基于证素分布探讨健脾清化方对糖尿病合并轻度认知功能障碍的影响  

Exploring the effect of Jianpi Qinghua Formula on diabetes mellitus combined with mild cognitive impairment based on TCM syndrome and elements characteristics

作　　者：郭秋月 陈清光[1] 韩煦 耿艳娜 田静 闫子慧 陆灏[1] GUO Qiu-yue;CHEN Qing-guang;HAN Xu;CENG Yan-na;TIAN Jing;YAN Zi-hui;LU Hao(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 130100,China)

机构地区：[1]上海中医药大学附属曙光医院糖尿病研究所,上海201203 [2]河北省中医院,河北石家庄130100

出　　处：《时珍国医国药》2023年第8期1905-1908,共4页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金(82074381,81874434);上海市科委科研计划项目(21S21900700);上海市临床重点专科(shslczdzk05401);上海市中医临床重点实验室(20DZ2272200);长三角中医内分泌代谢病专科联盟(ZY(2021-2023)-0302)。

摘　　要：目的探索糖尿病(diabetes mellitus,DM)合并轻度认知功能障碍(mild cognitive impairment,MCI)患者的证素分布,及健脾清化方(Jianpi Qinghua,JPQH)对DM患者MCI患病率的影响。方法(1)该研究纳入上海中医药大学附属曙光医院内分泌科就诊的249例DM患者,根据是否合并MCI分为DM组(n=165)和MCI组(n=84)并进行证素分析。(2)从249例患者中筛选服用JPQH满一年的受试者作为JPQH组(n=31),1∶1筛选性别、年龄等匹配的患者作为对照组(n=31),观察中药对DM患者MCI患病风险的影响。结果MCI组证素分布频数依次为阴虚>气虚>热>瘀;与DM组相比,MCI组患者乏力、夜尿多、入睡困难等症的频数明显升高(P<0.01)。与对照组相比,JPQH组患者认知功能评分显著升高(P<0.01);Logistics回归分析显示长期服用JPQH是DM未合并MCI的保护因素(P<0.05)。结论糖尿病合并MCI人群以阴虚证、气虚证为主,出现乏力、夜尿多、入睡困难等症的程度较重,病位在脾肾。JPQH可以降低DM人群MCI的患病率。该研究对祖国医学辨证论治DM合并MCI具有重要研究意义。Objective To investigate the effect of Jianpi Qinghua(JPQH)on the prevalence of mild cognitive impairment(MCI)in patients with diabetes mellitus(DM)based on the distribution of evidence elements.Methods(1)249 patients with DM attending the Department of Endocrinology,Shuguang Hospital,Shanghai University of TCM were included in this study and were divided into DM group(n=165)and MCI group(n=84)according to whether they were combined with MCI or not and analyzed for TCM syndrome and elements characteristics.(2)31 patients who had taken JPQH for one year were selected for JPQH group(n=31)and 1:1 screening patients with matched gender,age,et.al.as control group(n=31)to observe the effect of JPQH on the risk of MCI in patients with DM.Results The frequency of evidence distribution in the MCI group was Yin-Xu deficiency>Qi-Deficiency Syndrome>Heat syndrome>Stasis syndrome;compared with DM group,the frequency of weakness,nocturnal urination,and difficulty in sleeping was significantly higher in the MCI group(P<0.01).Cognitive func⁃tion scores were significantly higher in the JPQH group compared with the control group(P<0.01);Logistic regression analysis showed that long-term use of JPQH was a protective factor for DM without comorbid MCI(P<0.05).Conclusion Patients with DM combined with MCI had predominantly the deficiency of Qi and Yin Syndrome,they had more severe symptoms like weak⁃ness,nocturnal urination,and difficulty sleeping,and the location of disease was in the spleen and kidney.JPQH could reduce the prevalence of MCI in patients with DM.This study had important research implications for diagnosing and treating DM com⁃bined with MCI in TCM.

关 键 词：糖尿病 轻度认知功能障碍 证素分布 健脾清化方 

分 类 号：R259[医药卫生—中西医结合]