Objective To investigate the clinical effect of Metformin on inflammation,intestinal flora imbalance,and metabolic impairment in elderly patients with type 2 diabetes mellitus(T2DM) Methods A total of 74 elderly patients with T2DM admitted to our hospital from October 2014 to October 2016 were included in this study and assigned into an intervention group(n=37)and a control group(n=37)according to the sequence of admission.The intervention group was treated with 0.5 g Metformin once a day for 2 weeks,while the control group was given a placebo with the same frequency as in the intervention group.Fresh pre-and post-treatment stool samples were collected in sealed sterile anaerobic growth bags for the detection of changes in patient intestinal flora.Serum inflammatory factor levels,blood glucose levels,and blood lipid levels were measured.Results Before treatment,the numbers of beneficial intestinal flora(bacillus bifidus,bacillus acidi lactici,and bacteroides)in the intervention group were lower than in the control group(all P＜0.05);The levels of serum inflammatory factors(CRP,IL-6,and TNF-α)in the intervention group were higher than in the control group(all P ＜0.05);The levels of parameters for glucose and lipid metabolism(HbA1c,FPG,TC,TG,and LDL-C)in the intervention group were higher than in the control group,while the level of HDL-C was lower than in the control group (all P ＜ 0.05).After treatment,the number of beneficial intestinal flora significantly increased in the intervention group(all P＜0.05)but was not different from that in the control group(all P＞0.05);The levels of serum inflammatory factors had significant reductions in the intervention group compared with pre-treatment levels(all P＜0.05)but demonstrated no difference from those in the control group(all P＞0.05);Parameters for glucose and lipid metabolism in the intervention group showed improvement(all P ＜0.05)after treatment but no difference was observed between these two groups(all P＞0.05).Conclusions Metformin can effectively control blood glucose and blood lipid levels in elderly patients with T2DM,improve the chronic inflammatory state,increase the number of beneficial intestinal bacteria,and regulate flora imbalance.%目的 探讨二甲双胍对老年2型糖尿病(T2DM)患者炎症和肠道菌群失衡及代谢紊乱的临床疗效. 方法 前瞻性研究,连续选入2014年10月至2016年10月在我院住院治疗的74例老年T2DM患者作为研究对象,根据入院顺序随机分为观察组和对照组,各37例.观察组患者规律应用二甲双胍(0.5 g/次,1次/d)2周,给予对照组患者安慰剂治疗,用法及用量同观察组,收集两组用药前后新鲜粪便,密封于无菌厌氧袋,检测肠道菌群变化,并采集外周静脉血测定血清炎性因子、血糖及血脂水平. 结果 治疗前观察组肠道双歧杆菌、乳酸杆菌及拟杆菌等有益菌数量均低于对照组(均P＜0.05);观察组血清C反应蛋白、白细胞介素-6和肿瘤坏死因子-α均高于对照组;观察组血清糖化血红蛋白A1c、空腹血糖、总胆固醇、三酰甘油和低密度脂蛋白胆固醇高于对照组,高密度脂蛋白胆固醇低于对照组(均P＜0.05);治疗后观察组较治疗前肠道有益菌数量上升(P＜0.05),与对照组比较差异无统计学意义(P＞0.05);观察组血清炎性因子水平较治疗前明显下降(P＜0.05),与对照组比较差异无统计学意义(P＞0.05);观察组糖脂代谢相关指标与治疗前比较均改善(均P＜0.05),与对照组比较无统计学意义(P＞0.05). 结论 二甲双胍可有效控制老年T2DM患者的血糖、血脂水平,改善慢性炎症状态,同时增加患者肠道有益菌群的数量,调节菌群失衡.
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