Effects of probiotics and lactulose synergistic action on gastrointestinal motility,mucosal function and disease progression in elderly patients with type 2 diabetes mellitus nephropathy constipation
10.3969/j.issn.1671-8348.2024.20.007
- VernacularTitle:益生菌与乳果糖协同作用对老年2型糖尿病肾病便秘患者胃肠动力、黏膜功能及疾病进展的影响
- Author:
Xudong LU
1
;
Yutao GAO
;
Xiaoqing DING
Author Information
1. 河北省第八人民医院消化内科,石家庄 050000
- Keywords:
type 2 diabetes mellitus;
constipation;
kidney disease;
old age;
probiotics;
disease progres-sion;
lactulose;
constipation symptom
- From:
Chongqing Medicine
2024;53(20):3077-3083,3089
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of probiotics and lactulose synergistic action on gastroin-testinal motility,mucosal function and disease progression in elderly patients with type 2 diabetes mellitus(T2DM)nephropathy constipation.Methods A total of 108 elderly patients with T2DM nephropathy consti-pation admitted and treated in this hospital from May 2021 to March 2023 were selected as the study subjects and divided into the observation group,control group 1 and control group 2 by the random number table meth-od,36 cases in each group.The control group 1 was treated with bifidobacterium tetrad tablet,the control group 2 adopted the lactulose treatment,and the observation group was treated with bifidobacterium tetrad tablet combined with lactulose.The clinical efficacy,constipation symptoms before treatment and in 1,4 weeks after treatment,gastrointestinal motility,serum cerebrointestinal peptide[substance P(SP),nitric oxide(NO),vasoactive intestinal peptide(VIP)],intestinal mucosal barrier function[D-lactic acid(DLC),diamine oxidase(DAO),lipopolysaccharide(LPS)],renal function[creatinine(Cr),urea nitrogen(BUN),estimated glomerular filtration rate(eGFR)]and Toll-like receptor 4(TLR4)/nuclear factor κB(NF-κB)mRNA ex-pression were compared between the groups.Results After 1-,4-week treatment,the total effective rate,bari-um discharge rate at different time points in the observation group were higher than those in the control group 1 and control group 2,and the scores of rectal,abdominal and fecal traits in the observation group were lower than those in the control group 1 and control group 2(P＜0.05),but there was no statistically significant difference between the control group 1 and control group 2(P＞0.05).The serum NO and VIP levels in the observation group were lower than those in the control group 1 and control group 2(P＜0.05),the SP level was higher than that in the control group 1 and control group 2(P＜0.05).After 4-week treatment,the levels of serum DLC,DAO and LPS in the observation group were lower than those in the control group 1 and con-trol group 2(P＜0.05);the Cr and BUN levels,TLR mRNA expression and NF-κB mRNA expression in the observation group and control group 1 were decreased compared with before treatment(P＜0.05),the eGFR level was increased compared with before treatment(P＜0.05),but the above indexes had no statistically sig-nificant difference between these two groups(P＞0.05).Conclusion Probiotics and lactulose in the treat-ment of elderly patients with T2DM nephropathy constipation could play a synergistic role,alleviate the con-stipation symptom,promote the gastrointestinal motility and restore the intestinal mucosal barrier function,which may be reach the anti-inflammation and anti-apoptosis goal by inhibiting TLR4/NF-κB,so as to inhibit the further development of diabetic nephropathy.
