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Article(id=1241102738344431747, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202404405, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1713801600000, receivedDateStr=2024-04-23, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773831551394, onlineDateStr=2026-03-18, pubDate=1721836800000, pubDateStr=2024-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773831551394, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773831551394, creator=13701087609, updateTime=1773831551394, updator=13701087609, issue=Issue{id=1241102730337505325, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773831549486, creator=13701087609, updateTime=1773831697291, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241103350322745680, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241103350322745681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102730337505325, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2655, endPage=2661, ext={EN=ArticleExt(id=1241102739674026134, articleId=1241102738344431747, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Visual analysis of chronic disease management over the past decade both domestically and internationally, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To conduct a comparative analysis of the research topics on home and international chronic disease management from 2013 to 2023, aiming to provide valuable insights for future studies.

Methods

The Chinese databases selected for this study were CNKI, Wanfang Database, and Sinomed, while the English database chosen was Web of Science core dataset. EndNote 20 software was utilized to gather literature on "chronic disease management", and visual analysis was conducted using VOSviewer and CiteSpace software.

Results

A total of 6 621 Chinese articles and 4 096 English articles met the inclusion criteria. Over the course of the decade, there was a consistent upward trend in the number of articles pertaining to home-based chronic disease management both domestically and internationally. According to the co-occurrence cluster analysis, six clusters were identified in China for the management of chronic diseases, including community-based comprehensive disease management, common chronic disease management, self-management of chronic diseases, pharmaceutical care for chronic disease management, health education for chronic disease management, and traditional Chinese medicine-based prevention and treatment of chronic diseases. Abroad, there were also 6 cluster themes identified: Health-care of chronic diseases, Regional trends and management of chronic diseases, The impact of emergencies, Major chronic diseases, Quality of life for patients with chronic diseases, Multiple chronic diseases.

Conclusion

Foreign research is more sensitive to current affairs and frontier hotspots. Domestic research is based on domestic specific forms, which is more in line with the national conditions and has localized characteristics. Chronic disease management in China should continue to deepen the research on basic chronic disease management and chronic diseases in the elderly and other topics that fit the reality, and further develop the prevention and treatment of traditional Chinese medicine to form unique local advantages. At the same time, it keeps up with international research hotspots and supplements scientific research on digital health, mental health, multiple chronic diseases, etc.

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目的

比较2013年至2023年间国内外慢性病管理研究主题，为未来研究提供参考。

方法

国内选取中国知网（CNKI）、万方数据库和中国生物医学文献服务系统，国外选取Web of Science核心数据集，检索“慢性病管理”相关文献，用EndNote 20软件整理，VOSviewer和CiteSpace软件进行可视化分析。

结果

共纳入符合标准的中文文献6 621篇，英文文献4 096篇。十年间国内外慢性病管理领域的发文量整体呈上升趋势。根据共现聚类分析，国内有6个聚类，分别为慢性病的社区综合治理，常见慢性病管理，慢性病的自我管理，慢性病管理的药学服务，慢性病管理的健康教育，中医药的慢性病防治；国外共6个聚类，分别为Health-care of chronic diseases、Regional trends and management of chronic diseases、The impact of emergencies、Major chronic diseases、Quality of life for patients with chronic diseases、Multiple chronic diseases。

结论

国外研究对时事和前沿热点更为敏感；国内研究基于国内具体形式，更符合国情，也拥有本土化特色主题。国内慢性病管理应当继续加深基层慢性病管理、老年慢性病等契合实际的主题研究，并进一步发展中医药防治，形成特有的本土化优势；同时紧跟国际研究热点，补充数字健康、心理健康、多重慢性病等科研研究。

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张立实，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=QK9IbrreiSIBCvErs+KobA==, magXml=A5rXe3HorYH3sMS6s1VqLA==, pdfUrl=null, pdf=/KBszUb1z0hnW9wh9vjfJQ==, pdfFileSize=2119115, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=t05eRFgV0LpBJQoAf4FelA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=0LIog7K+kIjRO9T3pESIbg==, mapNumber=null, authorCompany=null, fund=null, authors=

