摘要
[目的]探讨调节肠道菌群微生态对老年糖尿病性肾病(DN)患者血糖水平和肾功能的影响.[方法]选取老年DN患者112例以随机数字表法按1:1比例分为观察组、对照组,各56例.对照组给予常规治疗,观察组在对照组基础上给予双歧三联活菌肠溶胶囊治疗.比较2组疗效、不良反应及治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1 c)、空腹胰岛素(FINS)]、肾功能指标[血肌酐(Scr)、尿素氮(BUN)、尿微量白蛋白(mAlb)、24 h尿蛋白定量(24 h PRO)]、血清炎症因子[白细胞介素(IL)-6、IL-1β、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)]、分泌型卷曲相关蛋白-4(SFRP-4)、骨形态发生蛋白-7(BMP-7)水平.[结果]观察组总有效率(91.07％)高于对照组(75.00％),2组比较P＜0.05;观察组治疗后FPG、2 h PG、HbA1 c、FINS低于对照组(P＜0.05);观察组治疗后Scr、BUN、mAlb、24 h PRO低于对照组(P＜0.05);观察组治疗后血清IL-6、IL-1β、TNF-α、hs-CRP水平低于对照组(P＜0.05);观察组治疗后血清SFRP-4水平低于对照组,血清BMP-7水平高于对照组(P＜0.05);2组不良反应发生率比较,差异无统计学意义(P＞0.05).[结论]老年DN患者采用双歧三联活菌肠溶胶囊调节肠道菌群微生态,可减轻机体炎症反应,调节血清SFRP-4、BMP-7表达,改善血糖水平和肾功能,药物安全性高.
Abstract
[Objective]To explore the effect of regulating the microecology of the intestinal flora on the blood glucose level and renal function in elderly patients with diabetic nephropathy(DN).[Methods]A pro-spective study was conducted on 112 elderly patients with DN were divided into an observation group and a control group at a ratio of 1:1 using a random number table method,with 56 cases in each group.The con-trol group was given conventional treatment,and the observation group was given bifid triple viable enteric-coated capsules on the basis of the control group.The efficacy,adverse reactions and blood glucose indexes before and after treatment were compared between the two groups[fasting blood glucose(FPG),2 h post-prandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1 c),fasting insulin(FINS)],renal function indexes(serum creatinine[Scr],urea nitrogen[BUN[,urine microalbumin[mAlb],24 h urine protein quan-tification[24 h PRO]),serum inflammatory factors(interleukin[IL]-6,IL-1β,tumor necrosis factor alpha[TNF]-α,high-sensitivity C-reactive protein[hs-CRP]),secreted frizzled-related protein-4(SFRP-4),bone morphogenetic protein-7(BMP-7)levels.[Results]The total effective rate of observation group was 91.07％higher than that of control group 75.00％(P＜0.05).FPG,2 h PG,HbA1 c,FINS after treatment in obser-vation group were lower than those of control group(P＜0.05).Scr,BUN,mAlb and 24 h PRO in observa-tion group after treatment were lower than those in the control group(P＜0.05);the serum levels of IL-6,IL-1β,TNF-α,and hs-CRP in the observation group after treatment were lower than those in the control group(P＜0.05).Serum levels of SFRP-4 in the observation group after treatment was lower than that of the control group,and the level of serum BMP-7 was higher than that of the control group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).[Conclusion]Elderly patients with DN adopt bifidus triple viable enteric-coated capsules can regulate the microecology of the intestinal flora,reduce the body's inflammatory response,regulate the expression of serum SFRP-4 and BMP-7,improve blood sugar levels and renal function,with significant ef-ficacy and safety high.
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