【摘要】：[目的]通過對2型糖尿病輕度認(rèn)知功能障礙患者進(jìn)行證型調(diào)查,分析其與2型糖尿病認(rèn)知功能正�；颊咦C型區(qū)別,歸納研究2型糖尿病輕度認(rèn)知功能障礙患者中醫(yī)證型特點(diǎn),尋找2型糖尿病發(fā)生輕度認(rèn)知功能障礙的影響因素,明確其發(fā)病是否與中醫(yī)證型的不同存在相關(guān)性,進(jìn)一步探討2型糖尿病輕度認(rèn)知功能障礙患者不同證型間認(rèn)知功能是否存在差異。[方法]使用蒙特利爾認(rèn)知評估(Montreal cognitive Assessment,MoCA)北京量表、簡易精神狀態(tài)量表(MMSE量表)、臨床癡呆分級量表(CDR量表)等量表,依據(jù)診斷標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)將77例2型糖尿病患者按是否存在輕度認(rèn)知功能障礙分為2型糖尿病輕度認(rèn)知功能障礙組和2型糖尿病認(rèn)知功能正常組,中醫(yī)證型分為氣虛、血虛、陰虛、陽虛、腎虛、脾氣虛、肺氣虛、肝虛、燥熱、血瘀、氣郁、氣郁化熱、痰濕、熱痰、熱毒、濕熱困脾、濕熱下注、肝膽濕熱、胃腸結(jié)熱共19個證型,采用調(diào)查問卷及實(shí)驗(yàn)室檢查的形式,收集患者的年齡、學(xué)歷、身高、體重、血壓、糖尿病病程、糖尿病并發(fā)癥及其他合并癥等一般資料,檢測空腹血糖、餐后血糖、空腹C肽及胰島素、糖化血紅蛋白水平。[結(jié)果]2型糖尿病輕度認(rèn)知功能障礙患者與2型糖尿病認(rèn)知功能正�；颊叩囊话闱闆r包括:年齡、糖尿病病程、BMI、血壓、空腹C肽、空腹胰島素、糖尿病并發(fā)癥及合并癥無明顯差異(P0.05);受教育年限與HbA1C存在差異(P0.05);認(rèn)知功能方面:視空間與執(zhí)行功能、注意、算數(shù)、語言、抽象、延遲回憶部分兩組患者存在顯著的差異(P0.01);證型特點(diǎn)方面:2型糖尿病輕度認(rèn)知功能障礙組證型以肝虛證、氣虛證、腎虛證、血瘀證、陽虛證、氣郁證為主,所占比率分別為18.1%、14.3%、13.2%、12.6%、11.0%,其中肝虛證、氣虛證、腎虛證、血瘀證、陽虛證、氣郁證之間的認(rèn)知評分不存在顯著差異(P0.05);2型糖尿病認(rèn)知功能正常組證型以燥熱證、陰虛證、脾氣虛證、痰濕證、氣郁化熱證、胃腸結(jié)熱證、肺氣虛證、肝膽濕熱證為主,所占的比率分別為 17.8%、15.9%、13.1%、12.1%、9.3%、6.5%、5.6%、4.7%、4.7%、3.7%,差異無統(tǒng)計學(xué)意義(P0.05);2型糖尿病輕度認(rèn)知功能障礙組及2型糖尿病認(rèn)知功能正常組在血瘀證及燥熱證的分布均有顯著差異(P0.05)。[結(jié)論]2型糖尿病輕度認(rèn)知功能障礙認(rèn)知功能的損傷主要在視空間與執(zhí)行功能、注意、算數(shù)、語言、抽象、延遲回憶方面,糖化血紅蛋白水平和受教育年限是2型糖尿病患者是否發(fā)生輕度認(rèn)知功能障礙的影響因素,其中糖化血紅蛋白水平為危險因素,受教育年限為保護(hù)性因素;2型糖尿病輕度認(rèn)知功能障礙證型以肝虛證、氣虛證、腎虛證、血瘀證、陽虛證、氣郁證為主;與認(rèn)知功能正常的2型糖尿病患者相比,兩組證型分布特點(diǎn)大致相似,2型糖尿病輕度認(rèn)知功能障礙以血瘀證為特點(diǎn),認(rèn)知功能正常組以燥熱證為特點(diǎn),證型對認(rèn)知功能影響的程度不確切。
[Abstract]:[objective] to investigate the syndromes of patients with mild cognitive dysfunction of type 2 diabetes mellitus, analyze the difference between them and the patients with normal cognitive function of type 2 diabetes mellitus, and sum up and study the characteristics of TCM syndromes in patients with mild cognitive dysfunction of type 2 diabetes mellitus. To find out the influencing factors of mild cognitive dysfunction in type 2 diabetes mellitus, and to find out whether there is correlation between the occurrence of type 2 diabetes mellitus and the different types of TCM syndromes. To further explore whether there are differences in cognitive function among different syndromes in patients with mild cognitive impairment in type 2 diabetes mellitus. [methods] using Montreal Cognitive Assessment (Montreal cognitive Assessment,MoCA) Beijing scale, Mini-Mental State scale (MMSE), Clinical dementia rating scale (CDR), etc. According to the diagnostic criteria and exclusion criteria, 77 patients with type 2 diabetes mellitus were divided into two groups according to whether there was mild cognitive dysfunction in type 2 diabetes mellitus and normal cognitive function of type 2 diabetes mellitus. The TCM syndromes were divided into qi deficiency and blood deficiency. Yin deficiency, yang deficiency, kidney deficiency, spleen qi deficiency, lung qi deficiency, liver deficiency, dryness and heat, blood stasis, qi stagnation, phlegm dampness, heat phlegm, heat toxin, damp-heat trapped spleen, damp-heat betting, liver and gallbladder damp-heat, gastrointestinal knot heat, 19 syndrome types, The patients' age, education, height, weight, blood pressure, course of diabetes, diabetic complications and other complications were collected by questionnaire and laboratory examination to detect fasting blood glucose and postprandial blood glucose. Fasting C-peptide and insulin, glycosylated hemoglobin levels. [results] the general conditions of patients with mild