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Article(id=1322168587842859116, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168387082502716, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.06.020, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1745164800000, receivedDateStr=2025-04-21, revisedDate=1770566400000, revisedDateStr=2026-02-09, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159156045, onlineDateStr=2026-10-28, pubDate=1774368000000, pubDateStr=2026-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159156045, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159156045, creator=13701087609, updateTime=1793159156045, updator=13701087609, issue=Issue{id=1322168387082502716, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='6', pageStart='881', pageEnd='1056', issueExtLink='null', onlineDate='null', pubDate='1774368000000', pubDateStr='2026-03-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159108180, creator='13701087609', updateTime=1793159108180, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1023, endPage=1027, ext={EN=ArticleExt(id=1322168588283261037, articleId=1322168587842859116, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Development and application of home-based dietary management protocol for diabetic foot patients based on the family nurses dietary therapy theory model, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To develop and apply home-based dietary management protocol for diabetic foot patients.

Methods

Literature analysis and quality assessment were conducted to formulate initial draft of the home-based dietary management protocol for diabetic foot patients.Expert consultation was organized to revise and refine the draft.The final version of the home-based dietary management protocol for diabetic foot patients was formed.A total of 90 home-based diabetic foot patients from a tertiary grade A hospital and communities in Shanxi province were selected as research subjects from July to October 2024.Participants were randomly divided into control group and observation group using random number table.There were 43 cases in each group after excluding dropout cases.The control group received routine diabetes dietary care instructions,while the observation group received guidance based on the home-based dietary management protocol for diabetic foot patients.The nutritional status,dietary management level,glycated hemoglobin (HbA1c) levels,and wound outcomes were assessed in both groups.

Results

The final home-based dietary management protocol for diabetic foot patients was established,structured according to the pathological stages of diabetic foot wounds(inflammatory phase,proliferative phase,remodeling phase).The effective recovery rate of questionnaire was 100%.The expert authority coefficient was 0.85.The Kendall's W coefficient was 0.318(P<0.001).The observation group showed superior outcomes compared to the control group in terms of Mini Nutritional Assessment(MNA) scores,Dietary Management Scale for Type 2 scores,HbA1c levels,and overall wound treatment effectiveness(all P<0.05).

Conclusions

The home-based dietary management protocol for diabetic foot patients is scientific and feasible.Its application is beneficial for improving the nutritional status,dietary management capabilities,glucose metabolism indicators,and wound outcomes of diabetic foot patients.

, authors=Lihong FAN1, Junhong AN2, Shifan HAN1, 2, 3, 4, 5, Xiaoye WANG1, Ruiqin GAO1, authorsList=Lihong FAN, Junhong AN, Shifan HAN, Xiaoye WANG, Ruiqin GAO, authorCompany=null, correspAuthors=Junhong AN, authorNote=null, correspAuthorsNote=
AN Junhong, E-mail:
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目的

构建居家糖尿病足病人饮食管理方案并应用。

方法

进行文献分析与文献质量评价，形成居家糖尿病足病人饮食管理方案初稿，组织专家函询对初稿进行修订和完善形成终稿。于2024年7月—10月从山西省某三级甲等医院及社区招募90例居家糖尿病足病人为研究对象，依据随机数字表法将其分为对照组和观察组，剔除脱落病例后，每组43例，对照组采用糖尿病饮食护理常规对病人进行指导，观察组采用居家糖尿病足病人饮食管理方案对病人进行指导，评估两组病人营养状况、饮食管理水平、糖化血红蛋白（HbA1c）水平及伤口转归情况。

结果

最终形成基于糖尿病足创面病理分期（炎症期、增殖期、重塑期）的居家糖尿病足病人饮食管理方案，问卷有效回收率为100%，专家权威系数为0.85，肯德尔和谐系数为0.318（P<0.001）。观察组病人微型营养评估量表得分、2型糖尿病患者饮食管理量表得分、HbA1c水平及伤口治疗总有效率均优于对照组（均P<0.05）。

