黄连素治疗2型糖尿病的疗效及对患者血糖、肠道菌群及Cys C、AN、FFA水平的影响

Efficacy of berberine in the treatment of type 2 diabetes and its effect on blood sugar,intestinal flora,and cystatin C,adiponectin,and free fatty acid levels

目的观察黄连素治疗2型糖尿病的疗效,并探讨其对患者血糖、肠道菌群及胱抑素C(CysC)、脂联素(AN)、游离脂肪酸(FFA)水平的影响。方法选择2019年7月至2020年12月上海中医药大学附属普陀医院内分泌科治疗的124例2型糖尿病患者为研究对象,按照随机数表法分为观察组与对照组,每组62例。对照组患者采用二甲双胍肠溶片治疗,观察组患者在对照组治疗的基础上采用黄连素治疗,两组均治疗1个月。1个月后,比较两组患者的临床疗效、治疗前后的餐后2 h血糖(2 hPG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、Cys C、AN、FFA水平和肠道菌群的变化。结果观察组患者的治疗总有效率为95.16%,明显高于对照组的74.19%,差异有统计学意义(P<0.05);治疗前,两组患者的2 hPG、FPG、HbA1c水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者的2 hPG、FPG、HbA1c水平分别为(7.12±0.93)mmol/L、(4.89±0.23)mmol/L、(7.28±0.21)%,明显低于对照组的(8.04±0.16)mmol/L、(6.25±0.51)mmol/L、(9.19±0.26)%,差异均有统计学意义(P<0.05);治疗前,两组患者的Cys C、AN、FFA水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者的Cys C、FFA水平分别为(0.96±0.27)mg/L、(1029.57±251.94)μmol/L,明显低于对照组的(1.18±0.32)mg/L、(1162.42±280.36)μmol/L,AN水平为(9.02±1.53)mmol/L,明显高于对照组的(8.36±1.37)mmol/L,差异均有统计学意义(P<0.05);治疗前后,两组患者的菌数、G-b、G+b、G-c、G+c及球杆比比较差异均无统计学意义(P>0.05)。结论黄连素联合二甲双胍肠溶片治疗2型糖尿病能明显降低患者的2 hPG、FPG水平,改善Cys C、AN、FFA水平,同时对患者的肠道菌群没有明显影响,临床治疗效果显著。

Objective To observe the curative effect of berberine in the treatment of type 2 diabetes,and to explore its effects on patients'blood sugar,intestinal flora,cystatin C(Cys C),adiponectin(AN),and free fatty acid(FFA)levels.Methods A total of 124 patients with type 2 diabetes who were treated by the Department of Endocrinology,Pu-tuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from July 2019 to December 2020 were selected as the research objects.The patients were divided into observation group and control group according to the random number table method,with 62 patients in each group.Patients in the control group were treated with metformin en-tericcoated tablets,and patients in the observation group were treated with berberine on the basis of the treatment in the control group,both for 1 month.One month later,the clinical efficacy,2 h postprandial blood glucose(2 hPG),fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),Cys C,AN,FFA levels,and intestinal flora of the two groups were compared before and after treatment.Results The total effective rate of treatment in the observation group was 95.16%,which was significantly higher than 74.19%in the control group(P<0.05);before treatment,the 2 hPG,FPG,and HbA1c levels showed no statistically significant difference between the two groups(P>0.05);after treatment,the lev-els of 2 hPG,FPG,and HbA1c in the observation group were(7.12±0.93)mmol/L,(4.89±0.23)mmol/L,(7.28±0.21)%,significantly lower than(8.04±0.16)mmol/L,(6.25±0.51)mmol/L,(9.19±0.26)%in the control group(P<0.05).Before treatment,the levels of Cys C,AN,and FFA showed no statistically significant difference between the two groups(P>0.05);after treatment,the levels of Cys C and FFA in the observation group were(0.96±0.27)mg/L,(1029.57±251.94)μmol/L,significantly lower than(1.18±0.32)mg/L,(1162.42±280.36)μmol/L in the control group,and AN level was(9.02±1.53)mmol/L,which was significantly higher than(8.36±1.37)mmol/L in the control group,with statistically significant difference(P<0.05).Before and after treatment,there was no significant difference in the number of bacteria,G-bacillus,G+bacillus,G-cocci,G+cocci,and bacillus/cocci ratio between the two groups of patients(P>0.05).Conclusion Ber-berine has a significant effect on the treatment of type 2 diabetes.It can significantly reduce the level of 2 hPG and FPG in patients,and improve the levels of Cys C,AN,and FFA,and it has no significant effect on the intestinal flora of pa-tients,which is worthy of popularization and application.