■观察两歧双歧杆菌片和金桂任气丸对糖尿病肾病患者肠道菌群和代谢的影响。
■在2021年3月至2022年12月在长治医学院和平医院进行的研究中,精心选择了30例诊断为糖尿病肾病的患者作为研究对象。采用双盲随机表法,这些患者被随机分为三组:对照组(n=10),双歧杆菌四角片组(n=10),金桂人气丸组(n=10)。对照组采用西医治疗糖尿病肾病,包括血清葡萄糖,血脂,血压管理,和其他常规疗法。除了标准治疗,双歧杆菌四角双歧杆菌片组接受双歧杆菌四角双歧杆菌片,而金桂人气丸组接受了金桂人气丸。在4周的治疗期之前和之后,评估了各种基线参数,包括空腹血糖,餐后2小时血糖,甘油三酯,血清总胆固醇,血清低密度脂蛋白胆固醇,血清高密度脂蛋白胆固醇,随机尿微量白蛋白/肌酐比值(ACR),血肌酐(SCr),和中医证据评分。治疗前后收集3组粪便标本进行16SrDNA高通量测序,其次是全面的分析,包括OUT聚类,阿尔法多样性,β多样性,物种组成分析,LEfSe分析,和KEGG函数预测。采用Spearman相关分析探讨肠道菌群与临床指标的关系。此外,双歧杆菌片组及对照组干预前后空腹外周静脉血测定肿瘤坏死因子-α(TNF-α)的光密度值,白细胞介素-2(IL-2),和白细胞介素-6(IL-6)使用北京BioliteELISA试剂盒。本研究经长治医学院伦理委员会批准。
■1.2hPBG,在所有组的糖尿病肾病(DKD)患者中观察到总胆固醇和LDL水平:金桂人芪丸组,双歧杆菌四角草片组,对照组(p<0.05)。2.与两歧双歧杆菌片组和对照组相比,金桂任气丸在缓解中医症状和降低ACR方面均表现出优异的疗效。相反,与金桂仁气丸和对照组相比,双歧杆菌片的TC水平降低更为明显。值得注意的是,两歧双歧杆菌片可有效降低DKD患者的IL-2水平。3.双歧杆菌四角双歧杆菌片剂也显示出降低DKD患者IL-2水平的功效。4.干预前后肠道微生物丰度和多样性分析,在这三个群体中,没有发现明显的改变。同样,ACE的比较,Chao,辛普森,与Shannon指数比较差异无统计学意义(p>0.05)。5.干预前后肠道微生物的定性分析,在这三个群体中,表明没有显著差异。Anosim测试结果也没有揭示定性差异(Anosim测试R=0.021,p=0.215)。6.LEfSe分析显示,干预后金桂人气丸组的Prevotella_7丰度显着增加(p<0.05)。7.此外,中医证据评分,身体质量指数,TC,LDL水平与Tyzzerella_3细菌菌群的相对丰度呈正相关。相反,年龄,疾病持续时间,2hPBG与Christensellaceae_R_7植物区系的相对丰度呈正相关,而TC和LDL水平与Christenellaceae_R_7菌群的相对丰度呈负相关。
■与单纯西药治疗相比,金桂仁气丸联合西药治疗在改善DKD患者临床症状和降低ACR方面具有优异的疗效。此外,这种联合疗法导致患者肠道菌群中Prevotella_7的丰度增加,表明肠道微生物群可能增强碳水化合物的代谢。另一方面,与单纯西药治疗相比,双歧杆菌双歧杆菌片细菌片联合西药治疗在降低DKD患者TC水平方面具有增强的疗效。此外,这种联合治疗有效降低了DKD患者的IL-2水平,从而减轻这些个体的炎症。
UNASSIGNED: To investigate the effects of Bifidobacterium bifidum tetragonum tablets and Jin Gui Ren Qi Pill on intestinal flora and metabolism in patients with diabetic kidney disease.
