红霉素对糖尿病胃轻瘫患者胃动素胃泌素及肠道菌群的影响

目的 观察红霉素对糖尿病胃轻瘫(DGP)患者胃动素、胃泌素及肠道菌群的影响.方法 将2011年9月至2013年9月本院消化内科门诊及住院收治的78例DGP患者按随机法分为观察组和对照组,对照组患者给予莫沙必利片治疗,观察组患者给予红霉素胶囊治疗.比较两组患者的疗效、血浆胃动素(MTL)和血清胃泌素(GAS)水平及肠道菌群数量.结果 治疗后观察组患者总有效率显著高于对照组患者(x2=12.889,P＜0.05),而两组患者血浆胃动素和血清胃泌素水平显著下降(均P＜0.05),且观察组中血浆胃动素和血清胃泌素水平显著低于对照组,差异均有统计学意义(t=13.865、6.272,均P＜0.05);治疗前后两组患者肠道内大肠杆菌、肠球菌、双歧杆菌、乳酸杆菌数量比较差异均无统计学意义(t=1.540、1.093、1.790、1.946,均P＞0.05);而治疗后观察组中拟杆菌数量明显多于对照组,差异具有统计学意义(t=8.073,P＜0.05).结论 红霉素治疗糖尿病胃轻瘫临床效果显著,能降低胃动素、胃泌素的分泌,对患者肠道菌群影响较小,具有良好应用价值,值得临床推广使用.

Effect of erythromycin on motilin,gastrin, and intestinal flora in diabetic patients with gastroparesis

Objective To observe effect of erythromycin on motilin,gastrin,and intestinal flora in diabetic patients with gastroparesis.Methods 78 DGP outpatients and inpatients treated at the department of gastroenterology of our hospital from September,2011 to September,2013 were randomly divided into an observation group and a control group.The control group were treated with mosapride tablets and the observation group erythromycin capsules.The efficacy,the levels of plasma motilin (MLT) and serum gastrin (GAS),and the numbers of intestinal flora were compared between these two groups.Results After the treatment,the total effective rate was significantly higher in the observation group than in the control group(x 2=12.889,P ＜ 0.05);the levels of plasma motilin and serum gastrin significantly decreased in both groups (P ＜ 0.05) and were significantly lower in the observation group than in the control group (t=-13.865 and 6.272,P ＜ 0.05);there were no statistical differences in the numbers of escherichia coli,bacillus,lactobacillus,lactic acid bacteria in the intestine between the two groups before and after the treatment (t=1.540,1.093,1.790,and 1.946,P ＞ 0.05);the number of bacteroid was significantly more in the observation group than in the control group (t=8.073,P ＜ 0.05).Conclusions Erythromycin in the treatment of diabetic gastroparesis is remarkably effective,can reduce motilin,gastrin secretion,and has little influence on intestinal flora of patients and better applied value,so it is worth being clinically used.