参苓白术散结合双歧杆菌四联活菌片对肥胖症患者代谢状况和脂肪因子及肠道菌群平衡影响的前瞻性研究

通过前瞻性研究探讨参苓白术散联合双歧杆菌四联活菌片对肥胖症患者代谢状况、脂肪因子及肠道菌群平衡的影响, 为临床干预方案的制定提供参考。

选取2018年10月至2020年10月我院112例肥胖症患者行前瞻性研究, 应用随机数字表法分为观察组(n=56)和对照组(n=56)。对照组患者予以饮食、运动等常规干预, 观察组患者在对照组基础上予以参苓白术散联合双歧杆菌四联活菌片治疗。两组患者均干预3个月。比较两组患者临床疗效、干预前和干预3个月后肥胖相关指标[体质量、体质量指数(BMI)、体脂百分率、肥胖度]、糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、脂肪因子[脂联素(APN)、抵抗素(resistin)、瘦素(LP)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)]水平和肠道菌群(双歧杆菌、乳杆菌、拟杆菌、肠杆菌、肠球菌)数量。

(1) 干预3个月后, 观察组患者总有效率为85.71%(48/56), 高于对照组的69.64%(39/56), 而体质量、BMI、体脂百分率、肥胖度水平均低于对照组(均P < 0.05)。(2)与干预前比较, 干预3个月后两组患者FBG、FINS、TC、TG、LDL-C、HDL-C水平均降低, 同时观察组低于对照组(均P < 0.05)。(3)干预3个月后, 两组患者血清APN水平高于干预前, resistin、LP水平低于干预前, 同时观察组均优于对照组(均P < 0.05)。(4)与干预前比较, 干预3个月后两组患者血清TNF-α、IL-6、IL-1β水平均呈降低趋势, 同时观察组降低幅度大于对照组(均P < 0.05)。(5)观察组患者干预3个月后肠道双歧杆菌、乳杆菌、拟杆菌数量均高于对照组, 而肠杆菌、肠球菌数量均低于对照组(均P < 0.05)。

参苓白术散、双歧杆菌四联活菌片联合干预方案在肥胖症患者中的应用效果理想, 可有效控制肥胖, 促进患者体质量降低, 同时对机体糖脂代谢、脂肪因子、炎症因子水平及肠道菌群均有良好调节作用, 临床应用价值较高。

Effects of Shenling-baizhu powder combined with Bifidobacterium Quadruple Viable Tablets on the metabolic status,adipokines and intestinal flora balance in obese patients: a prospective study

ObjectiveTo explore the effects of Shenling-baizhu Powder combined with Bifidobacterium Quadruple Viable Tablets on the metabolic status, adipokines and intestinal flora balance of obese patients through prospective research, and provide references for the formulation of clinical intervention.MethodsA total of 112 obese patients in our hospital from October 2018 to October 2020 were divided into observation group(n=56) or control group(n=56) randomly. The control group received conventional interventions such as diet and exercise, while the observation group was additionally treated with Shenling-aizhu powder combined with Bifidobacterium Quadruple Viable Tablets. The intervention lasted for 3 months. The clinical efficacy, related indicators of obesity [body mass, body mass index(BMI), body fat percentage, obesity], glucose and lipid metabolism indicators [fasting blood glucose(FBG), fasting insulin(FINS), total cholesterol(TC), triacylglycerol(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C)], fat factor [adiponectin(APN), resistance(resistin), leptin(LP)], inflammatory factors [tumor necrosis factor-α(TNF-α), levels of interleukin-6(IL-6) and interleukin-1β(IL-1β)] and the counts of intestinal flora(Bifidobacterium, Lactobacillus, Bacteroides, Enterobacter, Enterococcus) were compared between groups.Results(1) After 3 months of intervention, the total efficiency rate in the observation group was 85.71%(48/56), higher than the 69.64%(39/56) in the control group; body mass, BMI, body fat percentage and the level of obesity were lower than in the control group(P < 0.05).(2) The levels of FBG, FINS, TC, TG, LDL-C and HDL-C in the two groups were lower after 3 months of intervention, and those in the observation group were lower than in the control group(all P < 0.05).(3) After 3 months of intervention, the serum APN levels in the two groups were higher, while those of resistin and LP were lower than before the intervention, respectively; the observation group was superior to the control group(all P < 0.05).(4) The serum levels of TNF-α, IL-6, and IL-1β in the two groups showed a decreasing trend after 3 months of intervention, and those in the observation group decreased more(all P < 0.05).(5) The counts of Bifidobacterium, Lactobacillus and Bacteroides in the observation group were higher, while those of Enterobacter and Enterococcus were lower than those in the control group after 3 months of intervention, respectively(all P < 0.05).ConclusionThe intervention of Shenling-baizhu powder combined with Bifidobacterium Quadruple Viable Tablets has an ideal effect in obese patients. It can effectively control obesity, promote the loss of body mass in patients, has a good regulatory effect on the body′s glucose and lipid metabolism, adipokines, inflammatory factor expression and intestinal flora, and has high clinical application value.