结论

居家糖尿病足病人饮食管理方案具有科学性与可行性，应用该方案有利于改善糖尿病足病人营养状况、饮食管理水平、糖代谢指标及促进伤口转归。

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范丽红，护士，硕士研究生

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安俊红，E-mail:
AN Junhong, E-mail:
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General information of experts(n=10)

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编号专业领域职称学历工作年限（年）
专家1整形外科主任医师硕士研究生38
专家2整形外科副主任医师硕士研究生23
专家3血管外科主任医师本科27
专家4肾内科主任医师本科21
专家5内分泌科副主任护师本科23
专家6营养科主任医师本科39
专家7营养科副主任医师硕士研究生18
专家8护理主任护师硕士研究生37
专家9护理副主任护师本科26
专家10护理副主任护师本科21
), ArticleFig(id=1322530264581001328, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=CN, label=表1, caption=

专家一般资料（n=10）

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编号专业领域职称学历工作年限（年）
专家1整形外科主任医师硕士研究生38
专家2整形外科副主任医师硕士研究生23
专家3血管外科主任医师本科27
专家4肾内科主任医师本科21
专家5内分泌科副主任护师本科23
专家6营养科主任医师本科39
专家7营养科副主任医师硕士研究生18
专家8护理主任护师硕士研究生37
专家9护理副主任护师本科26
专家10护理副主任护师本科21
), ArticleFig(id=1322530264652304497, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=EN, label=Table 2, caption=

Comparison of MNA scores between the two groups（x±s）

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组别例数得分
观察组4317.81±2.36
对照组4316.83±1.55
), ArticleFig(id=1322530264706830450, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=CN, label=表2, caption=

两组MNA得分比较（x±s）

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组别例数得分
观察组4317.81±2.36
对照组4316.83±1.55
), ArticleFig(id=1322530264769745011, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=EN, label=Table 3, caption=

Comparison of Dietary Management Scale for Type 2 scores between the two groups

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组别例数糖尿病饮食知识(x±s)糖尿病饮食信念[M，(P25，P75)]糖尿病饮食行为(x±s)
观察组4324.19±4.2018(17,19)16.74±1.63
对照组4321.63±3.2318(16,19)15.49±3.05
统计值t=3.165Z=-2.566t=2.174
P<0.05<0.05<0.05
), ArticleFig(id=1322530264836853876, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=CN, label=表3, caption=

两组2型糖尿病患者饮食管理量表得分比较

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组别例数糖尿病饮食知识(x±s)糖尿病饮食信念[M，(P25，P75)]糖尿病饮食行为(x±s)
观察组4324.19±4.2018(17,19)16.74±1.63
对照组4321.63±3.2318(16,19)15.49±3.05
统计值t=3.165Z=-2.566t=2.174
P<0.05<0.05<0.05
), ArticleFig(id=1322530264903962741, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=EN, label=Table 4, caption=

Comparison of HbA1c levels between the two groups（x±s）

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组别例数HbA1c
观察组437.14±0.71
对照组438.04±1.37
), ArticleFig(id=1322530264975265910, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=CN, label=表4, caption=

两组HbA1c水平比较（x±s）

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组别例数HbA1c
观察组437.14±0.71
对照组438.04±1.37
), ArticleFig(id=1322530265054957687, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=EN, label=Table 5, caption=

Comparison of wound outcomes between the two groups

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组别例数无效好转治愈总有效
观察组439（20.9）19（44.2）15（34.9）34（79.1）
对照组4319（44.2）10（23.3）14（32.6）24（55.8）
), ArticleFig(id=1322530265130455160, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168587842859116, language=CN, label=表5, caption=

