强化认知训练在改善2型糖尿病患者认知功能障碍和日常生活活动能力中的作用

The role of intensive cognitive training in improving cognitive dysfunction and activity of daily living in patients with Diabetes mellitus type 2

目的探讨强化认知训练在改善2型糖尿病(T2DM)患者认知功能障碍和日常生活活动能力中的作用。方法选取2017年1月~2018年12月该院内科就诊T2DM患者92例。采用抛银币法将其分为强化组与常规组,各46例。两组均在口服降糖药或皮下注射胰岛素等控制血糖基础治疗上予以口服尼莫地平片30 mg/次,3次/d。常规组予以常规干预措施,强化组在常规组基础上加用强化认知训练。两组均干预12周。评估两组干预前与干预12周后认知功能及日常生活活动指标的变化,并比较临床效果。结果干预12周后,两组HDS评分、MOCA评分和WAISE评分较前均显著上升,FAQ评分和ADL评分较前显著下降(P<0.05或P<0.01),且强化组上升或下降幅度较常规组更明显(P<0.05);同时强化组患者临床总有效率(95.65%)较常规组(82.61%)的效果更佳(χ2=4.04,P<0.05)。结论强化认知训练用于T2DM患者效果较肯定,不仅能显著改善患者的认知功能,而且有利于提高患者日常生活活动能力。

Objective To explore the role of intensive cognitive training in improving cognitive dysfunction and activity of daily living in patients with diabetes mellitus type 2(T2DM).Methods 92 patients with T2DM who were treated in the hospital from January 2017 to December 2018 were selected.They were divided into the intensive group and the routine group using the silver coin method,46 cases each.The patients in two groups were received oral nimodipine tablets 30 mg/d,3 times/d in the basic treatment of blood glucose control such as oral hypoglycemic agents or subcutaneous injection of insulin.The routine group received routine interventions,and the intensive group added intensive cognitive training on the basis of the routine group.The patients in two groups were treated for 12 weeks.The changes in cognitive function and activity of daily living index were evaluated before and after 12 weeks of intervention and the clinical effects were compared.Results After 12 weeks'intervention,the HDS score,MOCA score,and WAISE score in the two groups were significantly higher than before,and the FAQ score was significantly lower than before(P<0.05 or P<0.01),and the increase or decrease in intensive group was more obvious than that in routine group(P<0.05);At the same time,the total clinical effective rate(95.65%)of intensive group was better than that of conventional group(82.61%)(χ2=4.04,P<0.05).Conclusion Intensive cognitive training is effective in patients with T2DM,which not only can significantly improve the cognitive function of patients but also improve the ability of patients to daily activities.