ICS11.020 CCSC05 团 体 标 准 T/BRACDCHE018—2025 基层医疗卫生机构“三高”患者 健康体重管理指南 Guidelinesforhealthyweightmanagementofpatientswith “ThreeHighs”inprimaryhealthcarefacilities 2025-10-27发布 2025-10-27实施 北京慢性病防治与健康教育研究会  发布 全国团体标准信息平台 T/BRACDCHE018-2025 I目次 前言.......................................................................................................................................................................II 引言.....................................................................................................................................................................III 1范围...................................................................................................................................................................1 2规范性引用文件...............................................................................................................................................1 3术语和定义.......................................................................................................................................................1 4体重管理内容...................................................................................................................................................2 4.1筛查...........................................................................................................................................................2 4.2建档...........................................................................................................................................................2 4.3评估...........................................................................................................................................................2 4.4干预...........................................................................................................................................................3 4.5随访管理...................................................................................................................................................5 4.6双向转诊...................................................................................................................................................5 4.7健康教育...................................................................................................................................................6 5体重管理流程...................................................................................................................................................6 6服务管理...........................................................................................................................................................7 6.1组建团队...................................................................................................................................................7 6.2设备配置...................................................................................................................................................7 6.3资源协作...................................................................................................................................................8 6.4信息化管理...............................................................................................................................................8 附录A（资料性）“三高”患者体重管理评估.............................................................................................9 附录B（资料性）“三高”患者体重管理随访服务记录...........................................................................12 附录C（资料性）中国成人（18岁及以上）体重判定标准......................................................................13 附录D（资料性）中国人群肥胖症的常用诊断标准...................................................................................14 附录E（资料性）各类降糖药物对体重的影响...........................................................................................15 附录F（资料性）目前获批减重药物............................................................................................................16 参考文献........................................................