两组伤口转归情况比较

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组别例数无效好转治愈总有效
观察组439（20.9）19（44.2）15（34.9）34（79.1）
对照组4319（44.2）10（23.3）14（32.6）24（55.8）
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基于家庭护士食疗理论模型的居家糖尿病足病人饮食管理方案构建及应用
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范丽红 1 , 安俊红 2, *, * , 韩世范 1, 2, 3, 4, 5 , 王小叶 1 , 高瑞琴 1
护理研究 | 综合研究 2026,40(6): 1023-1027
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护理研究 |综合研究 2026 , 40 (6) : 1023 -1027
基于家庭护士食疗理论模型的居家糖尿病足病人饮食管理方案构建及应用
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范丽红1, 安俊红2, *, * , 韩世范1, 2, 3, 4, 5, 王小叶1, 高瑞琴1
作者信息
  • 1山西医科大学，山西 030001
  • 2山西医科大学第一医院
  • 3山西医科大学食疗科技研究中心
  • 4山西省食疗和农产品处方产业技术创新战略联盟
  • 5山西省大健康产教融合重大平台载体与实训基地
通讯作者:
安俊红，E-mail:
AN Junhong, E-mail:
作者简介:

范丽红，护士，硕士研究生

Development and application of home-based dietary management protocol for diabetic foot patients based on the family nurses dietary therapy theory model
Lihong FAN1, Junhong AN2 , Shifan HAN1, 2, 3, 4, 5, Xiaoye WANG1, Ruiqin GAO1
Affiliations
  • 1Shanxi Medical University, Shanxi 030001 China
  • 2First Hospital of Shanxi Medical University
  • 3Dietotherapy Science and Technology Research Center, Shanxi Medical University
  • 4Shanxi Province Food Therapy and Agricultural Products Prescription Industry Technology Innovation Strategic Alliance
  • 5Major Platform Carrier and Training Base for the Integration of Health Industry and Education in Shanxi Province
    • Corresponding Author:
    AN Junhong, E-mail:
出版时间: 2026-03-25 doi: 10.12102/j.issn.1009-6493.2026.06.020
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摘要
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目的

构建居家糖尿病足病人饮食管理方案并应用。

方法

进行文献分析与文献质量评价，形成居家糖尿病足病人饮食管理方案初稿，组织专家函询对初稿进行修订和完善形成终稿。于2024年7月—10月从山西省某三级甲等医院及社区招募90例居家糖尿病足病人为研究对象，依据随机数字表法将其分为对照组和观察组，剔除脱落病例后，每组43例，对照组采用糖尿病饮食护理常规对病人进行指导，观察组采用居家糖尿病足病人饮食管理方案对病人进行指导，评估两组病人营养状况、饮食管理水平、糖化血红蛋白（HbA1c）水平及伤口转归情况。

结果

最终形成基于糖尿病足创面病理分期（炎症期、增殖期、重塑期）的居家糖尿病足病人饮食管理方案，问卷有效回收率为100%，专家权威系数为0.85，肯德尔和谐系数为0.318（P<0.001）。观察组病人微型营养评估量表得分、2型糖尿病患者饮食管理量表得分、HbA1c水平及伤口治疗总有效率均优于对照组（均P<0.05）。

结论

居家糖尿病足病人饮食管理方案具有科学性与可行性，应用该方案有利于改善糖尿病足病人营养状况、饮食管理水平、糖代谢指标及促进伤口转归。

家庭护士食疗理论  /  糖尿病足  /  居家护理  /  饮食管理  /  方案构建
Objective

To develop and apply home-based dietary management protocol for diabetic foot patients.

Methods

Literature analysis and quality assessment were conducted to formulate initial draft of the home-based dietary management protocol for diabetic foot patients.Expert consultation was organized to revise and refine the draft.The final version of the home-based dietary management protocol for diabetic foot patients was formed.A total of 90 home-based diabetic foot patients from a tertiary grade A hospital and communities in Shanxi province were selected as research subjects from July to October 2024.Participants were randomly divided into control group and observation group using random number table.There were 43 cases in each group after excluding dropout cases.The control group received routine diabetes dietary care instructions,while the observation group received guidance based on the home-based dietary management protocol for diabetic foot patients.The nutritional status,dietary management level,glycated hemoglobin (HbA1c) levels,and wound outcomes were assessed in both groups.

