润魄汤联合双歧杆菌对老年糖尿病性便秘患者肠道微生态的影响

Effects of Runpo Decoction Combined with Bifidobacterium on Intestinal Microecology in Elderly Patients with Diabetic Constipation

目的 探讨润魄汤联合双歧杆菌对老年糖尿病性便秘患者肠道微生态的影响。方法 选取2021年1月—2022年10月收治的老年糖尿病性便秘100例,按治疗方法不同将其分为观察组和对照组2组各50例。观察组给予润魄汤联合双歧杆菌治疗,对照组给予双歧杆菌治疗。比较2组治疗2周后临床效果,治疗前和治疗2周后中医证候积分、肠道微生态[双歧杆菌、乳酸菌、肠杆菌、二胺氧化酶(DAO)、D-乳酸、尿乳果糖/甘露醇(L/M)]、外周血单个核细胞PI3K/Akt信号通路相关蛋白,以及治疗期间不良反应、停药4周后复发率。结果 观察组有49例,对照组有48例完成研究。治疗2周后,观察组总有效率91.84%(45/49)高于对照组75.00%(36/48)(P<0.05)。治疗2周后,2组排便难度、排便间隔、大便性状、排便不尽感积分,肠杆菌、DAO、D-乳酸、L/M及外周血单个核细胞PI3K、Akt蛋白均低于治疗前,且观察组低于对照组;2组乳酸杆菌、双歧杆菌均高于治疗前,且观察组高于对照组(P<0.01)。治疗期间2组不良反应总发生率及停药4周后2组复发率比较差异无统计学意义(P>0.05)。结论 润魄汤联合双歧杆菌治疗老年糖尿病性便秘患者效果显著,可改善临床症状,调节肠道微生态,且安全性较高,分析原因可能与调节PI3K/Akt信号通路有关。

Objective To investigate the effects of Runpo Decoction combined with Bifidobacterium on intestinal microecology in elderly patients with diabetic constipation.Methods A total of 100 elderly patients with diabetic constipation treated from January 2021 to October 2022 were selected and divided into observation group(n=50)and control group(n=50)according to different treatment methods.The observation group was treated with Runpo Decoction combined with Bifidobacterium,and the control group was treated with Bifidobacterium.The clinical effects at 2 weeks after treatment,TCM syndrome scores,intestinal microecology[bifidobacteria,lactic acid bacteria,Enterobacter,diamine oxidase(DAO),D-lactic acid,urinary lactulose-mannitol ratio(L/M)]and PI3K/Akt signaling pathway related proteins of peripheral blood mononuclear cells before and at 2 weeks after treatment,adverse reactions during treatment and recurrence at 4 weeks after drug discontinuation were compared between the two groups.Results Finally,49 cases in the observation group and 48 cases in the control group completed the study.At 2 weeks after treatment,the total effective rate of the observation group was 91.84%(45/49),which was higher than that of the control group[75.00%(36/48)](P<0.05).At 2 weeks after treatment,difficulty in defecation,defecation interval,stool characteristics,incomplete defecation score,enterobacter,DAO,D-lactic acid,L/M,PI3K and Akt protein of peripheral blood mononuclear cells in the two groups were lower than those before treatment,and lower in the observation group than in the control group.Lactobacillus and Bifidobacterium in the two groups were higher than those before treatment,and higher in the observation group than in the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups during treatment and the recurrence rate at 4 weeks after drug withdrawal(P>0.05).Conclusion Runpo Decoction combined with Bifidobacterium has a significant effect in the treatment of elderly patients with diabetic constipation,which can improve clinical symptoms and regulate intestinal microecology,with good safety.This may be related to the regulation of PI3K/Akt signaling pathway.