益智合剂治疗老年2型糖尿病合并认知障碍的临床研究

发布时间：2018-05-01 11:06

本文选题：老年2型糖尿病 + 认知障碍　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:应用中医学辨证论治理论,观察中药制剂益智合剂治疗老年2型糖尿病合并认知障碍(肾虚髓减证)的临床疗效,并探讨其配伍特色及临床作用机理。方法:将山东中医药大学附属医院老年医学科(保健科)住院患者根据纳入及排除标准选取老年2型糖尿病合并认知障碍(肾虚髓减证)患者65例,根据随机单盲的分组方法将病人分为治疗组32例,对照组33例。在两组患者均在规范、有效控制血糖的基础上,对照组给予奥拉西坦注射液静脉滴注,治疗组在应给予奥拉西坦注射液的同时加用益智合剂口服。以4周为1个治疗疗程,共治疗3个疗程。在治疗的前后分别测定患者以下观察指标:血糖、血脂、血流变、血清同型半胱氨酸,计算神经心理学检查积分:简易精神状态检查量表(MMSE)、长谷川痴呆量表(HDS)、日常生活能力量表(ADL)评分,并观察两组治疗前后中医症状积分的改变情况及安全性指标情况。将所得数据应用SPSS17.0统计软件进行数据分析。结果:1.临床总疗效:治疗组总有效率为86.67%,对照组总有效率为66.67%,组间总有效率比较具有显著性差异(P0.05)。2.中医症状积分:症状总积分(治疗组治疗前为:42.15±4.16,治疗后为:19.11±6.78;对照组治疗前为:41.96±4.42,治疗后为:35.66±5.65)。治疗组患者与对照组相比有显著性差异(P0.01或P0.05)。3.简易精神状态检查量表(MMSE):治疗组患者简易精神状态检查量表(MMSE)评分明显增加(治疗前评分:15.74±3.57,治疗后评分:22.35±3.14),组内比较有极显著性差异(P0.01),且与对照组相比差异具有显著统计学意义(P0.01)。4.长谷川痴呆量表(HDS):治疗组患者长谷川痴呆量表(HDS)评分明显增加(治疗前评分:15.84±1.95,治疗后评分:23.26±1.84)组内比较具有极显著性差异(P0.01),且组间比较也具有显著的统计学意义(P0.01)。5.日常生活能力量表(ADL-Barthel指数)评分:治疗组患者日常生活能力量表(ADL-Barthel指数)评分显著增加(治疗前评分:67.32±12.73,治疗后评分:92.67±12.17),组内比较有显著性差异(P0.01),且与对照组组间比较也有显著统计学意义(P0.05)。6.实验室指标:治疗组患者血流变及血清同型半胱氨酸等实验室指标值较治疗前均明显改善,与治疗前相比结果有显著性差异(P0.05),且疗效优于对照组(P0.05或P0.01);但在血糖、血脂方面,治疗前后不论是组内还是组间均无明显差异(P0.05)。结论:中药益智合剂能有效改善老年2型糖尿病合并认知障碍(肾虚髓减证)患者临床症状、神经心理学评分及部分实验室指标,疗效优于单用奥拉西坦注射液,说明中药益智合剂明显提高了患者的生活质量和水平,为治疗老年2型糖尿病合并认知障碍(肾虚髓减证)开辟了新思路、提供了新方法。
[Abstract]:Objective: To observe the clinical effect of Chinese medicine preparation Yizhi mixture in the treatment of senile type 2 diabetes with cognitive impairment (kidney deficiency syndrome), and to explore its compatibility and clinical mechanism. Methods: the hospitalized patients in the Department of geriatrics (health care department) of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were included and excluded. 65 cases of senile type 2 diabetes mellitus combined with cognitive impairment (kidney deficiency syndrome) were selected to be divided into 32 cases in the treatment group and 33 cases in the control group according to the random single blind group method. On the basis of the standard and effective control of blood sugar in the two groups, the control group was given the Oxiracetam Injection intravenous drip. The treatment group should be given Ola Si Staw. A total of 1 treatment courses were treated for 4 weeks and 3 courses were treated. The following indexes were measured before and after the treatment: blood sugar, blood lipid, blood rheology, serum homocysteine, calculation of neuropsychological examination scores: simple mental state examination scale (MMSE), Kyohko Hasegawa Dementia Scale (HDS), daily life The score of the energy table (ADL) was scored and the changes of the TCM symptom score and the safety index were observed before and after the treatment of the two groups. The data were analyzed with the SPSS17.0 statistics software. Results: the total effective rate of the 1. clinical treatment group was 86.67%, the total effective rate of the control group was 66.67%, and the total effective rate of the group was significant. Difference (P0.05).2. TCM symptom score: total symptom score (42.15 + 4.16 before treatment group, 19.11 + 6.78 after treatment; 41.96 + 4.42 before treatment in control group, 35.66 + 5.65 after treatment). Compared with control group, the treatment group had significant difference (P0.01 or P0.05).3. simple mental state examination scale (MMSE): the patients in the treatment group were simple and simple The mental state examination scale (MMSE) score increased significantly (15.74 + 3.57, 22.35 + 3.14 after treatment), and there was a significant difference in the group (P0.01), and there was significant statistical difference (P0.01).4. Kyohko Hasegawa Dementia Scale (HDS) compared with the control group (HDS): the score of HDS (HDS) in the treatment group was significantly increased. Pre treatment score: 15.84 + 1.95, after treatment score: 23.26 + 1.84) in the group has a very significant difference (P0.01), and there is significant statistical significance (P0.01).5. daily living capacity scale (ADL-Barthel index) score: the treatment group patients' daily living capacity scale (ADL-Barthel index) score increased significantly (pre treatment evaluation) Score: 67.32 + 12.73, after treatment score: 92.67 + 12.17), there was a significant difference in the group (P0.01), and compared with the control group, there was also significant statistical significance (P0.05).6. laboratory index: the blood rheology and serum homocysteine in the treatment group were significantly improved than before the treatment, and the results were significant compared with those before the treatment. The effect of sex difference (P0.05) was better than that of the control group (P0.05 or P0.01), but there was no significant difference between the group and the group before and after the treatment (P0.05) in blood sugar and blood lipid. Conclusion: the Chinese medicine Yizhi mixture can effectively improve the clinical symptoms, neuropsychological score and some experiments of the elderly patients with type 2 diabetes with cognitive impairment (kidney deficiency syndrome). The effect of the room index is better than the single use of Oxiracetam Injection. It shows that the Chinese medicine Yizhi mixture obviously improves the quality of life and the level of the patients. It opens new ideas for the treatment of senile type 2 diabetes with cognitive impairment (kidney deficiency syndrome), and provides a new method.

【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R277.7

【参考文献】