肠道益生菌联合曲美布汀治疗糖尿病胃肠神经功能紊乱疗效观察.docVIP

精品论文 参考文献 肠道益生菌联合曲美布汀治疗糖尿病胃肠神经功能紊乱疗效观察 史胜奇 黄艳妮 　　（陕西省周至县人民医院内分泌科 陕西 西安 710400） 　　【摘要】 目的：观察肠道益生菌对糖尿病胃肠神经功能紊乱的临床疗效。方法：糖尿病胃肠神经功能紊乱者96例分为治疗组和对照组，分别给予口服叶酸片、维生素B12片、肠道益生菌1g/次 3次/日、曲美布汀片0.1g/次 3次/日（治疗组），口服叶酸片、维生素B12片（对照组），同时给予控制血糖。结果：肠道益生菌治疗糖尿病胃肠神经功能紊乱疗效差异显著。肠道益生菌联合曲美布汀片能明显改善症状，对胃肠道有效率，饱胀为75%、恶心、呕吐为80%、便秘为100%、顽固性呃逆为66.7%、腹胀便秘交替为88.89%。对照组症状改善效果明显较治疗组差。结论：肠道益生菌联合曲美布汀能明显改善糖尿病胃肠神经功能紊乱。 　　【关键词】 糖尿病；胃肠神经功能紊乱；肠道益生菌；曲美布汀 　　【中图分类号】R453 【文献标识码】A 【文章编号】2095-1752（2015）20-0379-02 　　【Abstract】Objective To observe the intestinal probiotics in clinical curative effect of diabetes gastrointestinal nerve dysfunction. Method 96 cases with diabetes gastrointestinal neurologic disorders were divided into treatment group and control group, were given oral folic acid, vitamin B12, intestinal probiotics 1 g/three times/day, trimebutine piece of 0.1 g/three times/day (treatment group), oral folic acid and vitamin B12 pills (control group), at the same time to control blood sugar. Results The intestinal probiotics have significant curative effect on diabetes gastrointestinal nerve dysfunction. Joint trimebutine intestinal probiotics can significantly improve symptoms, for efficient, gastrointestinal tract full bilge is 75% 80%, nausea, vomiting, constipation is 100%, intractable hiccups alternating (66.7%), abdominal distension constipation was 88.89%. The control group symptoms improved effect is obvious difference in the treatment group. Conclusion The intestinal probiotics joint trimebutine can obviously improve diabetes gastrointestinal nerve dysfunction. 　　糖尿病胃肠神经功能紊乱是糖尿病慢性并发症常见并发症之一，糖尿病诊断10年内常有明显的临床糖尿病神经病变的发生，其发生风险与糖尿病的病程、血糖控制差相关，神经功能检查发现60%～90%的病人有不同程度的胃肠神经病变[1]。 　　糖尿病胃肠神经功能紊乱发病机制：（1）动力异常：糖尿病患者有50%～70%患者有胃排空延缓。糖尿病胃轻瘫的胃底动力减弱、食物从近端向远端输送延缓，大量食物停留于近端、胃窦充盈减慢，排空延迟；（2）自主神经病变：资料证明糖尿病胃轻瘫患者迷走神经有明显结构异常，神经轴突脱髓鞘样改变、轴索萎缩、神经传导速度速度下降；（3）肠神经系统病变：肠神经内的胆碱能、多巴胺、去甲肾上腺素能、5-羟色胺能等构成调控胃肠运动的神经功能网，糖尿病引起肌间神经丛损害，破坏胃的顺应性舒张；（4）糖尿病改变胃肠激素如胃动素、胰多肽、生长抑素、胰高血糖素、胃泌素分泌，这些激素继发改变可导致交