cognitive impairment in type 2 diabetes mellitus and normal cognitive function patients with type 2 diabetes mellitus included: age, course of diabetes, BMIs, blood pressure, fasting C-peptide, fasting insulin, There was no significant difference in diabetic complications and complications (P0.05); there were differences between the years of education and HbA1C (P0.05); cognitive function: visual space and executive function, attention, arithmetic, language, abstraction, There were significant differences between the two groups in delayed recall (P0.01), the syndrome types of mild cognitive dysfunction of type 2 diabetes mellitus were liver deficiency, Qi deficiency, Kidney deficiency, Blood stasis, Yang deficiency, Qi stagnation. The ratios were 18.1C 14.3B and 12.60.There were no significant differences in the cognitive scores between liver deficiency syndrome, qi deficiency syndrome, kidney deficiency syndrome, blood stasis syndrome, yang deficiency syndrome and qi stagnation syndrome. (P0.05) there was no significant difference in the cognitive function of type 2 diabetes mellitus with dryness and heat syndrome, yin deficiency syndrome, spleen qi deficiency syndrome, and there was no significant difference between them (P0.05) the cognitive function of type 2 diabetes mellitus was characterized by dryness and heat syndrome, yin deficiency syndrome, spleen qi deficiency syndrome, and there was no significant difference between them (P0.05). Phlegm and dampness syndrome, qi stagnation and heat transfer syndrome, gastrointestinal knot heat syndrome, lung qi deficiency syndrome, liver and gallbladder dampness and heat syndrome, The ratios of 17.8R 15.9g and 12.1g were 9.3and 6.55.6and 4.7cm, respectively. There was no significant difference in the distribution of blood stasis and heat dryness (P0.05) between the mild cognitive impairment group of type 2 diabetes mellitus and the normal cognitive function group of type 2 diabetes mellitus (P0.05). The distribution of blood stasis syndrome and heat dryness syndrome in type 2 diabetes mellitus were significantly different (P0.05), and there was no significant difference between the two groups in the distribution of blood stasis syndrome and dryness heat syndrome (P0.05), and there was no significant difference between the two groups (P0.05). [conclusion] the impairment of cognitive function in type 2 diabetes mellitus with mild cognitive impairment is mainly related to visual space and executive function, attention, arithmetic, language, abstraction and delayed recall. The level of glycosylated hemoglobin and the years of education are the influencing factors of mild cognitive impairment in type 2 diabetes mellitus, and the level of glycosylated hemoglobin is the risk factor. The number of years of education was a protective factor. The main types of mild cognitive dysfunction in type 2 diabetes mellitus were liver deficiency, qi deficiency, kidney deficiency, blood stasis, yang deficiency and qi depression, compared with type 2 diabetes with normal cognitive function. The distribution characteristics of syndrome types in the two groups were similar to those in type 2 diabetes mellitus. The mild cognitive dysfunction of type 2 diabetes mellitus was characterized by blood stasis syndrome, while that of normal cognitive function group was characterized by dryness and heat syndrome, and the degree of influence of syndrome type on cognitive function was not exact.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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