内科

目的探讨贝那鲁肽联合双歧杆菌四联活菌片治疗肥胖型2型糖尿病（T2DM）的效果，及其对机体代谢、肠道菌群平衡的影响。方法选取77例肥胖型T2DM患者为研究对象，采用随机数字表法将其分为单一组（n=38）、联合组（n=39）。在控制饮食、合理运动、降脂控糖等常规治疗的基础上，单一组行双歧杆菌四联活菌片治疗，联合组行贝那鲁肽+双歧杆菌四联活菌片治疗，两组均连续治疗8周。比较两组的临床疗效、代谢指标、炎性因子水平、氧化应激指标、肠道菌群变化和不良反应发生情况。结果治疗8周后，联合组总有效率高于单一组（P<0.05）；联合组空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、C反应蛋白、内皮素-1、白细胞介素-6、F2-异前列腺素类化合物水平，以及粪便中拟杆菌、肠杆菌、肠球菌数量均低于单一组，高密度脂蛋白胆固醇、谷胱甘肽过氧化物酶、超氧化物歧化酶水平，以及粪便中双歧杆菌、乳酸杆菌数量均高于单一组（均P<0.05）。治疗期间，联合组不良反应发生率与单一组差异无统计学意义（P>0.05）。结论贝那鲁肽联合双歧杆菌四联活菌片治疗肥胖型T2DM可提高临床疗效，改善机体糖脂代谢，降低炎性因子水平，减轻机体氧化应激反应，调节肠道菌群，且安全性较高。

Objective To investigate the effects of beinaglutide combined with Bifidobacterium quadruple viable tablets in the treatment of obese patients with type 2 diabetes mellitus (T2DM) and its impacts on metabolism and intestinal flora balance. Methods A total of 77 obese patients with T2DM were selected as research subjects and were divided into a single group (n=38) or a combined group (n=39) by the random number table method. Based on conventional treatments such as diet control, reasonable exercise, lipid reduction, and glucose control, the single group was treated with Bifidobacterium quadruple viable tablets, the combined group was treated with beinaglutide and Bifidobacterium quadruple viable tablets, and both groups were treated continuously for 8 weeks. The clinical efficacy, metabolic indexes, inflammatory factor levels, oxidative stress indicators, changes in intestinal flora, and occurrence of adverse reactions were compared between the two groups. Results After 8 weeks of treatment, the total effective rate in the combined group was higher than that in the single group (P<0.05); the combined group had lower levels of fasting blood glucose, total cholesterol, triacylglycerol, low-density lipoprotein cholesterol, C-reactive protein, endothelin-1, interleukin-6, and F2-isoprostanes, as well as smaller numbers of Bacteroides, Enterobacter, and Enterococcus in feces, than the single group, and had higher levels of high-density lipoprotein cholesterol, glutathione peroxidase, and superoxide dismutase, as well as larger numbers of Bifidobacterium and Lactobacillus in feces, than the single group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions during the treatment between the combined group and the single group (P>0.05). Conclusion Beinaglutide combined with Bifidobacterium quadruple viable tablets can improve the clinical efficacy and the metabolism of glucose and lipids, reduce the levels of inflammatory factors, relieve the oxidative stress response of the body, and regulate the intestinal flora, with a high safety in the treatment of obese T2DM.