糖尿病认知障碍的中西医治疗进展概述

Overview of Progress in the Treatment of Diabetic Cognitive Impairment with Chinese Medicine and Western Medicine

糖尿病是导致认知障碍的一个重要危险因素。目前,有关糖尿病认知障碍的机制尚不明确,中西医治疗用药也未形成统一的临床标准。现代医学治疗糖尿病认知障碍主要采用降糖药物如鼻内胰岛素、胰高血糖素样肽1受体激动剂、二肽基肽酶4抑制剂、噻唑烷二酮等,这些药物在改善血糖的同时也对认知产生保护作用,非药物疗法主要为运动训练。中医认为,糖尿病认知障碍的病位在肝、脾、肾,病机可责之“痰、瘀、虚”;中药复方当归芍药散、益糖康、玉液汤、脑灵汤、七福饮等,中药药对西洋参-石菖蒲、葛根-知母等,以及中药成分中的黄酮类成分、皂苷、生物碱类化合物、青蒿素等均对糖尿病认知障碍具有一定的改善作用;针灸疗法通过调控炎症通路或调节神经递质等机制,改善糖尿病认知障碍患者的认知损伤。通过对近年来糖尿病认知障碍领域的中西医治疗进展进行综述,可为中西医防治糖尿病认知障碍提供参考。

Diabetes is an important risk factor for cognitive impairment.At present,the mechanism of diabetic cognitive impairment(DCI)is not clear,and there is no uniform clinical guideline for the treatment of DCI with Chinese medicine and western medicine.Modern medical treatment for DCI is mainly by using hypoglycemic drugs such as intranasal insulin,glucagon-like peptide-1 agonists,dipeptidyl peptidase-4 inhibitors,and thiazolidinediones.Glucose-lowering drugs also have a protective effect on cognition besides improving blood glucose,and non-drug therapy is mainly through exercise training.In the field of traditional Chinese medicine,DCI involves the liver,spleen and kidney,and the pathogenesis can be blamed on phlegm,blood stasis and deficiency;Chinese herbal medicines exert certain efficacy on improving DCI,and the medicines include the compound formulae of Danggui Shaoyao Powder,Yitangkang,Yuye Decoction,Naoling Decoction and Qifu Drink,Chinese herbal pairs of Panacis Quinquefolii Radix-Acori Tatarinowii Rhizoma and Puerariae Lobatae Radix-Anemarrhenae Rhizoma,and Chinese herbal ingredients of flavonoids,saponins,alkaloids and artemisinin.Acupuncture therapy can relieve the cognitive impairment in DCI patients through the modulation of inflammatory pathways or the regulation of neurotransmitters.The recent advances in the treatment of DCI with Chinese medicine and western medicine are reviewed in this article,and it is aimed to provide reference for the prevention and treatment of DCI with Chinese medicine and western medicine.