2型糖尿病轻度认知障碍中医证型与认知功能关系初探

Preliminary research on the relationship between TCM syndromes and the cognitive function in type 2 diabetes mellitus patients with mild cognitive impairment

目的探讨2型糖尿病轻度认知障碍中医证型与认知功能的关系。方法对56例2型糖尿病轻度认知障碍患者进行中医辨证分型,分为实证组和虚证组,实证组包括痰瘀互阻证、肝郁化热证,虚证组包括精髓亏虚证、脾肾两虚证。利用简易精神状态量表(MMSE)和蒙特利尔认知评估量表(Mo CA)评分,比较不同中医证型患者认知功能的差异。结果 MMSE量表评分,实证组与虚证组组间差异无统计学意义(P>0.05)。Mo CA量表评分,虚证组总分、命名和延迟回忆评分均明显低于实证组(P<0.05,P<0.01),其中延迟回忆评分中,虚证组老年和中青年评分均明显低于实证组(P<0.05,P<0.01);命名评分中,虚证组老年评分明显低于实证组(P<0.05),虚证组中青年评分与实证组差异无统计学意义(P>0.05)。结论对2型糖尿病轻度认知障碍中医证型的区分,Mo CA量表较MMSE量表更有优势。2型糖尿病轻度认知障碍虚证患者较实证患者延迟回忆能力更低,老年虚证患者命名能力更差。

Objective To investigate the relationship between TCM syndromes and the cognitive function in type 2 diabetes mellitus （T2DM） patients with mild cognitive impairment （MCI）. Methods 52 patients with T2DM and MCI were classified into excessive syndrome group and deficiency syndrome group, the excessive syndrome group included syndrome of obstruction of phlegm and stagnation, type of liver stagnation transforming into fire, and deficiency syndrome group included syndrome of deficiency of essence and marrow. The neuropsychological tests differences of cognitive function of patients with different syndromes were compared with the scores through Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA） were recorded. Results There were no significant statistical differences between excess syndrome group and deficiency syndrome group in MMSE （P 〉 0. 05）. But the total scores, nomenclature and delayed recall scores in MoCA of deficiency syndrome group were significantly lower than that of excess syndrome group（P〈0. 05, P 〈0. 01 ）. Wherein the delayed recall score, deficiency syndrome group in both older and young were significantly lower than that of excess syndrome group（ P 〈 0.05, P 〈 0. 01 ）. And in the nomenclature scores, deficiency syndrome group in older were significantly lower than that of excess syndrome group （ P 〈 0. 05）, but no significant statistical difference in young （P 〉 0. 05）. Conclusion There are some advantages in MoCA compared with MMSE in differentiating TCM syndromes for patients with T2DM and MCI. The patients with T2DM and MCI of deficiency syndrome have much lower delayed recall ability compared with that of excess syndrome. And the older patients with deficiency syndrome have much lower nomenclature capability.