[1]白小林,雷 雯,张家林,等.芪丹地黄汤联合茴拉西坦治疗老年糖尿病患者认知障碍临床研究[J].陕西中医杂志,2024,(4):502-506.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.015]
 BAI Xiaolin,LEI Wen,ZHANG Jialin,et al.Study of Qidan Dihuang decoction combined with aniracetam in the treatment of cognitive impairment in elderly patients with diabetes[J].,2024,(4):502-506.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.015]
点击复制

芪丹地黄汤联合茴拉西坦治疗老年糖尿病患者认知障碍临床研究
分享到:

《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年4期
页码:
502-506
栏目:
临床研究
出版日期:
2024-04-05

文章信息/Info

Title:
Study of Qidan Dihuang decoction combined with aniracetam in the treatment of cognitive impairment in elderly patients with diabetes
作者:
白小林雷 雯张家林裴瑞霞赵美云季艳丹张泽群冯 倩孙 迪
(西安市中医医院内分泌风湿免疫科,陕西 西安 710021)
Author(s):
BAI XiaolinLEI WenZHANG JialinPEI RuixiaZHAO MeiyunJI YandanZHANG ZequnFENG QianSUN DI
(Department of Endocrinology,Rheumatology and Immunology,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China)
关键词:
糖尿病 认知障碍 茴拉西坦 芪丹地黄汤 炎性反应 氧化应激
Keywords:
Diabetes Cognitive impairment Aniracetam Qidan Dihuang decoction Inflammatory reaction Oxidative stress
分类号:
R 587.1
DOI:
DOI:10.3969/j.issn.1000-7369.2024.04.015
文献标志码:
A
摘要:
目的:探讨芪丹地黄汤联合茴拉西坦治疗老年糖尿病认知障碍(CD)的临床疗效。方法:回顾性选取老年糖尿病CD患者的临床资料,根据治疗方案,选取采用常规西药治疗的35例患者纳入常规组,另选取在常规组西药治疗的基础上应用芪丹地黄汤治疗的35例患者纳入联合组。观察两组患者治疗前后空腹血糖、糖化血红蛋白(HbA1c)、中医症候积分、认知功能评分。比较两组血清氧化指标超氧化物歧化酶(SOD)、丙二醛(MDA)、总抗氧化能力(T-AOC)、氧化低密度脂蛋白(ox-LDL)及血清学指标同型半胱氨酸(Hcy)、白介素-6(IL-6)、超敏C蛋白(hs-CRP)、D-二聚体(D-D)的表达。结果:治疗后,联合组空腹血糖、HbA1c水平与中医症候积分低于常规组(均P<0.05)。联合组MMSE各子项得分高于常规组(均P<0.05)。联合组MoCA量表各子项得分高于常规组(均P<0.05)。联合组SOD、T-AOC高于常规组,MDA、ox-LDL低于常规组(均P<0.05)。联合组Hcy、hs-CRP、D-D、IL-6表达水平低于常规组(均P<0.05)。结论:芪丹地黄汤联合茴拉西坦治疗老年糖尿病患者CD疗效显著,可改善患者的血糖水平,调节氧化反应、炎性反应、凝血功能等指标。
Abstract:
Objective:Efficacy of Qidan Dihuang decoction combined with aniracetam in the treatment of senile diabetic cognitive impairment(CD).Methods:Clinical data of elderly diabetic patients with CD were retrospectively selected.35 patients treated with conventional western medicine were selected to be included in the conventional group,and 35 patients treated with Qidan Dihuang decoction on the basis of western medicine in the conventional group were selected to be included in the combination group.Fasting blood glucose,glycated hemoglobin(HbA1c),TCM symptom score and cognitive function score were observed before and after treatment.The expressions of serum oxidation indices superoxide dismutase(SOD),malondialdehyde(MDA),total antioxidant capacity(T-AOC),oxidized low density lipoprotein(ox-LDL)and serological indices homocysteine(Hcy),interleukin-6(IL-6),hypersensitive C protein(hs-CRP)and D-dimer(D-D)were compared between the two groups.Results:After treatment,fasting blood glucose,HbA1c levels,and traditional Chinese medicine syndrome scores in the combination group were lower than those in the conventional group(all P<0.05).The scores of each sub item of MMSE in the combined group were higher than those in the conventional group(all P<0.05).The scores of each sub item of the MoCA scale in the combined group were higher than those in the conventional group(all P<0.05).The SOD and T-AOC levels in the combined group were higher than those in the conventional group,while MDA and ox-LDL levels were lower than those in the conventional group(all P<0.05).The expression levels of Hcy,hs-CRP,D-D,and IL-6 in the combined group were lower than those in the conventional group(all P<0.05).Conclusion:Qidan Dihuang decoction combined with aniracetam has significant therapeutic effect on CD in elderly diabetic patients,which can improve the blood sugar level,regulate oxidation reaction,inflammatory response,coagulation function and other indicators.