陈怡依（1995—），女，硕士，研究实习员，研究方向：慢性病管理、全程管理

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陈怡依（1995—），女，硕士，研究实习员，研究方向：慢性病管理、全程管理

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articleId=1241102738344431747, language=EN, label=Fig.4, caption=The visualized network map of cooperation among foreign institutions, figureFileSmall=pOqN9aWlg4QtOyGzyPrAqQ==, figureFileBig=znPjs+tb3t/rF4mhD2gVWw==, tableContent=null), ArticleFig(id=1241102749908128524, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=图4, caption=国外机构合作可视化网络图谱, figureFileSmall=pOqN9aWlg4QtOyGzyPrAqQ==, figureFileBig=znPjs+tb3t/rF4mhD2gVWw==, tableContent=null), ArticleFig(id=1241102750012986135, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=EN, label=Fig.5, caption=The visualized network map of cooperation among domestic institutions, figureFileSmall=H08JnGhvubRSVJpZVW/kvA==, figureFileBig=QhFjZPu7+cOZQJM5L/m/8w==, tableContent=null), ArticleFig(id=1241102750122038042, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=图5, caption=国内机构合作可视化网络图谱, figureFileSmall=H08JnGhvubRSVJpZVW/kvA==, figureFileBig=QhFjZPu7+cOZQJM5L/m/8w==, tableContent=null), ArticleFig(id=1241102750247867172, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=EN, label=Fig.6, caption=Keyword co-occurrence clustering analysis in domestic literature on chronic disease management, figureFileSmall=WiwFlZOY8Q3TyzdLNZlPSw==, figureFileBig=mOHtIHb/ErGaZOslMWiVeA==, tableContent=null), ArticleFig(id=1241102750394667821, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=图6, caption=国内慢性病管理领域文献关键词共现聚类分析, figureFileSmall=WiwFlZOY8Q3TyzdLNZlPSw==, figureFileBig=mOHtIHb/ErGaZOslMWiVeA==, tableContent=null), ArticleFig(id=1241102750554051382, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=EN, label=Fig.7, caption=Keyword co-occurrence clustering analysis in foreign literature on chronic disease management, figureFileSmall=crZxEAhS/C295YU7OYesCg==, figureFileBig=nX7WftyMWPzIBBjzhl9ZMg==, tableContent=null), ArticleFig(id=1241102750692463421, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=图7, caption=国外慢性病管理领域文献关键词共现聚类分析, figureFileSmall=crZxEAhS/C295YU7OYesCg==, figureFileBig=nX7WftyMWPzIBBjzhl9ZMg==, tableContent=null), ArticleFig(id=1241102750994453323, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=EN, label=Table 1, caption=

The distribution of the top ten journals in the field of chronic disease management in China

, figureFileSmall=null, figureFileBig=null, tableContent=
序号期刊名发文量（%）
1中国全科医学524（7.91）
2中国慢性病预防与控制319（4.82）
3护理研究203（3.07）
4中国健康教育194（2.93）
5现代预防医学158（2.39）
6中国老年学杂志155（2.34）
7中国公共卫生107（1.62）
8护理学杂志104（1.62）
9中国实用护理杂志102（1.54）
10中国护理管理97（1.47）
合计1 963（29.71）
), ArticleFig(id=1241102751103505234, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=表1, caption=

国内慢性病管理领域发文量前十的期刊及分布

, figureFileSmall=null, figureFileBig=null, tableContent=
序号期刊名发文量（%）
1中国全科医学524（7.91）
2中国慢性病预防与控制319（4.82）
3护理研究203（3.07）
4中国健康教育194（2.93）
5现代预防医学158（2.39）
6中国老年学杂志155（2.34）
7中国公共卫生107（1.62）
8护理学杂志104（1.62）
9中国实用护理杂志102（1.54）
10中国护理管理97（1.47）
合计1 963（29.71）
), ArticleFig(id=1241102751246111580, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=EN, label=Table 2, caption=