Results

The final home-based dietary management protocol for diabetic foot patients was established,structured according to the pathological stages of diabetic foot wounds(inflammatory phase,proliferative phase,remodeling phase).The effective recovery rate of questionnaire was 100%.The expert authority coefficient was 0.85.The Kendall's W coefficient was 0.318(P<0.001).The observation group showed superior outcomes compared to the control group in terms of Mini Nutritional Assessment(MNA) scores,Dietary Management Scale for Type 2 scores,HbA1c levels,and overall wound treatment effectiveness(all P<0.05).

Conclusions

The home-based dietary management protocol for diabetic foot patients is scientific and feasible.Its application is beneficial for improving the nutritional status,dietary management capabilities,glucose metabolism indicators,and wound outcomes of diabetic foot patients.

family nurses dietary therapy theory  /  diabetic foot  /  home care  /  dietary management  /  protocol development
范丽红, 安俊红, 韩世范, 王小叶, 高瑞琴. 基于家庭护士食疗理论模型的居家糖尿病足病人饮食管理方案构建及应用. 护理研究, 2026 , 40 (6) : 1023 -1027 . DOI: 10.12102/j.issn.1009-6493.2026.06.020
Lihong FAN, Junhong AN, Shifan HAN, Xiaoye WANG, Ruiqin GAO. Development and application of home-based dietary management protocol for diabetic foot patients based on the family nurses dietary therapy theory model[J]. Chinese Nursing Research, 2026 , 40 (6) : 1023 -1027 . DOI: 10.12102/j.issn.1009-6493.2026.06.020
正文
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糖尿病足（diabetic foot，DF）是指有糖尿病史的病人出现与下肢神经病变和（或）外周动脉病变相关的足踝部远组织感染、溃疡或破坏[1]。2023年美国糖尿病协会数据显示，糖尿病足溃疡病人的3~5年复发率为65%，终生下肢截肢率为20%，5年死亡率为50%~70%[2]，病人医疗花费巨大，约占糖尿病治疗总费用的1/3，给病人家庭和社会带来巨大经济负担[3]。且研究结果显示，糖尿病足等慢性伤口存在高炎症水平、高氧化应激水平和低氧伤口环境等特征性病理改变，可能导致伤口愈合炎症期延长、增殖期缩短以及重塑紊乱，进而引发伤口迁延不愈，病人营养代谢紊乱[4-5]。良好的饮食干预可改善糖尿病足病人高炎症状态并促进伤口愈合[6]。目前，我国糖尿病足病人的饮食管理主要参照糖尿病病人饮食护理常规，对糖尿病足病人的高炎症水平、创面修复等问题缺乏针对性指导[7]。家庭护士食疗理论模型[8]将慢性病的发生、发展视为氧化应激、炎症反应和代谢紊乱三大因素共同作用的结果，强调通过抗炎、抗氧化、调节代谢3条路径辅助治疗慢性病。因此，本研究基于家庭护士食疗理论模型构建居家糖尿病足病人饮食管理方案并将方案应用于实践，旨在为糖尿病足病人饮食管理提供参考依据。
