柴胡疏肝散联合莫沙必利对糖尿病胃轻瘫患者临床症状及肠道菌群丰度的影响

Impacts of Chaihu Shugan Powder combined with mosapride citrate on clinical symptoms and intestinal flora abundance in patients with diabetic gastroparesis

关键词:  柴胡疏肝散  莫沙必利  糖尿病胃轻瘫  临床疗效  肠道菌群丰度

Key words:  Chaihu Shugan Powder  mosapride  diabetic gastroparesis  clinical efficacy  gut microbiota abundance

摘要:

[目的] 探究柴胡疏肝散联合莫沙必利（MC）对糖尿病胃轻瘫（DGP）患者临床症状及肠道菌群丰度的影响。[方法] 选取2022年1月—2023年12月在医院就诊的DGP患者120例，随机将其分为西药组和中西结合组，每组各60例。西药组患者采用MC治疗，中西结合组采用柴胡疏肝散联合MC治疗。观察两组患者治疗后的临床疗效、中医证候积分、胃排空率、胃肠激素、血糖水平、炎症因子、肠道菌群丰度情况。[结果] 中西结合组治疗后总有效率为95.00%，显著高于西药组的80.00%（P＜0.05）。两组患者治疗后的食后饱胀、反酸嗳气、恶心呕吐、腹痛评分较治疗前显著降低，且中西结合组显著低于西药组（P＜0.05）。两组患者治疗后胃排空率、IL-10水平较治疗前显著提高，且中西结合组显著高于西药组（P＜0.05），白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、胃动素（MTL）、胃泌素（GAS）、空腹血糖和餐后2 h血糖水平显著下降，中西结合组显著低于西药组（P＜0.05）。两组患者治疗后的厚壁菌门、放线菌门、疣微菌门、变形菌门丰度较治疗前显著下降，中西结合组显著低于西药组（P＜0.05）。[结论] 柴胡疏肝散联合MC治疗DGP患者效果显著，能够缓解临床症状，提高临床效果，促进胃排空率，改善肠道激素、肠道菌群丰度和血糖水平，降低炎症反应。

Abstract:

[Objective] To explore the impacts of Chaihu Shugan Powder combined with mosapride citrate（MC） on clinical symptoms and intestinal flora abundance in patients with diabetic gastroparesis（DGP）. [Methods] From January 2022 to December 2023，the 120 DGP patients who visited hospital were separated into a Western medicine group and a combined group stochastically，with 60 patients in each group. The Western medicine group received MC treatment，while the combined group received Chaihu Shugan Powder combined with MC treatment. The efficacy，TCM syndrome scores，gastric emptying rate，gastrointestinal hormones，blood glucose levels，inflammatory factors，and abundance of gut microbiota in both groups were observed after treatment. [Results] The total effective rate of the combined group after treatment was 95.00%，which was obviously higher than the Western medicine group’s 80.00%（P＜0.05）. After treatment，the scores of postprandial fullness，acid reflux，nausea and vomiting，and abdominal pain in both groups were prominently reduced compared to before treatment，and the combined group was prominently lower than the Western medicine group（P＜0.05）. After treatment，the gastric emptying rate and IL-10 level in both groups obviously increased compared to before treatment，and the combined group was obviously higher than the Western medicine group（P＜0.05）. The levels of interleukin-6（IL-6），tumor necrosis factor-α（TNF-α），motilin（MTL），gastrin（GAS），fasting blood glucose，and 2-hour postprandial blood glucose in both groups obviously decreased，while the combined group was prominently lower than the Western medicine group（P＜0.05）. After treatment，the abundances of Firmicutes，Actinobacteria，Verrucomycota and Proteobacteria in both groups decreased prominently compared to before treatment，and the combined group was obviously lower than the Western medicine group（P＜0.05）. [Conclusion] The combination of Chaihu Shugan Powder and MC has a prominent effect on DGP patients，which can alleviate clinical symptoms，improve clinical efficacy，promote gastric emptying rate，improve intestinal hormones，gut microbiota abundance，and blood glucose levels，and reduce inflammatory reactions.