Top 10 journals and distribution of publications in the field of chronic disease management abroad

, figureFileSmall=null, figureFileBig=null, tableContent=
序号期刊名发文量（%）
1Plos One153（3.74）
2BMC Health Srvices Research124（3.03）
3International Journal of Environmental Research and Public Health105（2.56）
4Bmj Open101（2.47）
5Bmc Public Health89（2.17）
6Journal of Medical Internet Research45（1.10）
7Healthcare41（1.00）
8Trials40（0.98）
9Frontiers in Public Health36（0.88）
10Bmc Family Practice36（0.88）
合计770（18.81）
), ArticleFig(id=1241102752714117987, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=表2, caption=

国外慢性病管理领域发文量前十的期刊及分布

, figureFileSmall=null, figureFileBig=null, tableContent=
序号期刊名发文量（%）
1Plos One153（3.74）
2BMC Health Srvices Research124（3.03）
3International Journal of Environmental Research and Public Health105（2.56）
4Bmj Open101（2.47）
5Bmc Public Health89（2.17）
6Journal of Medical Internet Research45（1.10）
7Healthcare41（1.00）
8Trials40（0.98）
9Frontiers in Public Health36（0.88）
10Bmc Family Practice36（0.88）
合计770（18.81）
), ArticleFig(id=1241102752860918632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=EN, label=Table 3, caption=

Top 10 institutions in the field of chronic disease management with the highest number of publications both domestically and internationally

, figureFileSmall=null, figureFileBig=null, tableContent=
序号国内国外
1四川大学华西医院悉尼大学
2中国疾病预防控制中心哈佛大学医学院
3北京大学第一医院多伦多大学
4中日友好医院蒙纳士大学
5北京大学第三医院伦敦卫生与热带医学院
6复旦大学开普敦大学
7复旦大学附属中山医院华盛顿大学
8重庆市疾病预防控制中心昆士兰大学
9北京大学人民医院德黑兰医科大学
10天津医科大学首尔大学
), ArticleFig(id=1241102753003524978, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102738344431747, language=CN, label=表3, caption=

国内外慢性病管理领域发文量前十的机构

, figureFileSmall=null, figureFileBig=null, tableContent=
序号国内国外
1四川大学华西医院悉尼大学
2中国疾病预防控制中心哈佛大学医学院
3北京大学第一医院多伦多大学
4中日友好医院蒙纳士大学
5北京大学第三医院伦敦卫生与热带医学院
6复旦大学开普敦大学
7复旦大学附属中山医院华盛顿大学
8重庆市疾病预防控制中心昆士兰大学
9北京大学人民医院德黑兰医科大学
10天津医科大学首尔大学
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2013—2023年国内外慢性病管理研究主题的可视化分析
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陈怡依 1 , 唐正 1 , 杜春霖 1 , 何宇恒 1 , 周永召 1 , 张立实 2
现代预防医学 | 疾病预防控制 2024,51(14): 2655-2661
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现代预防医学 | 疾病预防控制 2024, 51(14): 2655-2661
2013—2023年国内外慢性病管理研究主题的可视化分析
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陈怡依1, 唐正1, 杜春霖1, 何宇恒1, 周永召1, 张立实2
作者信息
  • 1.四川大学华西医院全程管理中心，四川 成都 610041
  • 2.四川大学华西公共卫生学院，四川省食品安全监测与风险评估重点实验室

    • 陈怡依（1995—），女，硕士，研究实习员，研究方向：慢性病管理、全程管理

通讯作者:

张立实，E-mail：
Visual analysis of chronic disease management over the past decade both domestically and internationally
Yi-yi CHEN1, Zheng TANG1, Chun-lin DU1, Yu-heng HE1, Yong-zhao ZHOU1, Li-shi ZHANG2
Affiliations
  • Sichuan University West China Hospital Full Process Management Center, Chengdu, Sichuan 610041, China
出版时间: 2024-07-25 doi: 10.20043/j.cnki.MPM.202404405
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摘要
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目的

比较2013年至2023年间国内外慢性病管理研究主题，为未来研究提供参考。

方法

国内选取中国知网（CNKI）、万方数据库和中国生物医学文献服务系统，国外选取Web of Science核心数据集，检索“慢性病管理”相关文献，用EndNote 20软件整理，VOSviewer和CiteSpace软件进行可视化分析。

结果

共纳入符合标准的中文文献6 621篇，英文文献4 096篇。十年间国内外慢性病管理领域的发文量整体呈上升趋势。根据共现聚类分析，国内有6个聚类，分别为慢性病的社区综合治理，常见慢性病管理，慢性病的自我管理，慢性病管理的药学服务，慢性病管理的健康教育，中医药的慢性病防治；国外共6个聚类，分别为Health-care of chronic diseases、Regional trends and management of chronic diseases、The impact of emergencies、Major chronic diseases、Quality of life for patients with chronic diseases、Multiple chronic diseases。

结论

国外研究对时事和前沿热点更为敏感；国内研究基于国内具体形式，更符合国情，也拥有本土化特色主题。国内慢性病管理应当继续加深基层慢性病管理、老年慢性病等契合实际的主题研究，并进一步发展中医药防治，形成特有的本土化优势；同时紧跟国际研究热点，补充数字健康、心理健康、多重慢性病等科研研究。

慢性非传染性疾病  /  慢性病管理  /  可视化分析  /  VOSviewer
Objective

To conduct a comparative analysis of the research topics on home and international chronic disease management from 2013 to 2023, aiming to provide valuable insights for future studies.

Methods

The Chinese databases selected for this study were CNKI, Wanfang Database, and Sinomed, while the English database chosen was Web of Science core dataset. EndNote 20 software was utilized to gather literature on "chronic disease management", and visual analysis was conducted using VOSviewer and CiteSpace software.

Results

A total of 6 621 Chinese articles and 4 096 English articles met the inclusion criteria. Over the course of the decade, there was a consistent upward trend in the number of articles pertaining to home-based chronic disease management both domestically and internationally. According to the co-occurrence cluster analysis, six clusters were identified in China for the management of chronic diseases, including community-based comprehensive disease management, common chronic disease management, self-management of chronic diseases, pharmaceutical care for chronic disease management, health education for chronic disease management, and traditional Chinese medicine-based prevention and treatment of chronic diseases. Abroad, there were also 6 cluster themes identified: Health-care of chronic diseases, Regional trends and management of chronic diseases, The impact of emergencies, Major chronic diseases, Quality of life for patients with chronic diseases, Multiple chronic diseases.

Conclusion

Foreign research is more sensitive to current affairs and frontier hotspots. Domestic research is based on domestic specific forms, which is more in line with the national conditions and has localized characteristics. Chronic disease management in China should continue to deepen the research on basic chronic disease management and chronic diseases in the elderly and other topics that fit the reality, and further develop the prevention and treatment of traditional Chinese medicine to form unique local advantages. At the same time, it keeps up with international research hotspots and supplements scientific research on digital health, mental health, multiple chronic diseases, etc.

