温阳益气活血方对肥胖2型糖尿病患者肠道菌群变化及脂质代谢的影响

Effect of Wenyang Yiqi Huoxue Formula on the Intestinal Flora and Lipid Metabolism of Obese Type 2 Diabetic Patients

目的观察温阳益气活血方加减对肥胖2型糖尿病患者肠道菌群变化和脂质代谢的影响。方法将98例肥胖2型糖尿病患者随机分为治疗组和对照组各49例。对照组给予基础治疗,同时服用盐酸二甲双胍片,每次250 mg,每天3次;治疗组在对照组的基础上加用温阳益气活血方加减,每日1剂。两组疗程均为2个月。评价两组中医证候疗效,观察两组患者治疗后中医证候积分、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、血脂以及肠道菌群的变化。结果治疗组证候疗效总有效率为93.88%,对照组为71.43%,治疗组明显优于对照组(P<0.05)。治疗后两组中医证候积分均较治疗前明显改善(P<0.05),治疗组FINS、HOMA-IR均较治疗前明显降低,血脂代谢各指标均较治疗前明显改善,双歧杆菌、拟杆菌、乳杆菌数量均较治疗前明显升高,肠杆菌、肠球菌、酵母菌数量均较治疗前明显降低(P<0.05)。治疗后治疗组中医证候积分、FINS、HOMA-IR、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、肠杆菌、肠球菌、酵母菌数量均明显低于对照组,高密度脂蛋白胆固醇、双歧杆菌、拟杆菌、乳杆菌数量均明显高于对照组(P<0.05)。结论温阳益气活血方加减能明显改善肥胖2型糖尿病患者症状及血脂代谢,调节其肠道菌群失调。

Objective To observe the influence of adjusted Wenyang Yiqi Huoxue Formula （WYYQHXF） on intestinal flora and lipid metabolism of obese type 2 diabetic patients. Methods Totally 98 obese type 2 diabetic patients were randomly assigned to a treatment group and a control group, each group of 49 cases. The control group received basic treatment and Metformin Hydrochloride Tablets, 250 mg three times a day, while on the basis of that, the treatment group received adjusted WYYQHXF orally, one dose daily, both groups were treated for 2 months. Before and after treatments, the TCM symptom scores, fasting insulin （FINS）, fasting plasma glucose （FPG）, insulin resistance index （ HOMA-IR）, serum lipids and changes of the intestinal flora were observed. Results The symptom effective rate of the treatment group and the control group was 93.88% and 71.43% respectively, the difference between groups was significant （ P 〈 0. 05 ）. After the treatments, the symptom scores of both groups improved significantly （P 〈 0.05 ） ; FINS and HOMA-IR of the treatment group decreased notedly ; indexes of lipid metabolism improved significantly ; the number of Bifidobacterium, Bacteroides and Lactobacillus notedly increased, with the number of Enterobacter, Enterococcus and yeast significantly reduced （P 〈 0. 05 ）. The symptom scores, FINS, HOMA-IR, total cholesterol, triglyceride, low density lipoprotein cholesterol and the number of Enterobacter, Enterococcus and yeast of the treatment group were significantly lower than those of the control group, while high density lipoprotein cholesterol and the number of Bifidobacterium, Bacteroides and Lactobacillus were significantly higher than those of the control group （P 〈 0. 05）. Conclusion Adjusted WYYQHXF could significantly improve the symptoms and lipid metabolism of obese type 2 diabetic patients, rebalancing their intestinal flora.