补肾活血方治疗2型糖尿病轻度认知功能障碍的临床研究

Effect of Bushen Huoxue Prescription on the Treatment of Mild Cognition Impairment of Type 2 Diabetes

目的观察自拟补肾活血方对2型糖尿病(T2DM)轻度认知功能障碍(MCI)的改善作用。方法将80例T2DM伴有MCI的患者随机(使用Excel随机法)分为对照组(40例)和治疗组(40例)。治疗组给予自拟补肾活血方加尼莫地平,对照组给予尼莫地平,服用3个月。治疗前后,采用蒙特利尔认知评估量表(MoCA)评价认知功能,观察中医临床证候疗效,检测空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、同型半胱氨酸(HCY)、超敏C反应蛋白(hs-CRP)的含量。同时观察两组不良反应发生情况。结果两组最终纳入合格病例各38例。与本组治疗前比较,治疗组治疗后MoCA量表总分及视空间与执行能力、命名、注意力、语言、抽象、记忆及延迟回忆评分均升高,FBG、Hb A1c、HCY和hs-CRP水平降低(P<0.05,P<0.01),且除命名和注意力外均优于对照组(P<0.05,P<0.01)。治疗组中医临床症候疗效总有效率为84.21%(32/38)高于对照组[34.21%(13/38)](P<0.01)。治疗组患者头晕、胃肠不适的发生率明显低于对照组(P<0.05)。结论补肾活血方能不同程度改善血糖,降低血清中HCY及hs-CRP的含量,提高糖尿病MCI患者的认识功能。

Objective To observe the effects of Bushen Huoxue Recipe on type 2 diabetes mellitus （T2DM） patients with mild cognitive impairment （MCI）. Methods Totally 80 T2DM patients with MCI were randomly （ Random method using Excel） assigned to treatment group （40 cases） and control group （40 cases）. Patients in the treatment group were treated with Bushen Huoxue Recipe and nimodipine, while patients in the control group were only given nimodipine, both treatment lasted for 3 months. Before and after the therapy, Montreal cognitive assessment （MoCA） was applied to evaluate cognitive function, clinical symptoms of traditional Chinese medicine （TCM） were observed to evaluate TCM clinical efficacy, while fasting blood glucose （ FBG）, glycosylated hemoglobin （ HbAlc）, homocysteine （HCY） and ultra sensitive C reactive protein （hs-CRP） were also detected to judge the clinical effects of the treatments. Results Thirty-eight cases of each group were enrolled by eliminating unqualified cases. After treatment, scores of MoCA, visuospatial executive function, naming, attention, language, abstraction,memory and delayed recall of sub-item scores in the treatment group increased. While the concentration of FBG, HbAlc, HCY and hs-CRP decreased （P 〈0.05, P 〈0.01 ）. And after the treatment, the effects except naming and attention of treatment group were better than control group （P 〈0.05, P 〈 0.01 ）.The total effective rate of clinical symptoms of TCM in the treament group was higher than that in the control group [84.21% （32/38） vs.34.21% （13/38） , P 〈0. 011. And the side effects such as dizzi- ness, and gastrointestinal discomfort in the treatment group were milder than those in the control group （P 〈0.05）. Conclusion Bushen Huoxue Recipe can CRP in serum, and improve the cognitive function of effectively ameliorate blood glucose, HCY and hsdiabetic patients with MCI.