Chronic noncommunicable diseases  /  Chronic disease management  /  Visual analysis  /  VOSviewer
陈怡依, 唐正, 杜春霖, 何宇恒, 周永召, 张立实. 2013—2023年国内外慢性病管理研究主题的可视化分析. 现代预防医学, 2024 , 51 (14) : 2655 -2661 . DOI: 10.20043/j.cnki.MPM.202404405
Yi-yi CHEN, Zheng TANG, Chun-lin DU, Yu-heng HE, Yong-zhao ZHOU, Li-shi ZHANG. Visual analysis of chronic disease management over the past decade both domestically and internationally[J]. Modern Preventive Medicine, 2024 , 51 (14) : 2655 -2661 . DOI: 10.20043/j.cnki.MPM.202404405
正文
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慢性病全称慢性非传染性疾病，往往持续时间长且迁延不愈，是遗传、生理、环境和行为因素综合作用的结果。根据世界卫生组织（WHO）统计，慢性病每年造成4 100万人死亡，占全球死亡人数的74%[1]。慢性病的外在社会驱动力往往包括无计划的快速城市化、不健康生活方式的全球化和人口老龄化。而中国作为一个正面临人口老龄化加剧、社会经济快速发展而居民健康素养滞后等问题的发展中国家，慢性病已经成为威胁居民健康的重大问题。
《中国居民营养与慢性病状况报告（2020年）》显示，2019年我国因慢性病导致的死亡占总死亡的88.5%，其中心脑血管病、癌症、慢性呼吸系统疾病死亡比例为80.7%[2]。虽然慢性病已被广泛认为是可防可控的，但我国慢性病管理领域起步较晚，尚未形成体系；而国外已形成多形式的管理方案并予以实践。基于此，本研究对近十年国内外慢性病管理领域发表的文章进行对比分析，以期为国内相关研究的开展提供参考。
1　数据与方法
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1.1　数据来源
中文文献来源于中国知网（CNKI）、万方数据库和中国生物医学文献服务系统。以检索式（主题=“慢性非传染性疾病”OR“慢性病”OR“慢病”）AND（主题=“管理”OR“防治”）进行检索，检索时间自2013-11-30至2023-11-30，来源类别选择SCI、北大核心、CSSCI。英文文献来源于Web of Science核心数据集，限定语言为English，限定文章类型为Article，限定时间为2013-11-30至2023-11-30，以检索式TS=(“chronic diseases” OR “non-communicable diseases” OR “chronic non-communicable diseases”) AND TS=(“management” OR “administration”) NOT CU=“CHINA”进行检索。最终共计获得有关慢性病管理的中文文献13510篇，英文文献4927篇。
1.2　纳入排除
纳入标准：慢性病管理领域的研究型论文。排除标准：重复文献、会议通知、报道、病例报告等其他类型收录文章。将检索获得的中英文文献分别导入文献分析软件EndNote 20，先剔除重复文献，再人工审阅排除，最终获得符合纳入标准的中文文献6 621篇，英文文献4 096篇。
1.3　分析方法
运用文献分析软件EndNote 20分别对纳入文献的发表年份、来源期刊等进行描述性统计分析，并进行预处理。再将文献导入VOSviewer 1.6.19和CiteSpace.6.3.R1进行文献计量学可视化分析，并辅以pajek软件绘制共现图谱，根据结果分析国内外慢性病管理领域的研究热点与发展趋势。
2　结果
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2.1　年度发文统计及趋势
国内外各年份发文统计如图1所示，2013年与2023年因未统计全年发文量，所以未在统计图中画出。国内发文量在2014至2021年稳定增加，2021至2022年维持发文高峰；国外发文量在2014至2018年间波动维持，2018至2021年间快速增加，2021至2022年时发文量达到高峰并进入稳定阶段。
