發(fā)布時(shí)間：2018-05-01 11:06

  本文選題：老年2型糖尿病 + 認(rèn)知障礙��； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:應(yīng)用中醫(yī)學(xué)辨證論治理論,觀察中藥制劑益智合劑治療老年2型糖尿病合并認(rèn)知障礙(腎虛髓減證)的臨床療效,并探討其配伍特色及臨床作用機(jī)理。方法:將山東中醫(yī)藥大學(xué)附屬醫(yī)院老年醫(yī)學(xué)科(保健科)住院患者根據(jù)納入及排除標(biāo)準(zhǔn)選取老年2型糖尿病合并認(rèn)知障礙(腎虛髓減證)患者65例,根據(jù)隨機(jī)單盲的分組方法將病人分為治療組32例,對(duì)照組33例。在兩組患者均在規(guī)范、有效控制血糖的基礎(chǔ)上,對(duì)照組給予奧拉西坦注射液靜脈滴注,治療組在應(yīng)給予奧拉西坦注射液的同時(shí)加用益智合劑口服。以4周為1個(gè)治療療程,共治療3個(gè)療程。在治療的前后分別測(cè)定患者以下觀察指標(biāo):血糖、血脂、血流變、血清同型半胱氨酸,計(jì)算神經(jīng)心理學(xué)檢查積分:簡(jiǎn)易精神狀態(tài)檢查量表(MMSE)、長(zhǎng)谷川癡呆量表(HDS)、日常生活能力量表(ADL)評(píng)分,并觀察兩組治療前后中醫(yī)癥狀積分的改變情況及安全性指標(biāo)情況。將所得數(shù)據(jù)應(yīng)用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析。結(jié)果:1.臨床總療效:治療組總有效率為86.67%,對(duì)照組總有效率為66.67%,組間總有效率比較具有顯著性差異(P0.05)。2.中醫(yī)癥狀積分:癥狀總積分(治療組治療前為:42.15±4.16,治療后為:19.11±6.78;對(duì)照組治療前為:41.96±4.42,治療后為:35.66±5.65)。治療組患者與對(duì)照組相比有顯著性差異(P0.01或P0.05)。3.簡(jiǎn)易精神狀態(tài)檢查量表(MMSE):治療組患者簡(jiǎn)易精神狀態(tài)檢查量表(MMSE)評(píng)分明顯增加(治療前評(píng)分:15.74±3.57,治療后評(píng)分:22.35±3.14),組內(nèi)比較有極顯著性差異(P0.01),且與對(duì)照組相比差異具有顯著統(tǒng)計(jì)學(xué)意義(P0.01)。4.長(zhǎng)谷川癡呆量表(HDS):治療組患者長(zhǎng)谷川癡呆量表(HDS)評(píng)分明顯增加(治療前評(píng)分:15.84±1.95,治療后評(píng)分:23.26±1.84)組內(nèi)比較具有極顯著性差異(P0.01),且組間比較也具有顯著的統(tǒng)計(jì)學(xué)意義(P0.01)。5.日常生活能力量表(ADL-Barthel指數(shù))評(píng)分:治療組患者日常生活能力量表(ADL-Barthel指數(shù))評(píng)分顯著增加(治療前評(píng)分:67.32±12.73,治療后評(píng)分:92.67±12.17),組內(nèi)比較有顯著性差異(P0.01),且與對(duì)照組組間比較也有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。6.實(shí)驗(yàn)室指標(biāo):治療組患者血流變及血清同型半胱氨酸等實(shí)驗(yàn)室指標(biāo)值較治療前均明顯改善,與治療前相比結(jié)果有顯著性差異(P0.05),且療效優(yōu)于對(duì)照組(P0.05或P0.01);但在血糖、血脂方面,治療前后不論是組內(nèi)還是組間均無(wú)明顯差異(P0.05)。結(jié)論:中藥益智合劑能有效改善老年2型糖尿病合并認(rèn)知障礙(腎虛髓減證)患者臨床癥狀、神經(jīng)心理學(xué)評(píng)分及部分實(shí)驗(yàn)室指標(biāo),療效優(yōu)于單用奧拉西坦注射液,說(shuō)明中藥益智合劑明顯提高了患者的生活質(zhì)量和水平,為治療老年2型糖尿病合并認(rèn)知障礙(腎虛髓減證)開(kāi)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.

【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259;R277.7

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