巧（IMB）模型的血糖负荷食物交换份法在2型糖尿病肥胖患者饮食干预中的效果。
方法采用便利抽样法，选取2019年3—11月在某三甲医院内分泌科门诊就诊的70例2型糖尿病肥胖患者为研究对象，按照随机数字表法分为对照组和试验组，每组各35例。对照组实施传统食物交换份的饮食干预，试验组实施基于IMB模型的血糖负荷食物交换份法的饮食干预。采用 t检验比较两组患者干预前后空腹血糖、餐后2 h血糖、糖化血红蛋白、甘油三酯、总胆固醇、BMI、腰围、糖尿病自我管理行为（SDSCA）量表得分。
结果对照组和试验组完成干预的患者例数分别为32、34例。试验组患者干预后空腹血糖、餐后2 h血糖、糖化血红蛋白、甘油三酯、总胆固醇、BMI、腰围低于对照组，SDSCA量表得分高于对照组，差异均有统计学意义（ t值分别为2.559、2.152、2.329、2.179、2.046、2.167、2.066、-6.435； P<0.05）。
结论应用基于IMB模型的血糖负荷食物交换份法对2型糖尿病肥胖患者进行饮食干预，能改善患者的自我管理行为以及血糖、血脂、人体测量学相关指标，可提高2型糖尿病肥胖患者的饮食干预效果。
ObjectiveTo explore the effect of the glycemic load food exchange method based on the information-motivation-behavioral skills (IMB) model in the diet intervention of obese patients with type 2 diabetes.
MethodsFrom March to November 2019, convenience sampling was used to select 70 obese patients with type 2 diabetes in the Outpatient Department of Endocrinology of a Class Ⅲ Grade A hospital as the research object. According to the random number table method, patients were divided into control group and experimental group, with 35 cases in each group. Control group implemented the diet intervention of traditional food exchange, and experimental group carried out the diet intervention of the glycemic load food exchange method based on the IMB model. We compared the fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, triglycerides, total cholesterol, body mass index (BMI) , waist circumference, and the Summary of Diabetes Self-Care Activities (SDSCA) score of patients between two groups before and after intervention.
ResultsThe number of patients who completed the intervention in control group and experimental group were 32 and 34 respectively. The fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, triglycerides, total cholesterol, BMI, and waist circumference of experimental group after intervention were lower than those of control group, and the SDSCA scale score was higher than that of control group, and the differences were statistically significant ( P<0.05) .
ConclusionsThe application of the glycemic load food exchange method based on the IMB model in diet intervention in obese patients with type 2 diabetes can improve the patients' self-management behavior, blood glucose, blood lipids, and anthropometric indicators, and can increase the diet intervention effect of obese patients with type 2 diabetes.
曹文倩,康凤英,滕云. 基于IMB模型的血糖负荷食物交换份法在2型糖尿病肥胖患者中的应用[J]. 中华现代护理杂志,2021,27(17)：2248-2254.
DOI:10.3760/cma.j.cn115682-20201020-05841版权归中华医学会所有。
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试验设计、论文修订为康凤英、曹文倩，研究实施、资料收集为滕云、曹文倩，论文撰写为曹文倩，康凤英审校
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