双歧杆菌四联活菌片联合莫沙必利对糖尿病胃轻瘫患者肠道菌群及脑肠肽的调节

目的 探讨双歧杆菌四联活菌片联合莫沙必利对糖尿病胃轻瘫（DGP）患者肠道菌群及脑肠肽的调节作用。方法 选取2015年1月至2018年7月嘉兴市南湖区中心医院内科就诊的DGP患者94例，随机分为观察组和对照组各47例。两组患者均予饮食调整、适当运动和药物控制血糖等常规治疗。对照组患者在此基础上加用莫沙必利片5 mg/次，3次/d，饭前30 min口服。观察组患者在对照组基础上再加用双歧杆菌四联活菌片1.5 g/次，3次/d，温水送服。两组患者均连用6周。观察两组患者治疗前后肠道菌群[乳杆菌、双歧杆菌、肠球菌和肠杆菌]及血清脑肠肽[生长抑素（SS）和一氧化氮（NO）]的变化，并比较其临床疗效。结果 治疗6周后，两组患者肠道乳杆菌和双歧杆菌数量较治疗前明显上升，肠球菌和肠杆菌数量较治疗前明显下降（均P<0.05），且治疗后观察组患者肠道菌群变化幅度较对照组更大（均P<0.05）。治疗后两组患者血清SS及NO水平与治疗前比较差异均有统计学意义（均P<0.05），且观察组患者变化幅度较对照组更大（均P<0.05）。治疗后观察组患者临床总有效率（95.7%）明显高于对照组（83.0%），差异有统计学意义（χ2=4.03，P<0.05）。结论 双歧杆菌四联活菌片联合莫沙必利治疗DGP患者的效果优于单用莫沙必利治疗，不仅能调节患者肠道菌群紊乱，还能纠正脑肠肽水平异常。

Effect of Tetragenous Viable Bifidobacterium Tablets combined with Mosapride for adjustment of intestinal flora and brain-gut peptides in patients with diabetic gastric paralyze

Objective To discuss the effect of Tetragenous Viable Bifidobacterium Tablets combined with Mosapride for adjustment of intestinal flora and brain-gut peptides in patients with diabetic gastric paralyze (DGP). Methods A total of 94 patients with DGP who were given treatment from January 2015 to July 2018 were randomly divided into Observation group or Control group, 47 cases in each group. Both groups were given the same conventional medical treatment and 5 mg of Mosapride tid orally 30 minutes before meal, while the observation group were additionally given 1.5 g of Tetragenous Viable Bifidobacterium Tablets tid orally, for 6 weeks. The changes in intestinal flora (Lactobacilli, Bifidobacteria, Enterococci and Enterobacteriaceae) and serum brain-gut peptides [somatostatin (SS) and nitric oxide (NO)] of patients in both groups were observed before and after treatment, and the clinical efficacy was compared between groups. Results After treatment, the quantities of Lactobacilli and Bifidobacteria in both groups obviously rose, while those of Enterococci and Enterobacteriaceae obviously declined (all P<0.05), with the extents of increase and decrease in observation group much higher than in control group (all P<0.05). Compared with those before treatment, the levels of serum SS and NO in two groups were statistically different (all P<0.05), with the extents of changes in observation group much higher than those in control group (all P<0.05). The total clinical efficiency in observation group was much higher than that in control group (95.7% vs 83.0%, χ2=4.03, P<0.05). Conclusion Compared with Mosapride alone, Tetragenous Viable Bifidobacterium Tablets combined with Mosapride has more favorable curative effect on patients with DGP, which can not only adjust the disorder of intestinal flora, but also correct abnormal level of brain-gut peptides.