胰岛素敏感性及胰岛素样生长因子结合蛋白-1与老年痴呆症中医辨证分型关系的临床研究

Relationship between insulin sensitivity,insulin-like growth factor binding protein-1 and TCM syndrome differentiation in patients with dementia

关键词:  胰岛素敏感性  胰岛素样生长因子结合蛋白-1  老年痴呆症  中医辨证分型  临床研究

Key words:  insulin sensitivity  insulin-like growth factor binding protein-1  dementia  differentiation of symptoms and signs for classification of syndrome  clinical study

摘要:

[目的]探讨胰岛素敏感性和血清胰岛素样生长因子结合蛋白-1(IGFBP-1)与老年痴呆症中医辨证分型的关系及临床意义。[方法]将50例老年痴呆症患者分为脾肾两虚(30例)和气虚血瘀(20例)2型。对老年痴呆症组和正常对照组(30例)进行血清IGFBP-1和空腹血清胰岛素(FINS)检测,计算胰岛素敏感性指数(IAI)。[结果]3组间空腹血糖(FBG)无统计学差异(P>0.05);与正常对照组相比,脾肾两虚组和气虚血瘀组的FINS、IGFBP-1均偏高,有显著统计学差异(P<0.01),两中医证型之间也存在统计学差异(P<0.01,P<0.05);脾肾两虚组和气虚血瘀组的IAI较正常对照组下降,3组间有统计学差异(P<0.05);通过Pearson相关性分析可以看出,IGFBP-1与FBG、FINS、IAI有相关性,与FBG、FINS呈正相关,与IAI呈负相关。[结论]老年痴呆症与胰岛素代谢水平异常有关,脾肾两虚是导致老年期痴呆的关键病机。

Abstract:

[Objective] To investigate the relationship and significance between insulin sensitivity,insulin-like growth factor binding protein-1 (IGFBP-1) and traditional Chinese medicine syndrome differentiation of dementia. [Methods] Syndromes of 50 patients were divided into two types:asthenia of both the spleen and kidney and deficiency of vital energy and stagnation of blood. The serum fasting insulin (FINS) and IGFBP-1 of dementia group and normal group were detected. The insulin resistance index (IAI) was calculated. [Results] There was no difference in the level of FBG among three groups (P>0.05). The level of FINS and IGFBP-1 increased in group with asthenia of both the spleen and kidney and with deficiency of vital energy and stagnation of blood group compared with the normal groups,hav-ing significantly differences (P<0.01),and there was differences in patients of two groups (P<0.01,P<0.05). Compared with the normal group,the level of IAI in group with asthenia of both the spleen and kidney and deficiency of vital energy and stagnation of blood group decreased. There was difference between three groups (P<0.05). Pearson correlation analysis showed that IGFBP-1 was correlated with FBG,FINS and IAI. Among them,IGFBP-1 was positively correlated with FBG and FINS,and negatively correlated with IAI. [Conclusion] The abnormal level of serum insulin is the important factor in the development of dementia. The asthenia of both the spleen and kidney was the major pathogenic factor in dementia.