参考文献/References:

[1] 陈伟铭,李静,霍莲莲,等.脑灵汤治疗糖尿病认知障碍的临床疗效观察[J].广州中医药大学学报,2021,38(3):449-454.
[2] 陈燕语,王双,朱欢,等.衰弱及认知障碍对老年糖尿病患者死亡影响的研究进展[J].中华糖尿病杂志,2020,12(12):1062-1064.
[3] 杜明洋,邱峰,曹辉,等.尤瑞克林联合丁苯酞胶囊对急性脑梗死患者血清学指标及认知功能的影响[J].中国药师,2018,21(11):1971-1974.
[4] 李云瑶,李正,任思敏,等.口腔菌群与认知功能障碍的研究进展[J].卒中与神经疾病,2023,30(6):633-637.
[5] 张健,谭丽,冯兴中.益智解毒汤对糖尿病大鼠认知功能障碍及糖脂代谢的影响[J].北京中医药,2021,40(5):477-481.
[6] 曹媛媛,高淑英,石川,等.疏肝益肾汤加减电针疗法治疗慢性精神分裂症共病2型糖尿病认知功能障碍的疗效观察[J].中国药物与临床,2021,21(6):972-974.
[7] SMITH E E,BEAUDIN A E.New insights into cerebral small vesseldisease and vascular cognitive impairment from MRI[J].Curr Opin Neurol,2017,31(1):36-43.
[8] MAGALHAES T,WEILER M,TEIXEIRA C,et al.Systemic inflammation and multimodal biomarkers in amnestic mild cognitive impairment and alzheimer's disease[J].Mol Neurobiol,2018,55(7):5689-5697.
[9] 李雪莉,姜亚云,张景玲,等.WHO与美国糖尿病学会糖尿病诊断标准异同的探讨[J].中华内分泌代谢杂志,2000,16(2):87-90.
[10] 田金洲.中国痴呆诊疗指南[M].北京:人民卫生出版社,2012:1-65.
[11] 张明园.精神科评定量表手册[M].2版.长沙:湖南科学技术出版社,1998:166-184.
[12] NASREDDINE Z S,PHILLIPS N A,BEDIRIAN V,et al.The montreal cognitive assessment,MoCA:A brief screening tool for mild cognitive impairment[J].J AM Geriatr Soc,2005,53(4):695-699.
[13] 徐欢,刘燕凤,杨超茅,等.基于“肠道菌群-肠-脑轴”探讨半夏泻心汤改善大鼠糖尿病认知功能障碍作用机制[J].广州中医药大学学报,2022,39(9):2115-2122.
[14] 李红典,郭翔宇,刘冰,等.糖尿病合并认知功能障碍中医药研究现状与进展[J].辽宁中医药大学学报,2022,24(10):115-120.
[15] 高淑英,曹媛媛.精神分裂症合并2型糖尿病及伴发认知功能障碍患者中医疗法干预[J].山西医药杂志,2020,49(14):1790-1792.
[16] 刘玲,张静文,张瑞华,等.七福饮调控JAK2/STAT3通路改善2型糖尿病认知障碍的效应与机制[J].中国药理学通报,2022,38(7):1093-1098.
[17] 范金,钟冬灵,李涓,等.中国2型糖尿病患者认知障碍检出率的Meta分析[J].中国循证医学杂志,2021,21(7):787-795.
[18] AYAZ A,李玉姣,李杉杉,等.糖尿病所致认知障碍与中药防治概况(英文)[J].生物化学与生物物理进展,2020,47(8):743-761.
[19] 章鸿雁,姜冬梅,杨婷,等.度拉糖肽对二甲双胍控制不佳的2型糖尿病患者血糖波动和微炎症状态的影响[J].中国医药导报,2023,20(30):89-92.
[20] 谌祖江.芪丹地黄汤抑制糖尿病肾病肾脏纤维化的作用和机制研究[D].广州:南方医科大学,2018.
[21] 张嘉妮,戴冰,李玉星,等.酒制山茱萸炮制研究进展[J].中国现代应用药学,2016,33(12):1604-1608.
[22] 刘明妍,刘力榕,冯梦晗,等.川芎调节血脑屏障通透性的作用及机制研究[J].中草药,2024,55(1):138-147.
[23] 陈岱宜,廖惠娟,严浩荣,等.益脑康胶囊联合盐酸多奈哌齐片对卒中后认知障碍患者的疗效研究[J].中药新药与临床药理,2023,34(12):1793-1798.
[24] 李健,王海峰,刘阳,等.同型半胱氨酸损伤血管内皮细胞的机制研究[J].老年医学与保健,2021,27(5):925-928,943.
[25] 陈雪吟,陈耿杭,杨丽虹,等.糖尿病肾病湿热证与微炎症的相关性分析[J].广州中医药大学学报,2023,40(11):2689-2696.

