达格列净联合双歧杆菌三联活菌胶囊对2型糖尿病患者糖脂代谢和肠道菌群的影响

Effect of dapagliflozin combined with bifidobacteria triple-live bacteria capsules on glucose and lipid metabolism and intestinal flora in patients with type 2 diabetes mellitu

目的探讨达格列净联合双歧杆菌三联活菌胶囊对2型糖尿病患者机体糖脂代谢、肠道菌群的影响。方法抽取2017年3月至2019年8月平煤总医院收治的150例2型糖尿病患者作为本次研究对象,经随机数字表法将其分为研究组与对照组,每组75例。对照组在二甲双胍治疗基础上加用达格列净,研究组在二甲双胍基础上加用达格列净、双歧杆菌三联活菌胶囊治疗。观察两组治疗前后糖代谢、脂代谢、肠道菌群相关指标变化情况及药物相关不良反应。结果两组患者治疗前空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2h PG)水平比较,差异未见统计学意义(P>0.05),治疗后研究组FPG、HbA1c、2hPG水平较之前降低效果优于对照组(P<0.05);治疗前两组患者总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等脂代谢指标比较,差异未见统计学意义(P>0.05),研究组治疗后TC、TG、LDL-C水平下降幅度及HDL-C水平上升幅度均优于对照组(P<0.05);两组治疗前粪便中双歧杆菌总菌数比较,差异未见统计学意义(P>0.05),治疗后研究组粪便中双歧杆菌总菌数较治疗前提高(P<0.05),对照组治疗前后粪便中双歧杆菌总菌数比较,差异未见统计学意义(P>0.05);两组治疗期间各项药物相关不良反应发生率比较,差异未见统计学意义(P>0.05)。结论应用达格列净、双歧杆菌三联活菌胶囊联合治疗2型糖尿病有效性及安全性均较优,有利于改善机体糖脂代谢情况及肠道菌群数量。

Objective To investigate the effect of dapagliflozin combined with bifidobacteria triple-live bacteria capsuleson glycolipid metabolism and intestinal flora in patients with type 2 diabetes mellitus(T2DM).Methods A total of 150 patients with type 2 diabetes mellitus treated in Pingmei General Hospital from March 2017 to August 2019 were randomly divided into study group and control group,with 75 cases in each group.On the basis of metformin,study group was treated with dapagliflozin and bifidobacteria triple-live bacteria capsules,while control group was treated with dapagliflozin on the basis of metformin treatment.The changes of glucose metabolism,lipid metabolism,intestinal flora and drug-related adverse reactions were observed before and after treatment in the two groups.Results Before treatment,the fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)and postprandial blood glucose(2hPG)levels were compared between the two groups,the differences were not statistically significant(P>0.05);FPG,HbA1c and 2 h PG levels in tstudy group were lower than those in control group after treatment(P<0.05),there was no significant difference between the two groups in total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and other lipid metabolism indexes before treatment(P>0.05);the decrease of TC,TG,LDL-C and the increase of HDL-C in study group were better than those in control group(P<0.05),there was no significant difference in the total number of bifidobacteria between the two groups before treatment(P>0.05);the total number of bifidobacteria in feces of study group was increased after treatment(P<0.05);there was no significant difference in the total number of bifidobacteria in feces of the control group before and after treatment(P>0.05);the incidence of drug-related adverse reactions was compared between the two groups,the difference was not statistically significant(P>0.05).Conclusions The efficacy and safety of dapagliflozin and bifidobacteria triple-live bacteria capsules in the treatment of type 2 diabetes are better,which is beneficial to the improvement of glucose and lipid metabolism and the number of intestinal flora.