UNASSIGNED: In the study conducted at Heping Hospital of Changzhi Medical College from March 2021 to December 2022, 30 cases of patients diagnosed with diabetic nephropathy were meticulously selected as study subjects. Employing a double-blind randomized table method, these patients were randomly allocated into three groups: the control group (n = 10), the Bifidobacterium bifidum tetragonum tablets group (n = 10), and the Jin Gui Ren Qi Pill group (n = 10). The control group received standard western medical treatments for diabetic nephropathy, including serum glucose, blood lipids, blood pressure management, and other conventional therapies. In addition to the standard treatments, the Bifidobacterium bifidum tetragonum tablets group received Bifidobacterium bifidum tetragonum tablets, while the Jin Gui Ren Qi Pill group received Jin Gui Ren Qi Pill. Before and after a 4-week treatment period, various baseline parameters were assessed, including fasting blood glucose, 2-h postprandial blood glucose, triglycerides, serum total cholesterol, serum low-density lipoprotein cholesterol, serum high-density lipoprotein cholesterol, random urine microalbumin/creatinine ratio (ACR), blood creatinine (SCr), and traditional Chinese medicine evidence scores. Stool specimens were collected from all three groups before and after treatment for 16S rDNA high-throughput sequencing, followed by comprehensive analyses including OUT clustering, Alpha diversity, Beta diversity, species composition analysis, LEfSe analysis, and KEGG function prediction. Spearman correlation analysis was employed to explore the relationship between intestinal flora and clinical indicators. Furthermore, fasting peripheral venous blood was collected from patients in the Bifidobacterium tetrapunctate tablets group and the control group before and after intervention to measure the optical density values of tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), and interleukin-6 (IL-6) using the Beijing Biolite ELISA kit. This study was conducted with the approval of the Ethics Committee of Changzhi Medical College.
UNASSIGNED: 1. The 2hPBG, total cholesterol and LDL levels were observed among patients with diabetic kidney disease (DKD) across all groups: the Jin Gui Ren Qi Pill group, the Bifidobacterium bifidum tetragonum tablets group, and the control group (p < 0.05). 2. The Jin Gui Ren Qi Pill demonstrated superior efficacy in alleviating TCM symptoms and reducing the ACR compared to both the Bifidobacterium bifidum tetragonum tablets group and the control group. Conversely, Bifidobacterium bifidum tetragonum tablets exhibited a more pronounced reduction in TC levels compared to both the Jin Gui Ren Qi Pill and control groups. Notably, Bifidobacterium bifidum tetragonum tablets effectively decreased (IL-2) levels in patients with DKD. 3. Bifidobacterium bifidum tetragonum tablets also demonstrated efficacy in reducing IL-2 levels in DKD patients. 4. Analysis of intestinal microorganism abundance and diversity before and after the intervention, as well as among the three groups, revealed no significant alterations. Similarly, comparisons of ACE, Chao, Simpson, and Shannon indices showed no statistically significant differences (p > 0.05). 5. Qualitative analysis of intestinal microorganisms before and after intervention, as well as among the three groups, indicated no significant differences. Anosim test results also did not reveal qualitative distinctions (Anosim test R = 0.021, p = 0.215). 6. LEfSe analysis unveiled a noteworthy increase in Prevotella_7 abundance within the Jin Gui Ren Qi Pill group post-intervention (p < 0.05). 7. Furthermore, Chinese medicine evidence scores, body mass index, TC, and LDL levels correlated positively with the relative abundance of Tyzzerella_3 bacterial flora. Conversely, age, disease duration, and 2hPBG correlated positively with the relative abundance of Christensenellaceae_R_7 flora, while TC and LDL levels displayed a negative correlation with the relative abundance of Christensenellaceae_R_7 flora.
UNASSIGNED: The combination of Jin Gui Ren Qi Pill with western medical treatment exhibited superior efficacy in ameliorating clinical symptoms and reducing the ACR in patients with DKD compared to western medical treatment alone. Furthermore, this combination therapy led to an increase in the abundance of Prevotella_7 within the intestinal flora of patients, suggesting a potential enhancement in carbohydrate metabolism by the intestinal microbiota. On the other hand, Bifidobacterium bifidum tetragonum tablets bacterial tablets combined with western medical treatment demonstrated enhanced efficacy in reducing TC levels in DKD patients compared to western medical treatment alone. Additionally, this combination therapy effectively reduced the levels of IL-2 in DKD patients, thus mitigating inflammation in these individuals.