双歧杆菌三联活菌联合西格列汀治疗2型糖尿病伴胃肠植物神经病变临床观察

Bifidobacterium Triple Viable Enteric-Coated Capsules Combined with Sitagliptin for Gastrointestinal Autonomic Neuropathy in Type 2 Diabetes Mellitus

目的探讨双歧杆菌三联活菌联合西格列汀治疗2型糖尿病伴胃肠植物神经病变的临床疗效及对患者肠道菌群的影响。方法选取长沙市第四医院2017年1月至2019年1月收治的2型糖尿病伴胃肠植物神经病变患者104例,按入院奇偶数分为观察组和对照组,各52例。两组患者均予基础治疗及磷酸西格列汀片口服,观察组患者加服双歧杆菌三联活菌胶囊,均连续治疗4周。结果观察组总有效率为90.38%,显著高于对照组的73.08%(P<0.05);与治疗前比较,两组患者治疗后的胃排空率,胃动素、P物质水平,双歧杆菌、乳酸杆菌及双歧杆菌/大肠杆菌(B/E)均显著升高,胆囊收缩素(CCK)水平、大肠杆菌、粪肠球菌均显著降低,观察组患者上述指标改善程度均显著优于对照组(P<0.05);观察组与对照组不良反应发生率相当(15.38%比9.62%,χ^2=0.791,P=0.374>0.05)。结论双歧杆菌三联活菌联合西格列汀治疗2型糖尿病胃肠植物神经病变,能改善患者胃肠道症状及胃肠道功能,调节肠道菌群分布。

Objective To study the clinical efficacy of bifidobacterium triple viable enteric-coated capsule combined with sitagliptin on gastrointestinal autonomic neuropathy in patients with type 2 diabetes mellitus and its effect on patients’intestinal flora.Methods A total of 104 patients with type 2 diabetes mellitus and gastrointestinal autonomic neuropathy from January 2017 to January 2019 were selected and divided into the observation group and control group according to the principle of random allocation,52 cases in each group.Both groups were treated with routine antidiabetic drugs and sitagliptin phosphate tablets,while the observation group was added with bifidobacterium triple viable enteric-coated capsules.Both groups were treated for four consecutive weeks.Results The total effective rate of the observation group was 90.38%,which was significantly higher than 73.08%of the control group(P<0.05).Compared with before treatment,the gastric emptying rate,motilin,substance level,Bifidobacterium P,Lactobacillus and Bifidobacterium/Escherichia coli(B/E)of the two groups were significantly increased after treatment,and the levels of cholecystokinin(CCK),E.coli,and Enterococcus faecalis were significantly reduced.The improvement of the above indicators in the observation group was significantly better than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was comparable to that of the control group(15.38%vs.9.62%,χ^2=0.791,P=0.374>0.05).Conclusion Bifidobacterium triple viable enteric-coated capsule combined with sitagliptin has better therapeutic effect on gastrointestinal autonomic neuropathy in type 2 diabetes mellitus.It can improve gastrointestinal symptoms,improve gastrointestinal function indexes,and regulate the distribution of intestinal flora in patients.