益气补脾法配合二甲双胍干预脾虚证2型糖尿病患者肠道菌群的临床研究

发布时间：2019-02-15 21:14

【摘要】：目的:探讨益气补脾法对脾虚证2型糖尿病患者肠道菌群及脂质代谢的影响。方法:选取2014年5月—2016年5月辽宁中医药大学附属医院内分泌K科收治的95例脾虚证2型糖尿病患者为研究对象,按随机数字表法将所有患者随机分为对照组(n=47)和观察组(n=48),选取40例本院同期体检健康者作为健康对照,对照组患者均给予常规基础治疗+二甲双胍片250 mg/次,3次/d,观察组加用降糖丸,1袋3次/d冲服,治疗前后提取粪便菌群基因组DNA,通过构建粪便菌群的细菌通用16S rRNA基因克隆文库分析患者肠道菌群变化,治疗2个月,观察患者治疗前后中医证候积分,血脂、血糖、胰岛素水平及肠道菌群变化。结果:观察组的证候疗效总有效率明显高于对照组(P0.05),治疗后两组中医证候积分、血脂、血糖及胰岛素指标(空腹胰岛素、胰岛素抵抗指数)有明显改善,肠道菌群中拟杆菌属、乳酸杆菌属、双歧杆菌属数量升高,肠球菌属、肠杆菌、酵母菌数量降低(P0.05),治疗后中医证候积分、血脂、血糖、胰岛素指标(空腹胰岛素、胰岛素抵抗指数)及肠道菌群数量观察组与对照组比较差异有统计学意义(P0.05)。结论:益气补脾法可有效改善脾虚证2型糖尿病患者肠道菌群失调,血糖、血脂代谢紊乱,有助于改善患者预后情况。
[Abstract]:Objective: to study the effect of invigorating qi and invigorating spleen on intestinal flora and lipid metabolism in type 2 diabetes mellitus with spleen deficiency syndrome. Methods: from May 2014 to May 2016, 95 patients with type 2 diabetes mellitus with spleen deficiency syndrome were selected from Department of Endocrine K, affiliated Hospital of Liaoning University of traditional Chinese Medicine, as the study objects. All the patients were randomly divided into two groups: control group (n = 47) and observation group (n = 48). 40 healthy persons in the same period were selected as healthy control group. All patients in control group were treated with metformin tablets for 250 mg/. Three times a day, the observation group was treated with Jiangtang pills, a bag and three times a day. The genomic DNA, of fecal flora was extracted before and after treatment. The bacterial 16s rRNA gene clone library of fecal flora was constructed to analyze the changes of intestinal flora of patients, and the patients were treated for 2 months. To observe the changes of TCM syndrome score, blood lipid, blood glucose, insulin level and intestinal flora before and after treatment. Results: the total effective rate of syndrome in the observation group was significantly higher than that in the control group (P0.05). After treatment, the TCM syndromes integral, blood lipid, blood glucose and insulin index (fasting insulin, insulin resistance index) were significantly improved in the two groups. Intestinal flora of Bacteroides, Lactobacillus, Bifidobacterium increased, Enterococcus, Enterobacter, yeast decreased (P0.05). After treatment, TCM syndrome score, blood lipid, blood glucose, insulin index (fasting insulin), Insulin resistance index (IR) and the number of intestinal flora in the observation group compared with the control group were significantly different (P0.05). Conclusion: the method of invigorating qi and invigorating spleen can effectively improve the intestinal flora disorder, blood sugar and lipid metabolism disorder in type 2 diabetes mellitus with spleen deficiency syndrome, and it is helpful to improve the prognosis of the patients.
【作者单位】：辽宁中医药大学附属医院内分泌康复科;辽宁中医药大学;
【基金】：国家科技支撑计划项目课题(2014BAI10B04)
【分类号】：R587.1

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