Clinical Study Of Probiotics In Adjuvant Treatment Of Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease

BackgroundBoth type 2 diabetes mellitus(T2DM)and non-alcoholic fatty liver disease(NAFLD)are frequent clinical diseases.The two diseases have the characteristics of mutual promotion,and their co-occurrence will seriously affect the prognosis of patients.At present,the main clinical treatments for T2 DM and NAFLD are diet adjustment,weight control,glucose reduction and liver protection,but their clinical efficacy is limited.Intestinal microbiota refers to the sum of a large number of microorganisms living in the human gut.At present,more and more clinical evidence has shown that intestinal microbiota disorder is closely related to the occurrence and progression of a variety of diseases.The regulation of intestinal flora has also become a new target for the treatment of many diseases.ObjectiveTo observe the clinical efficacy of probiotics in the adjuvant treatment of T2 DM complicated with NAFLD.MethodsA total of 90 T2 DM patients with NAFLD who were admitted to the Taikang County People’s Hospital from September 2021 to November 2021 were selected as the study subjects.They were divided into control group(n=45)and observation group(n=45)by random number table method.Routine treatment including diet adjustment,weight control,Polyene phosphatidylcholine(456mg/time,3 times/day),Metformin(0.5g/time,twice a day),Glimepiride tablet(2mg/time,once a day)were given to the control group.The observation group was additionally given probiotics preparation,bifidobacteria lactobacillus triplex live bacteria tablets: 2.0g/ time,twice a day,on the basis of diet,exercise intervention and routine hypoglycemic and liver protection treatment in the control group.Both groups were treated for 6 months.(1)Abdominal ultrasonography was performed in both groups before and after treatment to evaluate the degree of fatty liver disease.(2)Blood glucose levels: Fasting blood glucose(FPG),2h postprandial blood glucose(2h PG)and glycosylated hemoglobin(Hb A1c)levels were compared between the two groups before and after treatment.(3)Islet function: insulin resistance index(HOMA-IR)and islet β cell function index(HOMA-β)were compared between the two groups before and after treatment.(4)Blood lipid levels: The levels of triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL-C)were compared between the two groups before and after treatment.(5)Liver function the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutyltranspeptidase(GGT)and alkaline phosphatase(ALP)were compared between the two groups before and after treatment.(6)Inflammatory factors: The levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)were compared between the two groups before and after treatment.(7)Oxidative stress response: The levels of superoxide dismutase(SOD)and malondialdehyde(MDA)were compared between the two groups before and after treatment.(8)Total effective rate of T2 DM and NAFLD in the two groups was calculated.(9)The incidence of adverse reactions in the two groups was calculated.Results(1)After treatment,the degree of fatty liver disease in both groups was significantly improved,and the improvement of fatty liver disease was better than that in the control group(P<0.05).(2)Compared with before treatment,the levels of FPG,2h PG and Hb A1 c in the two groups were significantly decreased after treatment(P<0.05).After treatment,the levels of FPG,2h PG and Hb A1 c in observation group were significantly lower than those in control group(P<0.05).(3)Compared with before treatment,HOMA-β were increased in both groups,while HOMA-IR level was decreased in the control group.After treatment,the levels of HOMA-β in observation group were higher than those in control group,while the levels of HOMA-IR were lower than those in control group(P<0.05).(4)Compared with before treatment,the levels of TG,TC and LDL-C in the two groups were significantly decreased after treatment(P<0.05).After treatment,the levels of TG,TC and LDL-C in observation group were significantly lower than those in control group(P<0.05).(5)Compared with before treatment,the levels of ALT,AST,GGT and ALP in the two groups were significantly decreased after treatment(P<0.05).After treatment,the levels of ALT,AST,GGT and ALP in observation group were significantly lower than those in control group(P<0.05).(6)Compared with before treatment,the levels of TNF-α,CRP and IL-6 in the two groups were significantly decreased after treatment(P<0.05).After treatment,the levels of TNF-α,CRP and IL-6 in observation group were significantly lower than those in control group(P<0.05).(7)Compared with before treatment,SOD level in both groups increased,while MDA level decreased(P<0.05).After treatment,SOD level in observation group was higher than control group,while MDA level was lower than control group(P<0.05).(8)Total effective rate of T2 DM and NAFLD treatment in observation group(93.02%;90.70%)were significantly higher than those in the control group(75.61%;73.17%),significant difference(P<0.05).(9)The incidence of adverse reactions in the two groups(4.88%;4.65%)there was no difference between groups(P>0.05).ConclusionBifidobacteria lactobacillus triplex viable tablets can inhibit the body’s inflammatory reaction and peroxidation reaction by regulating intestinal flora,reduce the body’s IR and high blood lipid levels,and finally achieve the purpose of stabilizing blood glucose and repairing liver injury.