益气甘露颗粒联合胰岛素强化治疗对难治性2型糖尿病患者肠道菌群的影响

Effects of Yiqi Ganlu granules combined with intensive insulin therapy on intestinal flora in patients with refractory type 2 diabetes mellitus

目的探讨益气甘露颗粒联合胰岛素强化治疗对难治性2型糖尿病患者肠道菌群的影响。方法选取60例难治性2型糖尿病患者并将其随机分为治疗组和对照组,每组30例。对照组行胰岛素强化治疗,治疗组行益气甘露颗粒治疗联合胰岛素强化治疗,两组均治疗8周。比较两组患者临床疗效,以及治疗前后炎性因子、脂质代谢、血糖、肠道菌群水平。结果治疗8周后,治疗组患者临床治疗总有效率高于对照组(96.67%比73.33%);两组患者血清超敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-6、内皮素、同型半胱氨酸水平均下降,治疗组患者上述指标均低于对照组;两组患者血浆空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)水平均下降,血清空腹C肽(FCP)水平均上升,治疗组患者血浆FBG、2hPBG、HbA1c水平均低于对照组,血清FCP水平高于对照组;两组患者血清低密度脂蛋白-胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TAG)水平均下降,血清高密度脂蛋白-胆固醇(HDL-C)水平均上升,且治疗组血清LDL-C、TC、TAG水平均低于对照组,血清HDL-C水平高于对照组;两组肠道双歧杆菌、拟杆菌、乳酸杆菌水平均上升,且治疗组上述菌群水平均高于对照组;肠杆菌、肠球菌、酵母菌水平均下降,且治疗组上述菌群水平均低于对照组(均P<0.05)。结论益气甘露颗粒联合胰岛素强化治疗可提高难治性2型糖尿病治疗效果,减轻炎症反应,改善脂质代谢与肠道菌群。

Objective To investigate the effects of Yiqi Ganlu granules combined with intensive insulin therapy on the intestinal flora in patients with refractory type 2 diabetes mellitus.Methods A total of 60 patients with refractory type 2 diabetes mellitus were selected and randomly divided into a treatment group or a control group,with 30 cases in each group.The control group was treated with intensive insulin therapy,while the treatment group was treated with Yiqi Ganlu granules combined with intensive insulin therapy,and both groups were treated for 8 weeks.The clinical efficacy,as well as the inflammatory factors,lipid metabolism,blood glucose,and intestinal flora levels before and after the treatment were compared between the two groups.Results After 8 weeks of the treatment,the total effective rate for the clinical treatment of the treatment group was higher than that of the control group(96.67%vs.73.33%)(P<0.05).The serum hypersensitivity C-reactive protein,tumor necrosis factor-α,interleukin-6,endothelin,and homocysteine levels decreased in both groups,and the abovementioned indexes in the treatment group were lower than those in the control group(all P<0.05).The plasma fasting blood glucose(FBG),2h postprandial blood glucose(2hPBG),and hemoglobin A1c(HbA1c)levels decreased,while the serum fasting C-peptide(FCP)level increased in both groups;the treatment group had lower plasma FBG,2hPBG,and HbA1c levels and higher serum FCP level,as compared with the control group(all P<0.05).The serum low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),and triacylglycerol(TAG)levels decreased,while the serum high-density lipoprotein cholesterol(HDL-C)level increased in both groups;the treatment group had lower serum LDL-C,TC,and TAG levels and higher serum HDL-C,as compared with the control group(all P<0.05).The intestinal Bifidobacterium,Bacteroides and Lactobacillus levels in both groups increased,and the abovementioned flora levels in the treatment group were higher than those in the control group(all P<0.05).The intestinal Enterobacteria,Enterococcus and Saccharomyces levels in both groups decreased,and the abovementioned flora levels in the treatment group were lower than those in the control group(all P<0.05).Conclusion Yiqi Ganlu granules combined with intensive insulin therapy can improve the therapeutic effect in the treatment of refractory type 2 diabetes mellitus,reduce inflammatory reaction,and improve lipid metabolism and intestinal flora.