2.2　期刊分布
国内外慢性病管理领域相关文章发文量前十的期刊分布如表1和表2所示。国内主要分布于《中国全科医学》、《中国慢性病预防与控制》、《护理研究》等，发文量前十的期刊占总发文量的29.71%，期刊的领域范围主要是公共卫生、预防医学和护理学；国外主要分布于《Plos One》、《BMC Health Srvices Research》、《International Journal of Environmental Research and Public Health》，发文量前十的期刊占总发文量的18.81%，期刊的领域范围包括综合性期刊、公共卫生和预防医学。
2.3　作者合作研究情况分析
运用VOSviewer软件分别绘制作者合作网络图谱，详见图2和图3。国内以丁贤彬、张振香、董文兰、杨静、徐健、李辉、张娟等为主的团队发文较多，且相互间合作密切；也有以李伟、陈艳等为代表的团队以内部合作为主，尚未与其他机构或团队形成合作。国外科研团队以Chouinard Maud-Christine、Wensing Michel、Fourie Jean M、Prados-Torres Alexandra、Grande David、 Chouinard Maud-Christine、lee j等为代表，部分两两之间有协作，多为团队内部合作。
2.4　机构合作网络分析
国内外发文量前十的机构如表3所示，可以观察到国内发文机构以大型综合性三甲医院为主，也有各级疾控中心和高校发文；国外发文机构集中于国际排名靠前的科研高校。
运用VOSviewer 1.6.19和CiteSpace.6.3.R1分别对国外和国内机构合作情况作网络可视化分析，得到图谱如图4和图5所示。国外各机构间合作联系繁多，但显示出明显的地域性，即同个国家或同个地区之间的合作更为频繁；国内各机构之间也初步形成了合作关系，且同一高校的附属医院间表现出更频繁的合作倾向。
2.5　关键词共现聚类分析
对纳入的6 621篇国内文献和4 096篇国外文献进行同义词合并、无意义词删除等预处理，获得关键词共现频次排序。国内文献共现频次前十的高频关键词分别为慢性病、糖尿病、高血压、影响因素、自我管理、老年人、健康管理、慢性阻塞性肺疾病、慢病管理、生活质量；国外文献共现频次前十的高频关键词分别为chronic diseases、management、prevalence、care、diabetes、health、self-managemnt、interventions、hypertension、adherence。
应用VOSviewer 1.6.19软件进行共现聚类分析，用Pajek软件对可视化聚类图谱进行整理，得到共现聚类图谱。
国内慢性病管理领域关键词共现聚类分析共获得6个聚类，详见图6。聚类1：慢性病的社区综合治理，主要关键词有慢性病、老年人、社区卫生服务、管理模式等；聚类2：常见慢性病管理，主要关键词有糖尿病、慢性阻塞性肺疾病、患病率、心血管疾病等；聚类3：慢性病的自我管理，自我管理、生活质量、护理、自我效能等；聚类4：慢性病管理的药学服务，主要关键词有临床药师、药学服务、效果评价、依从性等；聚类5：慢性病管理的健康教育，主要关键词有健康教育、健康素养、影响因素、知晓率等；聚类6：中医药的慢性病防治，主要关键词有中医药、治未病、慢性肾脏病等。
国外慢性病管理领域关键词共现聚类分析共获得6个聚类，详见图7。聚类1：Health-care of chronic diseases，主要关键词有chronic diseases、care、ehealth、mhealth等；聚类2：Regional trends and management of chronic diseases, 主要关键词有management、prevalence、hypertension、burden等；聚类3：The impact of emergencies，主要关键词有covid-19、comorbidity、pandemic、sars-cov-2等；聚类4：Major chronic diseases，主要关键词有diabetes、cardiovascular-disease、risk、cancer等；聚类5：Quality of life for patients with chronic diseases，主要关键词有quality-of-life、self-efficacy、validity等；聚类6：Multiple chronic diseases，主要关键词有adherence、multimorbidity、older-adults等。
