补肾健脾活血方治疗老年2型糖尿病合并轻度认知功能障碍脾肾两虚兼血瘀证疗效观察  

Bushen Jianpi Huoxue Formula in effect on type 2 diabetic elderly patients with mild cognitive impairment of deficiency of spleen and kidney and blood stasis

作　　者：俞金鑫[1] 夏卫明[2] 陈庆宇[1] 夏伟[1] 刘春辉[1] YU Jinxin;XIA Weiming;CHEN Qingyu;XIA Wei;LIU Chunhui(Department of Endocrinology,Qidong Hospital of Traditional Chinese Medicine,Qidong,Jiangsu 226200;Department of Traditional Chinese Medicine,Qidong Hospital of Traditional Chinese Medicine,Qidong,Jiangsu 226200)

机构地区：[1]江苏省启东市中医院内分泌科,江苏启东226200 [2]江苏省启东市中医院中医内科,江苏启东226200

出　　处：《河北中医》2022年第8期1282-1286,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2021年度南通市基础研究和民生科技计划指导性项目(编号:MSZ21027)。

摘　　要：目的观察补肾健脾活血方治疗老年2型糖尿病合并轻度认知功能障碍(MCI)脾肾两虚兼血瘀证的疗效。方法将84例老年2型糖尿病合并MCI脾肾两虚兼血瘀证患者按照随机数字表法分为2组,对照组42例(后脱落2例)于常规降糖、降压、降脂基础上予阿司匹林肠溶片口服治疗,治疗组42例(后脱落2例)在对照组治疗基础上予补肾健脾活血方治疗。2组均治疗3个月。比较2组治疗前后蒙特利尔认知评估量表(MoCA)评分、糖化血红蛋白(HbA_(1)c)、胰岛素抵抗指数(HOMA-IR)、C反应蛋白(CRP)、中医证候评分,并统计2组中医证候疗效及不良反应发生情况。结果2组治疗后HbA_(1)c、CRP水平均较本组治疗前降低(P<0.05),且治疗组治疗后HbA_(1)c水平低于对照组(P<0.05),2组治疗前后HOMA-IR比较差异无统计学意义(P>0.05)。治疗组治疗后MoCA评分较本组治疗前升高(P<0.05),且高于对照组(P<0.05)。治疗组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组总有效率77.5%(31/40),对照组总有效率10.0%(4/40),治疗组中医证候疗效优于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论补肾健脾活血方不仅对老年2型糖尿病合并MCI脾肾两虚兼血瘀证患者有辅助降血糖作用,还能使患者的中医证候得到显著改善,其认知功能也有了一定的提升。Objective To observe the curative effect of Bushen Jianpi Huoxue Formula for type 2 diabetes mellitus(T2DM)elderly patients with mild cognitive impairment(MCI)of deficiency of spleen and kidney and blood stasis.Methods T2DM elderly patients(n=84)with MCI(deficiency of spleen and kidney and blood stasis)were randomly assigned into the treatment group(n=42,2 cases of shedding)and the control group(n=42,2 cases of shedding);the control group received oral aspirin enteric-coated tablets+conventional therapy(hypoglycemic,anti-hypertension,lipid-lowering),the treatment group received Bushen Jianpi Huoxue Formula based on the control group.Treated for 3 months,the aim was to compare Montreal Cognitive Assessment(MoCA)scores,glycosylated hemoglobin A_(1)c(HbA_(1)c),Homeostatic Model Assessment for Insulin Resistance(HOMA-IR),C-reactive protein(CRP),traditional Chinese medicine(TCM)syndrome score;TCM syndrome and the adverse reaction were assessed.Results After treatment,HbA_(1)c and CRP in groups were decreased(P<0.05),HbA_(1)c was decreased in the treatment group as compared to the control group(P<0.05);the difference was not statistically significant in HOMA-IR between groups(P>0.05);MoCA in the treatment group was increased(P<0.05),which was higher than that in the control group(P<0.05);TCM symptom scores in the treatment group were decreased(P<0.05),and which were lower than those in the control group(P<0.05).The overall effective rate was higher in the treatment group(77.5%,31/40)than that in the control group(10.0%,4/40),(P<0.05),respectively.None of the incidence of adverse reactions differed significantly between groups(P>0.05).Conclusions For T2DM elderly patients with MCI(deficiency of spleen and kidney and blood stasis),Bushen Jianpi Huoxue Formula can not only help lower blood sugar,but also significantly improve TCM syndromes and improve cognitive function.

关 键 词：糖尿病 2型 老年人 认知功能障碍 补肾 健脾 活血 中药疗法 

分 类 号：R587.1[医药卫生—内分泌] R742[医药卫生—内科学]