相似文献/References:

[1]罗荔.降糖饮联合西药治疗儿童1型糖尿病44例[J].陕西中医杂志,2016,(10):1299.
[2]单亮亮,邓小敏,王振刚,等.五味消渴方治疗糖尿病机理探析[J].陕西中医杂志,2017,(06):783.
[3]王巍,赵平.参芪麦味地黄汤联合运动疗法对妊娠期糖尿病气阴两虚型患者 糖脂代谢及妊娠结局的影响*[J].陕西中医杂志,2018,(10):1339.
[4]王颖.益气降糖饮联合胰岛素对妊娠期糖尿病孕妇血糖、 内脂素水平及妊娠结局的影响*[J].陕西中医杂志,2018,(10):1342.
 Wang Ying..Effects of Yiqi Jiangtang decoction combined with insulin on blood glucose, visfatin level and pregnancy outcome in patients with gestational diabetes mellitus[J].,2018,(4):1342.
[5]张 新.益气养血汤联合痔炎冲洗灵治疗肛周脓肿合并糖尿病患者切开〖JZ〗对口引流挂线术后创面愈合的影响[J].陕西中医杂志,2019,(3):368.
[6]刘 辉,王连伟,乔 飞,等.知柏地黄汤联合个体化营养支持治疗糖尿病合并肺结核疗效及对患者T淋巴细胞亚群的影响*[J].陕西中医杂志,2019,(1):76.
[7]杨 敏,姜钧文,肖 蕾.中医体质与急性心肌梗死及其危险因素的相关性研究*[J].陕西中医杂志,2019,(4):437.
 YANG Min,JIANG Junwen,XIAO Lei..Study on the correlation between constitution of traditional Chinese medicine and acute myocardial infarction and its risk factors[J].,2019,(4):437.
[8]秦福芳,阎 磊,申凤娟,等.血必净注射液治疗老年糖尿病合并急性肾盂肾炎疗效研究[J].陕西中医杂志,2019,(4):456.
 QIN Fufang,SHEN Fengjuan,SHAO Fengmin..Effect of Xuebijing injection on acute pyelonephritis in elderly patients with diabetes[J].,2019,(4):456.
[9]刘 扬,韩家凯,王 前.麝香养心散治疗糖尿病合并冠状动脉粥样硬化性心脏病 及对患者血脂、血流变与凝血功能的影响*[J].陕西中医杂志,2019,(5):576.
 LIU Yang,HAN Jiakai,WANG Qian..Effect of Shexiang Yangxin powder on diabetic mellitus complicated with coronary atherosclerotic heart disease and its influence on blood lipid, hemorheological index and coagulation function〖WT4”BZ〗[J].,2019,(4):576.
[10]何 丽,朱亚丽,罗 方,等.盐酸帕罗西汀片联合养阴益气中药治疗糖尿病合并抑郁症 疗效研究*[J].陕西中医杂志,2019,(5):645.
 HE Li,ZHU Yali,LUO Fang,et al.Effects of paroxetine hydrochloride tablets combined with Yangyin Yiqi TCM on SDS,DQOL and TESS score in diabetic patients with depression[J].,2019,(4):645.

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2022SF-158)
更新日期/Last Update: 2024-04-10