3　讨论
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3.1　发文情况
根据近十年的发文量来看，国内外慢性病管理领域发文整体都处于持续增加的状态。这反映慢性病管理领域的关注度仍在不断上升。
国内的发文量上升可能与十年来国家陆续出台慢性病管理相关政策，并实施“健康中国”战略，形成政府主导、部门协作、社会动员、全民参与的慢性病综合防治机制有关。国外的发文量以2018年为节点，于2019年开始大幅增加，这可能与新型冠状病毒肺炎大流行等时事有关。
3.2　发文领域
国内发文的期刊领域范围主要是公共卫生、预防医学和护理学；国外发文的期刊领域范围主要为综合性期刊、公共卫生和预防医学。慢性病兼具疾病特征和社会特征，公共管理或者公共政策的介入对于治理慢性病具有很大的作用[3]。这反映在发文领域，就是无论国内还是国外，公共卫生和预防医学大类都是产出慢性病管理领域文章的主体。
此外，护理学也是国内慢性病管理发文的重点领域，而国外更倾向于综合类期刊。这说明国内护理是慢性病管理中的重要组成部分。
3.3　作者和机构合作网络
国内外作者和机构间的合作都已形成相对稳定的协作网络。国内发文较多的作者团队间常有协作，而国外更倾向于团队内合作。国外的发文机构多为科研高校，国内的发文机构多为高校附属的大型三甲医院、各级疾控中心和高校，都显示出同洲国、同省市间更加频繁的合作倾向。这可能与同地区内研究主体和对象同质性高有关。
3.4　研究主题
3.4.1　国内外研究主题的相似性
根据国内外慢性病管理领域共现聚类分析的结果，可归纳出2个相似的研究主题。
（1）常见/重大慢性病主题。四大慢性病包括心脑血管疾病、癌症、慢性呼吸系统疾病和糖尿病，是国际公认的威胁居民健康的最主要疾病。数据显示2018年中国慢性病导致的死亡人数占比约为88.5%，其中心脑血管疾病、癌症、慢性呼吸系统疾病和糖尿病分别占死亡人数的47.1%、24.1%、8.8%和2.5%[4]。国内外慢性病管理均对常见/重大慢性病，尤其是四大慢性病保持关注。
根据本文分析结果，国内主要关注的常见慢性病是糖尿病、慢性阻塞性肺疾病、心血管疾病，而恶性肿瘤作为高位死因在分析图中的圆形节点较小，这说明慢性病管理领域中与癌症相关的研究较少。可能与癌症研究多为基础或临床研究，并未划分到慢性病综合管理领域有关。国外主要关注的常见慢性病是糖尿病、肥胖、心脑血管疾病以及癌症。不同于国内，国外对四大慢性病中的慢性呼吸系统疾病关注度较低，而对肥胖和超重更为重视，这可能与国外高碳高脂的饮食习惯有关。
（2）老年慢性病患者共病主题。随着经济社会的发展，越来越多的国家进入到老龄化社会。老年人是慢性病的高发群体，人口老龄化进程的加速会导致慢性病负担愈发严重。而各类慢性病的危险因素多有重复或相互影响，同一患者易有两种或两种以上的慢性病共存，即共病（multimorbidity）[5]。如今，老年多重慢病已经成为世界范围的研究热点趋势。
从聚类分析结果来看，国外更聚焦于“共病”，在共病主题之下侧重老年人和药物治疗方向[6-7]。而国内基于人口老龄化进程迅速加快的现状[8]更聚焦于“老年人”，对共病的关注也逐年增加。结合国内外研究趋势，可以预测共病和老年慢性病作为相关的研究热点，将是未来很长一段时间的慢性病管理重点研究方向，而国内的共病方向则需要更多的实践与研究填补空白[9]。
3.4.2　国内外研究主题的特异性
3.4.2.1　国内特异性研究主题
（1）慢性病的社区综合治理。基于慢性病本身需长期监测随访、迁延不愈、患者人群大、工作量大的特点，以及我国卫生服务的架构特征，以社区为单位的基层卫生机构已经成为了慢性病防控的主战场[10]。研究热点包括分级诊疗、互联网+/远程医疗、家庭医生等。
（2）中医药在慢性病管理中的运用。中医药是中华传统文化的瑰宝。《中国防治慢性病中长期规划（2017—2025年）》中明确提出，要发挥中医药在慢性病防治中的作用。中医药的“治未病”思想与现代公共卫生的“预防”理念如出一辙，更与“预防为主”的健康中国规划契合。而中医药作为中华民族特有的一种传统文化，其中包含的概念理论更宜于融入到日常生活中去[11-12]。今后继续发挥中医药的特有优势，实现我国中医药事业与慢性病防治工作共同发展也将是我国特有的慢性病管理主题。
