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目的:探讨补肾活血汤对糖尿病认知功能障碍的改善作用及对氧化应激和炎性反应的影响。方法:将114例患者随机按数字表法分为对照组和实验组各57例。对照组采用尼莫地平片,30 mg/次,3次/d;拜阿司匹林肠溶片,100 mg/次,1次/d。实验组在对照组治疗的基础上内服补肾活血汤,两组疗程均为3个月。采用蒙特利尔量表(Mo CA)评价治疗前后认知能力,检测治疗前后空腹血糖(FBG)、糖化血红蛋白(Hb Alc),胰岛素抵抗指数(HOMA-IR),超氧化物歧化酶(SOD),丙二醛(MDA),总抗氧化能力(T-AOC),白细胞介素1β(IL-1β),肿瘤坏死因子α(TNF-α),同型半胱氨酸(Hcy)水平。结果:治疗后实验组视空间与执行能力、注意力、语言、抽象、记忆及延迟回忆、定向力及Mo CA量表总分高于治疗后对照组(P<0.05,P<0.01);治疗后实验组Hb A1c和HOMA-IR低于对照组(P<0.01);治疗后实验组T-AOC和SOD水平高于对照组,MDA水平低于对照组(P<0.01);治疗后实验组TNF-α,IL-1β,Hcy水平低于对照组(P<0.01)。结论:补肾活血汤能提高2型糖尿病认知功能障碍患者的认识能力,其作用机制可能是通过改善胰岛素抵抗,抗氧化应激和减轻炎症反应来实现的。
Objective: To investigate the effect of Bushen Huoxue Decoction on diabetic cognitive dysfunction and its effect on oxidative stress and inflammatory response. Methods: 114 patients were randomly divided into control group and experimental group by digital table method in 57 cases. The control group used nimodipine tablets, 30 mg / time, 3 times / d; aspirin enteric-coated tablets, 100 mg / time, 1 time / d. The experimental group in the control group based on the internal administration of Bushenhuoxue soup, two groups of treatment were 3 months. The cognitive function was evaluated by Mo CA before and after treatment. The levels of fasting blood glucose (FBG), HbAc, HOMA-IR, SOD, (MDA), T-AOC, IL-1β, TNF-α and Hcy were measured. Results: After treatment, the total scores of visual acuity, executive ability, attention, language, abstraction, memory and delayed recall, orientation and Mo CA were higher in the experimental group than those in the control group (P <0.05, P <0.01) The levels of Hb A1c and HOMA-IR in the experimental group were significantly lower than those in the control group (P <0.01). The levels of T-AOC and SOD in the experimental group were significantly higher than those in the control group (P <0.01) TNF-α, IL-1β, Hcy levels were lower than the control group (P <0.01). Conclusion: Bushen Huoxue Decoction can improve the cognition ability of patients with type 2 diabetes mellitus with cognitive impairment. Its mechanism may be through improving insulin resistance, anti-oxidative stress and alleviating inflammatory reaction.