1　居家糖尿病足病人饮食管理方案的构建
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1.1　成立研究小组
研究小组由9名多学科专家构成，其中具有国际伤口治疗师资质的研究生导师1人，负责研究的整体架构；内分泌科医生1人，负责糖尿病足病人的血糖调控与并发症防治；整形外科（创面修复方向）副主任医师1人，负责糖尿病足创面的诊断与治疗方案的制定；营养学专家与食疗专家各1人，协同制定符合病人需求的个性化营养方案；资深伤口治疗师（具有10年伤口管理经验）1人，负责糖尿病足病人的伤口处置；护理专业研究生3人，负责文献检索、数据采集、管理及分析。
1.2　构建居家糖尿病足病人饮食管理方案初稿
1.2.1　文献检索
以“糖尿病足”“足溃疡”“营养管理”“营养不良”“膳食干预”“非营养素”“抗炎”“抗氧化”“伤口修复”为中文检索词，以“diabetic foot*”“foot ulcer”“nutrition management”“malnutrition”“dietary intervention”“non-nutrient”“anti-inflammation”“antioxidant”“wound healing”为英文检索词，采用主题词联合自由词的检索方式检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、医脉通、国际指南协作网（IGCN）、苏格兰校际指南协作网（SIGN）、乔安娜布里格斯研究所（JBI）循证护理数据库、新西兰指南工作组（NZGG）官网、美国糖尿病协会官网、Cochrane Library、PubMed、Web of Science、Wiley、BMJ Best Practice，检索时限为建库至2024年6月1日。文献纳入标准：1）研究对象为糖尿病足病人；2）涉及糖尿病足病人的营养干预内容；3）文献类型为指南、专家共识、系统评价、随机对照试验、临床决策、证据总结；4）语言为中文或英文。排除标准：1）信息不全或无法获取全文；2）干预措施不明确。
1.2.2　文献筛选与评价
由2名具备循证护理培训背景的护理研究生负责文献筛选工作，文献筛选过程中如遇分歧，则邀请第3名研究者共同参与讨论。最终纳入文献17篇[3,7,9-23]，包括8篇指南[7,9-15]、3篇专家共识[3,16-17]、6篇系统评价[18-23]。使用指南研究与评价工具Ⅱ（AGREE Ⅱ）[24]对纳入的指南进行评价，使用JBI质量评价清单[25]对纳入的专家共识进行评价，使用第2版评估系统评价类研究的方法学质量工具（AMSTER2）[26]对纳入的系统评价进行评价。17篇文献质量均较高，均予纳入。研究小组提取文献中糖尿病足病人饮食干预相关证据形成居家糖尿病足病人饮食管理方案初稿。
1.3　实施专家函询
1.3.1　专家遴选
纳入标准：1）整形外科、血管外科、肾内科、内分泌科、营养科等领域的专家（包括临床医学、护理学）；2）临床医学专家具有副高级及以上职称；护理学专家具有副主任护师及以上职称；3）本科及以上学历；4）三级甲等医院工作年限≥10年；5）自愿参与本研究。共纳入10名专家，纳入专家一般资料见表1。
1.3.2　专家函询问卷
根据居家糖尿病足病人饮食管理方案初稿制定专家函询问卷，分为4个部分。1）前言：介绍本研究的背景、目的、意义，问卷填写方法及计分方式；2）专家基本情况：包括年龄、学历、职称、主要专业领域、工作年限等；3）初稿内容重要性评价：包括对各维度、条目的重要性评分和修改意见栏；4）专家自评：包括专家熟悉程度及专家对选项内容的判断依据。
1.3.3　专家函询结果