（3）慢性病管理的药学服务主题。从聚类分析结果可以看出，国内慢性病管理的药学服务已经成为新兴的研究主题。其中关注重点有临床药师、依从性、效果评价等；新兴的热点有用药安全和药物治疗管理。慢性病患者在治疗中通常伴随着长期服药与调整，这对药学服务提出了新的要求。近年来，药学服务逐渐从“保障药品供应”向“提供药学专业技术服务和参与临床用药”转变，有助于提高患者的服药依从性与合理用药[13]。而老年慢性病共病患者的增加，又提升了多重用药的复杂性，对慢性病用药安全与管理提出了新的需求[10]。
3.4.2.2　国外特异性研究主题
（1）Health-care of chronic diseases（慢性病管理的卫生保健）。国外慢性病管理发展较早，已有广为使用的慢性病管理模式。从本文的聚类分析结果来看，digital health（数字健康）、mhealth（移动健康）等基于信息技术和互联网发展的新兴领域是研究的前沿热点。世界卫生组织（WHO）于2019年在日内瓦发布了《数字卫生保健全球战略（2020—2025年）》，确立了数字健康战略的优先地位[14]。数字健康尚未有统一的概念，但根本目的都在于用信息技术手段满足患者个性化需求，并提高医疗服务提供的质量与能力，一般包含可穿戴设备、健康信息技术等[15]。相较于国内“互联网+”等概念，数字健康涵盖更广、内涵更深，明确指出了信息技术手段加持下的远程医疗发展方向。
（2）Quality of life for patients with chronic diseases（慢性病患者的生活质量）。国外对生活质量的关注主要在心理健康上，包括抑郁情绪、焦虑情绪、精神压力等。在对象方面尤其重视儿童和青少年，常用的调查方式为问卷调查。国内生活质量尚未形成独立的研究主题，且关注点主要在个体生理功能的实现上。心理卫生方向的研究也许是未来国内慢性病患者生活质量的关注热点。
（3）The impact of emergencies（突发事件的影响）。与国内相比，国外对突发事件对慢性病管理的影响更加敏感，研究较多，可独立形成相关研究主题。这其中最为突出的热点就是COVID-19，关注内容主要是大流行背景下对慢性病共病患者的管理。
4　小结
收起
本研究使用文献计量学方法，对近十年国内外慢性病管理领域的研究主题进行对比，旨在为相关研究提供参考。十年来国内外慢性病管理领域发文量均呈上升趋势。国内外慢性病管理领域的研究有大趋势上的相似性[16-17]。比如都聚焦于常见慢性病的管理，关注老年慢性病共病的发展。但具体又各有侧重。如国内的慢性病管理更注重基层的重要性，更关注老年慢性病领域的发展。而国外重视以心理健康为主的生命质量，更聚焦于共病的研究。此外，国外主题更能反应国际趋势与前沿热点，如数字健康与医疗；而国内也拥有特色化的主题领域，如中医药治疗等。
基金
收起
  • 四川省科技计划项目(2021ZHYZ0023)
  • 四川省医院协会医院管理科研专项资金项目(YG2304)
文献
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参考文献 引证文献
排序方式：
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2024年第51卷第14期
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doi: 10.20043/j.cnki.MPM.202404405
  • 接收时间：2024-04-23
  • 首发时间：2026-03-18
  • 出版时间：2024-07-25
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  • 收稿日期：2024-04-23
基金
四川省科技计划项目(2021ZHYZ0023)
四川省医院协会医院管理科研专项资金项目(YG2304)
作者信息
    1.四川大学华西医院全程管理中心，四川 成都 610041
    2.四川大学华西公共卫生学院，四川省食品安全监测与风险评估重点实验室

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
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
栓菌属 Trametes 5 2.39
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