双歧杆菌四联活菌片对2型糖尿病胰岛素敏感性和肠道菌群及糖脂代谢的作用

Effects of bifidobacterium tetragenous viable tablets on insulin sensitivity,intestinal microflora,glycolipid metabolism in type 2 diabetes mellitus

目的探讨双歧杆菌四联活菌片对2型糖尿病患者胰岛素敏感性和肠道菌群及糖脂代谢的影响。方法选择2020年2月至2022年2月来唐山市协和医院就诊的2型糖尿病患者,随机分为对照组(43例)和观察组(42例)。对照组选用二甲双胍进行治疗,观察组在对照组的基础上加用双歧杆菌四联活菌片治疗。比较两组治疗前后胰岛功能、肠道菌群、糖脂代谢指标的变化。结果治疗前,两组患者肠道各菌群菌落形成单位(CFU)对比,差异无统计学意义(P>0.05)。治疗后,两组双歧杆菌、乳酸杆菌CFU较治疗前均升高,肠球菌、肠杆菌CFU较治疗前均降低(P<0.05)。治疗后,两组患者的空腹胰岛素、胰岛β细胞功能指数均升高,胰岛素抵抗指数均下降,且观察组的空腹胰岛素、胰岛β细胞功能指数更高,而胰岛素抵抗指数更低(P<0.05);两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均降低,且观察组各指标明显低于对照组(P<0.05);两组患者总胆固醇、低密度脂蛋白胆固醇、三酰甘油较治疗前降低,高密度脂蛋白胆固醇较治疗前上升,且观察组四指标优于对照组(P<0.05)。结论双歧杆菌四联活菌片能够增强2型糖尿病患者的胰岛素敏感性,改善肠道菌群及糖脂代谢。

Objective To explore the effect of bifidobacterium tetragenous viable tablets on insulin sensitivity,intestinal flora and glucose and lipid metabolism in type 2 diabetes mellitus(T2DM)patients.Methods Patients with T2DM in Tangshan Xiehe Hospital from February 2020 to February 2022 were selected and divided into control group(n=43)and observation group(n=42)randomly.The control group was treated with metformin,and the observation group was treated with bifidobacterium tetragenous viable tablets on the basis of the control group.The changes of islet function,intestinal flora,glucose and lipid metabolism indexes were compared between the two groups before and after treatment.Results Before treatment,there was no significant difference in the colony-forming units(CFU)of bacterial groups between two groups(P>0.05).After treatment,The CFU of Bifidobacteria and Lactobacilli in the two groups were higher than that before treatment,and the CFU of Enterobacteria and Enterococci were lower than those before treatment.The CFU of Bifidobacteria and Lactobacilli in the observation group were higher than those in the control group,while The CFUs of Enterobacteria and Enterococci were lower than those in the control group(P<0.05).After treatment,the fasting insulin and pancreatic isletβcell function index of the two groups increased and the insulin resistance index decreased.Compared with the control group,the fasting insulin and pancreatic isletβcell function index in the observation group were higher,but insulin resistance index was lower(P<0.05).The fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the two groups decreased,and the indexes in the observation group were significantly lower than those in the control group(P<0.05).The total cholesterol,low-density lipoprotein cholesterol and triacylglycerol of the patients in the two groups decreased compared with those before treatment,and high-density lipoprotein cholesterol increased compared with that before treatment,and the four indexes in the observation group were better than those in the control group(P<0.05).Conclusion Bifidobacterium tetragenous viable tablets can enhance insulin sensitivity,improve intestinal flora and glucose and lipid metabolism in patients with T2DM.