肠道菌群:未来2型糖尿病治疗的新靶点  

Intestinal microbiota:a new target for treatment of type 2 diabetes in future

作　　者：梁磊 念馨[1] LIANG Lei;NIAN Xin(Depart-ment of Endocrinology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院内分泌一科,昆明650032

出　　处：《实用医学杂志》2022年第3期261-265,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金地区科学基金资助项目(编号:81660153);云南省卫生和计划生育委员会医学学科带头人培养计划资助项目(编号:D-2017041)。

摘　　要：随着饮食、运动、传统降糖药和减肥手术过程中肠道微生物区系改变的发现,肠道菌群与2型糖尿病(T2DM)的关联引起医学领域广泛的关注,肠道菌群也被证实与T2DM发生发展有着密切的关系。肠道菌群作用T2DM的治疗主要是通过调控肠道微生物区系,增加肠道产短链脂肪酸细菌的组成,通过影响胆汁酸代谢,降低肠道内毒素,增强肠道屏障功能,进而减轻全身炎症反应,改善T2DM的胰岛素抵抗。在此基础上,提出和证实了益生菌、益生元和粪菌移植等新型肠道菌群治疗方法在T2DM治疗中的作用。虽然肠道菌群被认为是未来T2DM治疗的新靶点,但目前这些新型的肠道菌群治疗方法应用于临床具有一定局限性,肠道菌群的复杂性、新型治疗方法循证医学和临床大数据的缺乏等问题都需要未来的进一步探索和研究。The discovery in intestinal microflora changes during treatment of type 2 diabetes mellitus(T2DM)by dietary therapy,exercise therapy,traditional hypoglycemic drugs and bariatric surgery has aroused the interest of medical world in the association between intestinal flora and T2DM.Meanwhile,the intestinal flora has also been proved to be closely related to the occurrence and development of T2DM.T2DM is treated by improving its insulin resistance,in mechanism,mainly through regulating intestinal microflora,increasing the composition of intestinal short-chain fatty acid-producing bacteria,reducing intestinal endotoxin and enhancing intestinal barrier function by affecting bile acid metabolism and then reducing systemic inflammatory response.On this basis,the role of probiotics,prebiotics and fecal bacteria transplantation in the treatment of T2DM has been proposed and confirmed.Although intestinal flora is considered as a new therapeutic target for T2DM in the future,the application of these new therapeutic approaches to intestinal flora has certain limitations in clinical application.The complexity of intestinal flora,evidence-based medicine of new therapeutic approaches and lack of clinical big data all require further exploration and research in the future.

关 键 词：2型糖尿病 肠道菌群 机制 临床应用 

分 类 号：R587.1[医药卫生—内分泌]