1）专家积极程度：共发放问卷10份，全部有效回收，问卷有效回收率为100%，表明专家积极性较高。2）专家权威程度：由专家权威系数（Cr）表示，通过专家判断依据系数（Ca）和熟悉程度系数（Cs）计算获得，Ca为0.86，Cs为0.84，Cr为0.85，表明专家权威性较高。3）专家协调程度：肯德尔和谐系数（Kendall's W值）为0.318（P<0.001），表明专家协调性较好。4）条目修改情况：根据专家提出的意见及小组讨论结果，增加3个条目、修改3个条目、删除1个条目，如专家认为糖尿病足病人应该具有相应的知识储备，了解哪些食物可以吃，哪些食物不适合吃，故增加“营养知识”条目“炎症期补充维生素D，推荐摄入量为每天800 IU”“增殖期补充富含β胡萝卜素的食物”；专家认为“禁食促炎食物”内容不明确，应补充促炎食物种类；“病人每天摄入0.5 kg以上新鲜蔬菜，血糖稳定时每日摄入不超过200 g水果”已包含在食物交换份法中，故予以删除。
2　居家糖尿病足病人饮食管理方案的应用
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2.1　对象与方法
2.1.1　研究对象
于2024年7月—10月，从山西省某三级甲等医院整形外科门诊、伤口门诊以及社区招募90例居家糖尿病足病人为研究对象。纳入标准：1）符合《中国糖尿病足诊治指南》[27]中的糖尿病足诊断标准；2）Wagner分级为1~3级；3）糖尿病足病程≥3个月；4）年龄18~75岁；5）自愿配合研究，签署知情同意书。排除标准：1）有认知障碍或严重的精神疾病；2）患有癌症、肿瘤或存在严重的心、肝、肾等器官功能障碍；3）近3个月内出现过急性并发症。采用随机数字表法将其分为对照组和观察组，每组45例。研究过程中对照组和观察组各脱落2例，最终每组各完成干预43例。本研究已获得山西医科大学第一医院伦理管理委员会批准（伦理号：KYLL-2024-164）。两组病人一般资料比较，差异无统计学意义（P>0.05）。
2.1.2　干预方法
2.1.2.1　对照组
采用糖尿病饮食护理常规对病人进行指导。根据病人性别、身高、体重以及身体活动量计算其每日所需能量，在目标热量基础上每日减少250~500 kcal的能量摄入，按照三大营养素占比（糖类占45%，蛋白质占30%，脂肪占25%），结合《成人糖尿病食养指南（2023年版）》[10]和《中国食物成分表》[28]为病人制定高蛋白、低血糖生成指数1周食谱。干预周期为3个月，干预期间维持常规治疗和生活方式不变，研究者实时在线解答病人饮食方面的问题。
2.1.2.2　观察组
采用居家糖尿病足病人饮食管理方案对病人进行指导。居家糖尿病足病人饮食管理方案以家庭护士食疗理论模型中抗炎、抗氧化、调节代谢的观点为指导，以糖尿病足创面愈合炎症期、增殖期、重塑期病理生理特征和营养需求为导向，于不同阶段采取不同干预方式。首先，向病人发放并讲授常见低血糖生成指数食物表[28]、常见膳食纤维食物及常见食物交换份表[10]，丰富病人的营养知识储备。其次，根据《中国2型糖尿病防治指南（2020年版）》[9]计算病人每日能量需求，采用食物交换份法计算各类食物份数。在伤口愈合的不同时期为病人制定每周个性化食谱。炎症期为病人选择抗炎、抗氧化、优质蛋白食物，禁食促炎食物，补充维生素D；增殖期选择优质蛋白以及富含膳食纤维、花青素、β-胡萝卜素的食物；重塑期禁食饱和脂肪酸和反式脂肪酸，增加低血糖生成指数食物和富含膳食纤维的食物，维持高蛋白食物摄入，增加不饱和脂肪酸摄入。干预周期为3个月。干预期间维持常规治疗和生活方式不变，研究者实时在线解答病人饮食方面的问题。
2.1.3　评价指标
于干预结束后7 d采用微型营养评估量表（Mini Nutritional Assessment，MNA）[29-30]、2型糖尿病患者饮食管理量表[31]对病人进行评价，测量病人糖化血红蛋白（HbA1c），统计病人伤口转归情况。1）MNA：包括18项内容，满分30分，得分越高代表营养状态越好[29-30]。2）2型糖尿病患者饮食管理量表：包括糖尿病饮食知识（7个条目）、糖尿病饮食信念（4个条目）、糖尿病饮食行为（4个条目）3个维度，共15个条目，得分越高表示病人饮食管理能力越好[31]。3）病人伤口转归：分为无效、好转、治愈，其中无效即伤口愈合面积<25%；好转即伤口愈合面积25%~75%；治愈即伤口愈合面积>75%。好转和治愈均视为有效。
2.1.4　统计学方法
