益生菌对2型糖尿病患者肠道菌群及胰岛素敏感性的影响  

The effect of probiotics on the intestinal flora and insulin sensitivity of type 2 diabetic patients

作　　者：乐忠宏[1] 崔婷婷[1] 王朏朏 王小春[1] 赵晓光[1] LE Zhonghong;CUI Tingting;WANG Feifei(Department of Endocrinology,People’s Hospital of Jiaozuo City,Jiaozuo 454002,China)

机构地区：[1]焦作市人民医院内分泌科,454002

出　　处：《中国糖尿病杂志》2022年第7期491-495,共5页Chinese Journal of Diabetes

摘　　要：目的 探讨益生菌对T2DM患者肠道菌群及IS的影响。方法 选取2019年1月至2021年2月于焦作市人民医院内分泌科首次就诊的T2DM患者125例,随机分为益生菌组(Pro,n=80)及对照组(Con,n=45)。Pro组在服用二甲双胍降糖的基础上联合双歧杆菌四联活菌片治疗,若血糖控制不达标则加用那格列奈。Con组服用二甲双胍,若血糖控制不达标则加用那格列奈。比较两组临床资料、血糖控制情况、Matsuda指数变化、肠道主要菌群数目变化、血糖达标率和不良反应率。Pearson相关分析治疗后Matsuda指数与肠道主要菌群数目的相关性。结果 与Con组比较,Pro组治疗后FPG和HbA1c降低,FIns和Matsuda指数升高(P<0.05),大肠埃希菌和脆弱拟杆菌水平降低,乳酸杆菌、双歧杆菌和柔嫩梭菌水平升高(P<0.05)。Pro组治疗后血糖达标率高于Con组(P<0.05)。Pearson相关分析显示,Pro组治疗后Matsuda指数与粪肠球菌、乳酸杆菌、双歧杆菌和柔嫩梭菌数目呈正相关(P<0.05),与大肠埃希菌和脆弱拟杆菌数目呈负相关(P<0.05)。Pro组治疗期间总不良反应率低于Con组(P<0.05)。结论 添加益生菌治疗T2DM可升高IS并改善肠道菌群,有利于血糖控制,不增加治疗期不良反应率。Objective To investigate the effect of probiotics on the intestinal flora and insulin sensitivity(IS)index of patients with T2DM.Methods A total of 125 patients with T2DM were selected from January 2019 to February 2021,and randomly divided into probiotic group(Pro,n=80)and control group(Con,n=45). On the basis of taking Metformin,patients in Pro group were treated with Bifidobacterium quadruple viable bacteria tablets. If the blood glucose control did not reach the target,Nateglinide was added in both Con group and Pro group. The clinical data,blood sugar control status,changes in Matsuda index and in the number of main intestinal flora,and adverse reaction rates were compared between the two groups.The correlation between Matsuda index and the number of main intestinal flora after treatment was analyzed.Results Compared with Con group,FPG and HbA1c decreasedin Pro group,FIns and Matsuda indices increased(P<0. 05),the abundance of Escherichia coli and Bacteroides fragilis decreased,and the abundance of Lactobacillus,Bifidobacterium and Clostridium fragilis increased.(P<0. 05). The rate of reaching glucose target in Pro group was higher than that in Con group(P<0. 05). Pearson correlation analysis showed that Matsuda index was positively correlated with the number of Enterococcus faecalis,Lactobacillus,Bifidobacterium and Clostridium tenuiflorain Pro group(P<0. 05),and was negatively correlated with the number of Escherichia coli and Bacteroides fragilis(P<0. 05). The total rateof adverse reaction in Pro group was lower than that in Con group(P<0. 05).Conclusion Supplementation of probiotics in T2DM patients can improve IS and intestinal flora,which is not only beneficial to blood sugar control,but also reduces the incidence of adverse reactions.

关 键 词：糖尿病 2型 益生菌 肠道菌群 胰岛素敏感性 

分 类 号：R587.1[医药卫生—内分泌]