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  

Intervention Study of Tonifying Qi and Strengthening Spleen Method on Intestinal Flora in Patients with Type 2 Diabetes

作　　者：刘小溪[1] 李小娟[1] 石岩[2] 王莉[1] 

机构地区：[1]辽宁中医药大学附属医院内分泌康复科,辽宁沈阳110032 [2]辽宁中医药大学,辽宁沈阳110032

出　　处：《辽宁中医杂志》2017年第11期2311-2313,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家科技支撑计划项目课题(2014BAI10B04)

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(P<0.05),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(P<0.05),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(P<0.05)。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。Objective： This aim was to investigate the effect of tonifying Qi and strengthening spleen method on intestinal flora and lipid metabolism in patients with type 2 diabetes. Methods： A total of 95 patients with type 2 diabetes from March 2012 to May2016 in the hospital were selected. Patients were randomly divided into control group（ n = 47） and observation group（ n = 48）.Forty healthy people at the same period in our hospital were selected as control group. Patients were given conventional basic therapy combined with metformin 250 mg/time,3 times/d,while patients in the observation group were treated with Tonifying Qi and Strengthening Spleen Decoction,a preparation/d. The clinical efficacy after two months treatment was compared. Genomic DNA was extracted from fecal bacteria. The symptom scores,blood lipids,blood glucose,insulin levels and intestinal flora were observed before and after treatment. Results： The total effective rate in observation group was significantly higher than that in control group（ P〈0. 05）. After treatment,the symptom score,blood lipids,blood glucose and insulin levels（ fasting insulin and insulin resistance index） had significantly improved. The volume of Bacteroides,Lactobacillus,Bifidobacterium genus increased,while Enterococcus,Escherichia coli,yeast reduced（ P〈0. 05）. The difference on symptom score,blood lipids,blood glucose,insulin levels（ fasting insulin and insulin resistance index） and the number of intestinal flora in observation group and control group was statistically significant（ P〈0. 05）. Conclusion： The results show that Tonifying Qi and Strengthening Spleen Decoction can improve intestinal flora,blood glucose and lipid metabolism in patients with type 2 diabetes,which helps to improve prognosis in patients.

关 键 词：2型糖尿病 肠道菌群 脂质代谢 

分 类 号：R587.1[医药卫生—内分泌]