采用SPSS 27.0软件进行统计分析，符合正态分布的定量资料以均数±标准差（x±s）表示，组间比较采用t检验；不符合正态分布的定量资料以中位数（四分位数）[M（P25，P75）]表示，组间比较采用秩和检验；定性资料以频数及百分比（%）表示，组间比较采用χ2检验。以P<0.05为差异有统计学意义。
2.2　结果
2.2.1　两组MNA得分比较（见表2）
2.2.2　两组2型糖尿病患者饮食管理量表得分比较（见表3）
2.2.3　两组HbA1c水平比较（见表4）
2.2.4　两组伤口转归情况比较（见表5）
3　讨论
收起
3.1　居家糖尿病足病人饮食管理方案具有科学性及可靠性
本研究系统检索国内外相关文献，经文献筛选与文献质量评价后提取糖尿病足病人饮食管理相关证据，形成居家糖尿病足病人饮食管理方案初稿，并通过专家函询法对方案进行修订和完善。纳入专家在糖尿病足治疗、临床营养领域具有丰富的治疗或护理经验，专家意见具有一定代表性；专家函询问卷有效回收率为100%，表明专家积极性较高；Cr为0.85，体现了专家的权威性；Kendall's W值为0.318（P<0.001），表明专家意见较协调。最终形成基于糖尿病足创面愈合病理分期（炎症期、增殖期、重塑期）的阶段性营养干预方案，并制定贯穿治疗全过程的饮食规范，方案内容有据可循，可为更多居家糖尿病足病人提供饮食指导。
3.2　居家糖尿病足病人饮食管理方案的应用有利于改善病人营养状况、饮食管理水平、糖代谢及伤口转归
本研究结果显示，观察组病人MNA得分、2型糖尿病患者饮食管理量表得分及伤口愈合的总体有效率均高于对照组，HbA1c水平低于对照组，差异均有统计学意义（均P<0.05），提示居家糖尿病足病人饮食管理方案对于Wagner分级为1~3级的居家糖尿病足病人营养状况、饮食管理水平、糖代谢以及创面愈合具有积极意义，该方案重视病人在营养知识方面的学习与掌握，可一定程度上提升病人自我管理能力，在食物选择上以家庭护士食疗理论模型中抗炎、抗氧化、调节代谢的观点为指导，以糖尿病足创面炎症期、增殖期、重塑期病理特征和营养需求为导向，于不同阶段给予不同干预，可为病人伤口愈合提供更具针对性的营养支持。
4　小结
收起
本研究基于家庭护士食疗理论模型，通过文献分析、专家函询构建了居家糖尿病足病人饮食管理方案，包括总体实施过程以及病人创面愈合各阶段的食物选择等内容。方案的应用有利于改善糖尿病足病人营养状况、饮食管理水平、糖代谢以及促进创面转归。但本研究仅纳入了Wagner分级为1~3级的病人，不能代表所有糖尿病足病人，且本研究的随访时间较短，未来仍需延长随访周期以观察方案对于糖尿病足病人的长远影响。

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doi: 10.12102/j.issn.1009-6493.2026.06.020
  • 接收时间：2025-04-21
  • 首发时间：2026-10-28
  • 出版时间：2026-03-25
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  • 收稿日期：2025-04-21
  • 修回日期：2026-02-09
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    1山西医科大学，山西 030001
    2山西医科大学第一医院
    3山西医科大学食疗科技研究中心
    4山西省食疗和农产品处方产业技术创新战略联盟
    5山西省大健康产教融合重大平台载体与实训基地

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Number of
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Number of
species		 占总种数比例
Percentage of
total species (%)		 属
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
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