摘要
目的观察重复经颅磁刺激联合认知功能训练治疗糖尿病合并早期认知功能障碍的临床疗效。方法采用随机数字表法将80例2型糖尿病合并早期认知功能障碍患者分为观察组及对照组，2组患者均给予常规药物治疗及认知功能训练，观察组患者在此基础上辅以重复经颅磁刺激，连续治疗4周。于治疗前、治疗4周后检测2组患者空腹血糖水平，并通过蒙特利尔认知评估量表（MoCA）对2组患者认知功能改善情况进行评定，同时采用NTS-2000型肌电图与诱发电位仪检测2组患者事件相关电位P300潜伏期及波幅变化情况。结果治疗后2组患者空腹血糖水平均显著降低（P〈0．05），但组间差异无统计学意义（P〉0．05）；治疗后2组患者MoCA量表各分项评分及总分均较治疗前显著提高（P〈O．05），并且观察组患者上述指标改善幅度均显著优于对照组水平（P〈0．05）；治疗后2组患者P300潜伏期显著缩短，波幅显著增加，并且观察组患者P300潜伏期及波幅改善幅度亦屁著优于对照组水平（P〈O．05）。结论在常规认知干预基础上辅以重复经颅磁刺激治疗，能显著改善2型糖尿病合并早期认知功能障碍患者认知功能，并且该联合疗法还具有安全可靠、患者依从性好等优点，值得临床推广、应用。
Objective To explore the clinical effect of cognitive rehabilitation therapy combined with repetitive transcranial magnetic stimulation （rTMS） on diabetes mellitus patients complicated with early cognitive impairment. Methods Eighty patients with type 2 diabetes mellitus complicated with early cognitive impairment admitted to our hospital between February 2016 and February 2018 were randomly divided into a control group and an observation group. Patients in both groups were treated with conventional medications and comprehensive rehabilitation training, while the observation group was additionally treated with rTMS for 4 weeks. The fasting blood glucose （FBG） was detected before and after the treatment. The cognitive status, as well as the latency and amplitude of P300 were evaluated using Montreal cognitive assessment （MoCA）, NTS-2000 Instrument for electromyography and evoked potentials before and after the treatment. Results After the treatment, significant decrease was observed within both groups in terms of FBG compared to before the treatment, but no significant differences between the two groups were revealed （P〉0.05）. After the treatment, the sub-scores and total scores of the MoCA scale of the two groups were significantly higher than those before treatment, with those of the observation group significantly higher than the control group. After the treatment, the latency of P300 decreased significantly, while the amplitude of P300 increased significantly in both group, with significantly higher improvement in the observation group than the control group （P〈0.05）. Conclusion rTMS, in addition to cognitive function rehabilitation, significantly improved cognitive function status in patients with type 2 diabetes mellitus complicated with early cognitive impairment. Such combination is worthy of clinical promotion with its safety, reliability and patient compliance.
作者
杨慧慧
阚全娥
于璐
李瀛
Yang Huihui;Kan Quan＇e;Yu Lu;Li Ying(Department of Endocrinology,Henan Provincial People＇s Hospital,Zhengzhou 450003,China)
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2018年第9期666-670,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
重复经颅磁刺激
认知训练
糖尿病
认知障碍
Repetitive transcranial magnetic stimulation
Comprehensive rehabilitation
Diabetes melli-tus
Cognitive impairment
