黄葵胶囊对糖尿病肾病肠道菌群的影响及机制研究  

Effect of Huangkui Capsule(黄葵胶囊)on Intestinal Flora in Patients with Diabetic Nephropathy and Its Mechanism

作　　者：沙琦 宗音[1] 赵艳[1] 冯悦华 杨敏[1] 汪心水[1] SHA Qi;ZONG Yin;ZHAO Yan;FENG Yuehua;YANG Min;WANG Xinshui(Changzhou First Peopled Hospital,Changzhou 213000,Jiangsu,China)

机构地区：[1]常州市第一人民医院,江苏常州213000

出　　处：《中华中医药学刊》2021年第4期196-199,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：江苏省卫生与计划生育委员会面上项目(KY2018105)。

摘　　要：目的探讨黄葵胶囊对糖尿病肾病患者肠道菌群的影响及作用机制。方法选取2017年5月—2019年5月医院收治的糖尿病肾病患者,共96例,作为本次的研究对象,随机分为对照组和试验组,各48例。对照组行使控制血压、血脂和血糖等常规治疗。试验组患者同样实施糖尿病肾病常规治疗,并且在此基础上联合黄葵胶囊治疗,患者在治疗前和治疗2个月后分别抽取空腹外周静脉血,检测空腹血糖(FBG),尿素氮(BUN)、24 h尿白蛋白清除率(24 h UAER),血肌酐(SCr)。采集并化验各组患者粪便,稀释样本涂片、革兰染色鉴定肠道菌群中革兰氏阳/阴性杆菌和革兰氏阳/阴性球菌的分布状况。采用实时荧光定量聚合酶链式反应(polymerase chain reaction,PCR)扩增重要菌群拟杆菌、双歧杆菌、柔嫩梭菌和乳杆菌的特异性片段,计算含量,分析患者在联合黄葵胶囊治疗后上述菌群的变化差异。结果治疗两个月后,与对照组相比试验组患者的FPG、BUN、24 h UAER、SCr、β2-MG等各项生化指标均显著性降低,差异具有统计学意义(P<0.05)。同时,黄葵胶囊治疗2个月后,试验组患者肠道内的革兰氏阳性和阴性杆菌均升高。与对照组相比,肠道内的4种重要的菌群拟杆菌、双歧杆菌、柔嫩梭菌和乳杆菌均发生显著改变,联合黄葵胶囊治疗的试验组患者中拟杆菌、双歧杆菌的含量较低,而柔嫩梭菌和乳杆菌相对升高。结论黄葵胶囊有助改善和调节糖尿病肾病患者血糖水平,影响肠道菌群的分布和亚群,为进一步研究黄葵通过肠道菌群评估糖尿病肾病患者发生、发展和治疗提供了一定的数据基础。Objective To investigate the effect and mechanism of Huangkui Capsule(黄葵胶囊)on intestinal flora in patients with diabetic nephropathy.Methods A total of 96 patients with diabetic nephropathy admitted to our hospital from May 2017 to May 2019 were selected as the subjects in this study.They were randomly divided into control group and test group with 48 cases in each.The control group were performed controlling blood pressure,blood lipid and blood glucose routine treatment.Patients in the test group also received routine treatment for diabetic nephropathy and combined Huangkui Capsule.Fasting peripheral venous blood was extracted before treatment and 2 months after treatment,respectively.We detected fasting blood glucose(FBG),blood urea nitrogen(BUN),24 h urine albumin clearance rate(24 hUAER)and serum creatinine(SCr).Feces of patients in each group were collected and analyzed,and the distribution of gram-positive/negative bacilli and gram-negative cocci in the intestinal flora were identified by diluted sample smear and gram staining.By using real-time quantitative polymerase chain reaction(PCR),the specific fragments of bacteroidetes,bifidobacterium,clostridium softener and lactobacillus were amplified,and the content was calculated to analyze the changes and differences of the above-mentioned bacteroidetes in patients.Results Two months after treatment,compared with those of the control group,the biochemical indexes(FPG,BUN,24 hUAER,SCr andβ2-MG)in the test group were significantly decreased(P<0.05).Meanwhile,after 2 months of treatment with Huangkui Capsule,both gram-positive and gram-negative bacteria in the intestinal tract of the test group were increased.Compared with the control group,the fiyr important bacterial groups in the intestinal tract,including bacteroidetes,bifidobacteria,clostridium softener and lactobacillus,all changed significantly.The contents of bacteroidetes and bifidobacteria in the test group treated with Huangkui Capsule were lower,while the contents of clostridium softener and

关 键 词：黄葵胶囊 糖尿病肾病 肠道菌群 肾功能 

分 类 号：R259.872[医药卫生—中西医结合]