脑灵汤治疗糖尿病认知障碍的临床疗效观察  

Clinical Effect of Naoling Decoction for Treatment of Diabetic Cognitive Impairment

作　　者：陈伟铭 李静 霍莲莲 杨静 李玲 CHEN Wei-Ming;LI Jing;HUO Lian-Lian;YANG Jing;LI Ling(Shaanxi Traditional Chinese Medicine Hospital,Xi’an 710000 Shaanxi,China)

机构地区：[1]陕西省中医医院,陕西西安710000

出　　处：《广州中医药大学学报》2021年第3期449-454,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(编号:2018YFC2002500)。

摘　　要：【目的】观察脑灵汤治疗2型糖尿病(T2DM)认知障碍的临床疗效,并探讨其可能的作用机制。【方法】将74例2型糖尿病认知障碍患者随机分成治疗组和对照组,每组各37例。2组患者均给予常规糖尿病治疗,在此基础上,对照组患者给予盐酸多奈哌齐口服治疗,治疗组患者在对照组基础上加用脑灵汤治疗,疗程为6个月。观察2组患者治疗前后简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、早餐后2 h血糖(2hPBG)、体质量指数(BMI)及血糖波动指标[血糖波动幅度最大值(LAGE)、餐后血糖波动值(PPGE)、平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)]的变化情况,并评价2组患者的临床疗效及安全性。【结果】(1)治疗6个月后,治疗组的总有效率为94.59%(35/37),对照组为70.27%(26/37),治疗组的疗效明显优于对照组,差异有统计学意义(P<0.01)。(2)治疗后,2组患者MMSE评分均较治疗前提高(P<0.01),且治疗组对MMSE评分的提高作用优于对照组(P<0.01)。(3)治疗后,2组患者MoCA各项评分及总分均较治疗前提高(P<0.01),且治疗组对MoCA中的注意力、语言、延迟回忆评分及总分的提高作用明显优于对照组(P<0.01)。(4)治疗后,2组患者BMI、HbAlc、FBG、2hPBG、LAGE、早餐PPGE、MAGE、MODD水平均较治疗前降低(P<0.05),且治疗组对HbAlc、LAGE、早餐PPGE、MAGE、MODD水平的降低作用优于对照组(P<0.05)。(5)治疗过程中,2组患者均未出现明显不适症状,且患者的血、尿、大便常规和肝肾功能、心电图等安全性指标均未见异常改变。【结论】脑灵汤联合盐酸多奈哌齐治疗2型糖尿病认知障碍患者疗效确切,既可改善患者的临床症状和认知功能,又可改善患者的血糖波动指标。Objective To observe the clinical effect of Naoling Decoction for the treatment of cognitive impairment in type 2 diabetes mellitus(T2DM)patients and to explore its possible mechanism.Methods A total of 74 T2DM patients with cognitive impairment were randomly divided into treatment group and control group,37 cases in each group.The patients in the two groups were given routine treatment for the diabetes,and additionally,the control group was given oral use of Donepezil Hydrochloride while the treatment group was given oral use of Naoling Decoction combined with Donepezil Hydrochloride.The treatment course for the two groups covered 6 months.Before and after treatment,we observed the scores of Mini-mental State Examination(MMSE),scores of Montreal Cognitive Assessment(MoCA),glycosylated hemoglobin(HbAlc),fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),body mass index(BMI),and the parameters of blood glucose fluctuation such as large amplitude of glycemic excursion(LAGE),breakfast postprandial glycemic excursion(PPGE),mean amplitude of glycemic excursions(MAGE)and mean of daily differences(MODD)in the two groups.After treatment,the clinical efficacy and safety of the two groups were also evaluated.Results(1)After treatment for 6 months,the effective rate of the treatment group was 94.59%(35/37),and that of the control group was 70.27%(26/37).The intergroup comparison showed that the clinical efficacy of the treatment group was superior to that in the control group,the difference being statistically significant(P<0.01).(2)After treatment,MMSE scores in the two groups were increased in comparison with those before treatment(P<0.01),and the increase of MMSE scores in the treatment group was superior to that in the control group(P<0.01).(3)After treatment,scores of each item of MoCA and the overall MoCA scores in the two groups were increased in comparison with those before treatment(P<0.01),and the treatment group had stronger effect on increasing the scores of items of attention,language,and delay

关 键 词：2型糖尿病认知障碍 脑灵汤 盐酸多奈哌齐 认知功能 血糖波动指标 

分 类 号：R259.872[医药卫生—中西医结合]