中国全科医学2017，Vol.20Issue(13)：1642-1647,6.DOI:10.3969/j.issn.1007-9572.2017.13.022
从胰岛素抵抗角度探讨化瘀解毒法治疗轻度认知功能障碍的临床疗效研究
Clinical Effect of Dissolving Blood Stasis and Detoxication on Patients with Mild Cognitive Impairment on the Basis of Insulin Resistance
摘要
Abstract
Objective To investigate the effect of dissolving blood stasis and detoxication on patients with mild cognitive impairment(MCI) on the basis of insulin resistance.Methods 135 MCI patients with insulin resistance who were treated at Yangpu Hospital of Tongji University in Shanghai from January 2013 to January 2014 were selected.All the patients were divided into Western medicine therapy group,Chinese medicine therapy group and combination of Chinese and Western medicine therapy group by random number table method,and each group had 45 patients.Western medicine group took nimodipine tablets orally,Chinese medicine therapy group took "four high" particles(high blood pressure,high cholesterol,high blood sugar,and high uric acid) orally,the combination of Chinese and Western medicine group took nimodipine tablets as well as "four high" particles,and the treatment lasted for 6 months.The BMI,blood pressure and laboratory testing indicators and scores of Mini-mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA) and Activity of Daily Living Scale(ADL) of patients in the three groups before and after treatment were compared in the study.Results 122 patients(90.4%) had completed the six-month treatment as required,of which 42 in Western medicine therapy group,40 in Chinese medicine therapy group and 40 in the combination of Chinese and Western medicine therapy group.There was no significant difference in BMI,systolic pressure and diastolic blood pressure of patients in the three groups before treatment(P>0.05).There was no significant difference in BMI and diastolic blood pressure of patients in the three groups after treatment(P>0.05);while there was significant difference in systolic blood pressure(P<0.05).There was no significant difference in fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),creatinine(Cr),ALT,fasting insulin(Ins),homeostasis model assessment insulin resistance index(HOMA-IR),human insulin-like growth factor binding protein-1(IGFBP-1),plasminogen activator inhibitor-1(PAI-1),and tumor necrosis factor alpha(TNF-α) of patients in the three groups before treatment(P>0.05).There were significant differences in FPG,TC,Ins,HOMA-IR,IGFBP-1,PAI-1 and TNF-α of patients in the three groups after treatment(P<0.05);there was no significant difference in HbA1c,TG,Cr and ALT(P>0.05).There was no significant difference in scores of MMSE,MoCA and ADL of patients in the three groups before treatment after treatmenrt(P>0.05);the scores of MMSE,MoCA and ADL of patients in the three groups were significantly different after treatment(P<0.05).Conclusion Healthy eating habits and appropriate physical exercise can improve the state of insulin resistance in patients with MCI,and the dissolving blood stasis and detoxication method can reduce the level of inflammatory factors by antagonizing the hypercoagulable state,and further reduce patients′ insulin resistance and improve cognitive function.关键词
轻度认知障碍/胰岛素抵抗/化瘀解毒/四高颗粒/治疗结果Key words
Mild cognitive impairment/Insulin resistance/Dissolving blood stasis and detoxication/"Four high" particles/Treatment outcome分类
医药卫生引用本文复制引用
梁兴伦,朱敏洁,李琛,周文锐,童迪夷,陆媛,陈似俊,陆文会,陈缵珅..从胰岛素抵抗角度探讨化瘀解毒法治疗轻度认知功能障碍的临床疗效研究[J].中国全科医学,2017,20(13):1642-1647,6.基金项目
上海市卫生局中医药科研基金2013-2015年度课题计划(2012L005A) （2012L005A）
