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安徽中医药大学第一临床医学院,合肥 230031
安徽中医药大学第一附属医院针灸康复二科,合肥 230031
韦艳,安徽中医药大学硕士研究生。E-mail:205128825@qq.com
✉袁爱红,主任医师。E-mail:490603279@qq.com
收稿:2024-09-03,
网络首发:2025-04-27,
纸质出版:2025-09-12
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韦艳, 曲宇豪, 袁爱红, 等. 不同温度艾灸治疗2型糖尿病认知功能减退:随机对照试验[J]. 中国针灸, 2025,45(9):1233-1240.
WEI Yan, QU Yuhao, YUAN Aihong, et al. Moxibustion at different temperatures for cognitive impairment in type 2 diabetes mellitus: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2025, 45(9): 1233-1240.
韦艳, 曲宇豪, 袁爱红, 等. 不同温度艾灸治疗2型糖尿病认知功能减退:随机对照试验[J]. 中国针灸, 2025,45(9):1233-1240. DOI: 10.13703/j.0255-2930.20240903-k0006.
WEI Yan, QU Yuhao, YUAN Aihong, et al. Moxibustion at different temperatures for cognitive impairment in type 2 diabetes mellitus: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2025, 45(9): 1233-1240. DOI: 10.13703/j.0255-2930.20240903-k0006.
目的
2
观察不同温度艾灸对2型糖尿病(T2DM)认知功能减退患者认知功能及血糖水平的影响。
方法
2
将66例T2DM认知功能减退患者随机分为高温组(22例,脱落1例、剔除1例)、中温组(22例,剔除2例)和低温组(22例,剔除2例)。3组均在原有降糖方案基础上予艾灸百会、大椎和神庭,高温组、中温组、低温组分别维持灸温在44~46 ℃、41~43 ℃和38~40 ℃,每次20 min,隔日1次,每周3次,连续治疗3个月。分别于治疗前后观察3组患者蒙特利尔认知评估量表(MoCA)评分、简易精神状态量表(MMSE)评分、短时记忆编码试验(STM)正确率和平均反应时间、复杂图形测验(ROCF)评分及空腹血糖(FPG)、糖化血红蛋白(HbA1c)数值,并于治疗结束后评定临床疗效。
结果
2
治疗后,3组患者MMSE评分高于治疗前(
P
<
0.05);高温组患者Mo
CA总分及视空间与执行功能、记忆与延迟记忆能力、注意力、命名能力、语言能力、抽象能力评分高于治疗前(
P
<
0.05),ROCF复制、瞬时回忆、延迟回忆评分高于治疗前(
P
<
0.05),HbA1c值低于治疗前(
P
<
0.05);中温组患者MoCA总分及记忆与延迟记忆能力、注意力、语言能力评分高于治疗前(
P
<
0.05);高温组和中温组患者STM正确率高于治疗前(
P
<
0.05),STM平均反应时间低于治疗前(
P
<
0.05)。治疗后,高温组患者MoCA总分及视空间与执行功能、记忆与延迟记忆能力、注意力、语言能力评分高于中温组及低温组(
P
<
0.05),MMSE评分、STM正确率及ROCF瞬时回忆、延迟回忆评分高于中温组及低温组(
P
<
0.05),STM平均反应时间低于中温组及低温组(
P
<
0.05),HbA1c值低于低温组(
P
<
0.05);中温组患者MoCA总分及注意力评分、MMSE评分高于低温组(
P
<
0.05),STM平均反应时间低于低温组(
P
<
0.05)。3组患者治疗前后FPG值组内、组间比较差异均无统计学意义(
P
>
0.05)。高温组、中温组和低温组总有效率分别为75.0%(15/20)、50.0%(10/20)和15.0%(3/20),高温组总有效率高于低温组(
P
<
0.05)。
结论
2
不同温度艾灸治疗2型糖尿病认知功能减退疗效存在差异,灸温介于44~46 ℃时在提高认知功能及稳定近2~3个月的平均血糖水平方面更有优势。
Objective
2
To observe the effects of moxibustion at different temperatures on cognitive function and blood glucose levels in patients with cognitive impairment associated with type 2 diabetes mellitus (T2DM).
Methods
2
A total of 66 T2DM patients with cognitive impairment were randomly assigned to a high-temperature group (22 cases
1 case dropped out
1 case was eliminated)
a medium-temperature group (22 cases
2 cases were eliminated)
and a low-temperature group (22 cases
2 cases were eliminated). All groups received moxibustion at Baihui (GV20)
Dazhui (GV14)
and Shenting (GV24) based on their existing glycemic control treatment. Moxibustion temperatures were maintained at 44-46 ℃ (high-temperature group)
41-43 ℃ (medium-temperature group)
and 38-40 ℃ (low-temperature group)
respectively
for 20 min per session
every other day
3 times a week for 3 months. The Montreal cognitive assessment (MoCA) score
mini-mental state examination (MMSE) score
short-term memory (STM) accuracy and average reaction time
Rey-Osterrieth complex figure (ROCF) score
fasting plasma glucose (FPG)
and glycated hemoglobin (HbA1c) were assessed before and after treatment. Clinical efficacy was evaluated after treatment.
Results
2
After treatment
MMSE scores in all three groups were higher than those before treatment (
P
<
0.05). In the high-temperature group
the total MoCA score and the scores of visuospatial and executive function
memory and delayed recall
attention
naming
language
and abstraction were higher than those before treatment (
P
<
0.05); the scores of ROCF copy
immediate recall
and delayed recall were higher than those before treatment (
P
<
0.05); the HbA1c level was lower than that before treatment (
P
<
0.05). In the medium-temperature group
the total MoCA score and the scores of memory and delayed recall
attention
and language were higher than those before treatment (
P
<
0.05). STM accuracy was higher than before treatment (
P
<
0.05)
and STM average reaction time was shorter than before treatment (
P
<
0.05) in both the high-temperature and medium-temperature groups. After treatment
the total MoCA score and the scores of visuospatial and executive function
memory and delayed recall
attention
and language in the high-temperature group were higher than those in the medium- and low-temperature groups (
P
<
0.05); MMSE score
STM accuracy
and ROCF immediate recall and delayed recall scores were higher than those in the medium- and low-temperature groups (
P
<
0.05); STM average reaction time was shorter than that in the medium- and low-temperature groups (
P
<
0.05); HbA1c level was lower than that in the low-temperature group (
P
<
0.05). The total MoCA score
attention score
and MMSE score in the medium-temperature group were higher than those in the low
-temperature group (
P
<
0.05)
and STM average reaction time was shorter than that in the low-temperature group (
P
<
0.05). There were no statistically significant differences in FPG within or between the three groups before and after treatment (
P
>
0.05). The total effective rates were 75.0% (15/20) in the high-temperature group
50.0% (10/20) in the medium-temperature group
and 15.0% (3/20) in the low-temperature group; the total effective rate in the high-temperature group was significantly higher than that in the low-temperature group (
P
<
0.05).
Conclusion
2
Moxibustion at different temperatures has a dose-effect relationship in treating cognitive impairment in T2DM patients. A temperature range of 44-46 ℃ is more effective in improving cognitive function and stabilizing average blood glucose levels over 2-3 months.
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