益生菌制剂对2型糖尿病患者的疗效及其对其肠道菌群的影响

Effect of probiotic preparation in patients with type 2 diabetes and its influence on intestinal microflora

目的探讨益生菌制剂对2型糖尿病患者的疗效及其对肠道菌群的影响。方法选取医院收治的92例2型糖尿病患者随机分为对照组和研究组,各46例。对照组给予基础治疗,研究组给予基础治疗联合益生菌制剂。对比治疗前后两组患者临床症状评分和糖代谢指标水平变化,肠道菌群的组成及多样性变化,治疗效果和药物不良反应。结果治疗后两组患者Chao1指数和Shannon指数均升高(均P<0.05),且研究组Chao1指数和Shannon指数均高于对照组(均P<0.05);治疗后两组疲乏无力、失眠口渴、多饮多尿临床症状评分,空腹血糖、餐后2 h血糖和糖化血红蛋白水平,拟杆菌属及肠球菌属的相对丰度均下降(均P<0.05),且研究组的各项指标均低于对照组(均P<0.05);治疗后两组乳杆菌属、柔嫩梭菌属及双歧杆菌属相对丰度均升高(均P<0.05),且研究组这三个菌属的相对丰度均高于对照组(均P<0.05);两组疗效等级分布差异具有统计学意义(P<0.05),研究组总有效率显著高于对照组(P<0.05)。两组药物不良反应发生率差异无统计学意义(P>0.05)。结论益生菌制剂能够控制2型糖尿病患者的临床症状,改善糖代谢,增加肠道菌群的多样性,调节肠道菌群属水平相对丰度,还可增强疗效且安全。

Objective To explore the effect of probiotic preparation in patients with type 2 diabetes and its influence on intestinal microflora. Methods A total of 92 patients with type 2 diabetes admitted to the hospital were randomly divided into control group or research group, each with 46 patients. The patients in the control group were treated with basic treatment, while those in the research group were treated with basic treatment and probiotic preparation. Before and after treatment, the changes of clinical symptom scores, glucose metabolism indexes, composition and diversity of intestinal flora, therapeutic effect and adverse drug reactions were compared between the two groups. Results After treatment, both Chao1 index and Shannon index in the two groups increased(all P<0.05), with the research group superior to the control group(all P<0.05). After treatment, the clinical symptom scores of fatigue and weakness, insomnia and thirst, and polydipsia and polyuria, as well as the levels of fasting blood glucose, 2 hours postprandial blood glucose and glycosylated hemoglobin and relative abundances of Bacteroides and Enterococcus in both groups decreased(all P<0.05), with those in the research group lower than in the control group(all P<0.05). After treatment, the relative abundances of Lactobacillus, Clostridium tenella and Bifidobacterium in both groups increased(all P<0.05), with those in the research group higher than in the control group(all P<0.05). There was a significant difference in the distribution of curative effect between the two groups(all P<0.05), and the total efficiency rate in the research group was higher than that in the control group(P<0.05). There was no significant difference in the incidences of adverse drug reactions between the two groups(P>0.05). Conclusion In patients with type 2 diabetes, probiotic preparation can control the clinical symptoms, improve glucose metabolism, increase the diversity of intestinal flora, regulate the relative abundance of intestinal flora, and enhance the efficacy and safety.