白术颗粒对脾虚湿盛型单纯性肥胖人群肠道菌群的调节作用研究

Study on the regulating effect of Baizhu granule on intestinal microflora in simple obese people with spleen deficiency and dampness excess

目的:观察白术颗粒对脾虚湿盛型单纯性肥胖人群肠道菌群的调节作用。方法:将60例脾虚湿盛型单纯性肥胖患者随机分成3组:对照组20例予以饮食控制、适当运动锻炼干预;低剂量组20例在对照组治疗基础上,加服白术颗粒3 g,1次/d;高剂量组20例在对照组治疗基础上,加服白术颗粒6 g,1次/d。疗程均为3个月。比较3组治疗前后体质量指数(BMI)、脂肪百分率(F%)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)以及肠道双歧杆菌、乳杆菌、大肠杆菌、肠球菌的数量。结果:低剂量组治疗后BMI、F%、TG、LDL-C、FINS、HOMA-IR均较治疗前明显下降(P<0.05或P<0.01);高剂量组治疗后BMI、F%、TC、TG、LDL-C、FINS、HOMA-IR均较治疗前明显下降(P<0.05或P<0.01);对照组治疗后BMI、F%、TG、FINS、HOMA-IR较治疗前明显下降(P<0.05)。治疗后,白术颗粒低剂量组及高剂量组双歧杆菌、乳杆菌数量均较各自及对照组治疗后明显升高(P<0.05);治疗后,对照组较治疗前大肠杆菌数量差异无统计学意义(P>0.05),白术颗粒两组较治疗前明显下降(P<0.05),高剂量组较对照组差异有统计学意义(P<0.05)。结论:白术对脾虚湿盛型单纯性肥胖患者可能通过调节肠道菌群,进而调节和改善胰岛素抵抗及脂代谢,从而达到减重及改善体质量的治疗目标。

Objective:To observe the regulatory effect of Baizhu granule on intestinal flora in simple obese people with spleen deficiency and dampness excess.Methods:60 patients with simple obesity of spleen deficiency and dampness excess were randomly divided into three groups:control group(n=20),low dose group(n=20)and high dose group(n=20).On the basis of treatment in the control group,20 patients in the high dose group were treated with 6g Baizhu granule once a day.The course of treatment was 3 months.Body mass index(BMI),percentage of fat(F%),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR)and the number of intestinal bifidobacteria,Lactobacillus,Escherichia coli and enterococci were compared among the three groups before and after treatment.Results:BMI,F%,TG,LDL-C,FINS and HOMA-IR in low dose group decreased significantly after treatment,BMI,F%,TC,TG,LDL-C,FINS and HOMA-IR in high dose group decreased significantly after treatment,and BMI,F%,TG,FINS and HOMA-IR in control group decreased significantly after treatment.After treatment,the numbers of Bifidobacterium and Lactobacillus in low-dose and high-dose groups of Baizhu granule were significantly higher than those in their respective groups and the control group(P<0.05),but there was no significant difference in the number of Escherichia coli in the control group after treatment(P<0.05).The number of Escherichia coli in the control group was significantly lower than that before treatment(P<0.05),and there was significant difference between the high dose group and the control group(P<0.05).Conclusion:Atractylodes macrocephala on simple obesity patients with spleen deficiency and dampness may regulate and improve insulin resistance and lipid metabolism by regulating intestinal flora,so as to achieve the therapeutic goal of weight loss/im-provement of body mass.