益生菌对T2DM 患者肠道菌群和脂联素的影响

Curative efficacy of probiotics on intestinal microflora and adiponectin in patients with type 2 diabetes mellitus

摘要:

目的 探讨益生菌辅助口服降糖药物治疗2 型糖尿病（T2DM）疗效及对患者肠道菌群和脂联 素水平的影响。方法 选取2015 年1 月-2015 年12 月于西南医科大学附属医院就诊的120 例T2DM 患者 作为研究对象，按照随机数字表法分为对照组和观察组。常规治疗基础上，对照组患者给予口服降糖药物（二 甲双胍＋阿卡波糖）治疗，观察组患者在对照组基础上给予益生菌（双歧杆菌乳杆菌三联活菌片）治疗。比 较两组患者血糖指标、肠道菌群、血浆脂联素水平及不良反应发生情况。结果 治疗后，与对照组相比，观 察组患者空腹血糖、餐后2 h 血糖、糖化血红蛋白A1c 水平降低，粪便中革兰阳性杆菌、革兰阴性杆菌数量 增多（P <0.05），而两组革兰阳性球菌、革兰阴性球菌数量比较无差异（P >0.05）。脂联素水平检测显示，观 察组患者治疗后血浆脂联素水平高于对照组（P <0.05）。治疗过程中，均未出现低血糖反应。观察组和对照 组不良反应发生率分别为11.7% 和8.3%，两组比较无差异（P >0.05）。结论 益生菌辅助口服降糖药物在 T2DM 中应用效果良好，能够改善血糖，调节肠道菌群，升高血浆脂联素水平，且不良反应轻微，临床上值得 应用。

Abstract:

Objective To investigate the clinical effect of adjuvant therapy of probiotics in treating type 2 diabetes mellitus (T2DM) patients given oral hypoglycemic agents and its effect on intestinal microflora and adiponectin. Methods A total of 120 patients who received therapy in our hospital from January 2015 to December 2015 were collected as research objects. According to random number table, those patients were randomly divided into two groups with equal number. Besides conventional treatment, the control group was given oral hypoglycemic agents (Metformin+Acarbose), while the observation group was given adjuvant therapy of probiotics (Live Combined Bifidobacterium and Lactobacillus Tablets) additionally. Then, glucose-related indices, intestinal florarelated indices including number of bacteral colonies and coccus/bacillus (C/B) value, level of plasma adiponectin and incidence of adverse reactions were compared between the two groups. Results In comparison with the control group after treatment, glucose-related indices FPG, 2hPG and HbA1c were statistically lower in the observation group (P < 0.05). As to intestinal microflora, the number of Gram-positive bacilli and Gram-negative bacilli was statistically higher, and C/B value was statistically lower in the observation group than those in the control group after treatment (P < 0.05), while the number of Gram-positive cocci and Gram-negative cocci in the two groups was not statistically different (P > 0.05). The level of plasma adiponcetin in the observation group was statistically higher than that in the control group (P < 0.05). During treatment, there was no case of hypoglycemia. And the incidence of adverse reactions in the observation group was 11.7%, which was not statistically different from 8.3% in the control group (P > 0.05). Conclusions Adjuvant therapy of probiotics is effective in treating T2DM patients taking oral hypoglycemic agents, and can significantly improve blood glucose, regulate intestinal microflora and increase the plasma level of adiponectin with mild adverse reactions.