强化认知训练对改善2型糖尿病患者认知功能障碍和日常生活活动能力的效果探讨

Effect of intensive cognitive training in improving cognitive dysfunction and activities of daily living in patients with type 2 diabetes mellitus

目的分析强化认知训练对改善2型糖尿病(T2DM)患者认知功能障碍和日常生活活动能力的效果。方法80例参与家庭医生签约团队管理的T2DM合并认知功能障碍患者,以随机数字表法分为对照组和观察组,各40例。两组患者均接受常规治疗,对照组患者接受常规饮食、运动指导、用药咨询等基础干预,观察组患者在对照组基础上接受强化认知训练。对比两组训练效果以及训练前后认知功能障碍和日常生活活动能力改善情况。结果观察组患者训练总有效率97.50%高于对照组的77.50%,差异具有统计学意义(P<0.05)。训练前,两组患者韦氏成人智力测验(WAIS)、蒙特利尔认知评估量表(MOCA)、长谷川痴呆修改量表(HDS)评分对比,差异无统计学意义(P>0.05);训练后,观察组患者WAIS评分(90.55±5.65)分、MOCA评分(26.87±2.98)分、HDS评分(29.87±3.01)分均高于对照组的(83.29±5.32)、(22.98±2.37)、(24.28±2.76)分,差异有统计学意义(P<0.05)。训练前,两组患者日常生活能力量表(ADL)、功能活动调查表(FAQ)评分对比,差异无统计学意义(P>0.05);训练后,观察组患者ADL评分(82.11±2.38)分高于对照组的(76.67±2.54)分,FAQ评分(6.11±0.35)分均低于对照组的(7.01±0.37)分,差异有统计学意义(P<0.05)。结论对T2DM合并认知功能障碍患者行强化认知训练可有效促进其认知功能的改善,患者日常活动能力也得以提高,临床应用价值显著。

Objective To analyze the effect of intensive cognitive training in improving cognitive dysfunction and activities of daily living in patients with type 2 diabetes mellitus(T2DM).Methods A total of 80 T2DM patients with cogntive dysfunction who participated in the management of the contracted team of family doctors were divided into a control group and an observation group according to the random numerical table,with 40 cases in each group.Patients in both groups received conventional treatment.On this basis,patients in the control group received basic interventions of routine diet,exercise guidance,medication consultation,and patients in the observation group received intensive cognitive training on the basis of the control group.The effects of training and the improvement of cognitive dysfunction and activities of daily living before and after training were compared between the two groups.Results The total effective rate of 97.50%in the observation group was higher than that of 77.50%in the control group,and the difference was statistically significant(P<0.05).Before training,there was no statistically significant difference in Wechsler Adult Intelligence Scale(WAIS),Montreal Cognitive Assessment Scale(MOCA)and Hasegawa's Dementia Scale(HDS)scores between the two groups(P>0.05).After training,the observation group had WAIS score of(90.55±5.65)points,MOCA score of(26.87±2.98)points and HDS score of(29.87±3.01)points,which were higher than those of(83.29±5.32),(22.98±2.37)and(24.28±2.76)points in the control group,and the differences were statistically significant(P<0.05).Before training,there was no statistically significant difference in Activities of Daily Living Scale(ADL)and Functional Activities Questionnaire(FAQ)scores between the two groups(P>0.05).After training,ADL score of(82.11±2.38)points in the observation group was higher than that of(76.67±2.54)points in the control group,and FAQ score of(6.11±0.35)points in the observation group was lower than that of and(7.01±0.37)points in the control group,and the differences were statistically significant(P<0.05).Conclusion Intensive cognitive training for T2DM patients with cogntive dysfunction can effectively improve their cognitive function and activities of daily living,which is of great clinical value.