粪菌胶囊治疗慢传输型便秘15例临床疗效分析

Capsulized fecal microbiota transplantation for the treatment of slow transit constipation: A therapeutic analysis of 15 cases

目的明确粪菌胶囊移植(capsulized FMT)治疗慢传输型便秘的疗效。方法纳入2014年12月至2015年11月南京大学医学院附属金陵医院肠道微生态治疗中心确诊为慢传输型便秘(STC)的15例病人,口服3 d粪菌胶囊治疗,记录移植治疗前后临床治愈率、临床缓解率、每周自主排便次数、Bristol评分、Wexner便秘评分、胃肠生活质量及相关不良反应。治疗后随访12周。结果与治疗前比较,粪菌胶囊移植治疗后临床治愈率维持在40.0%(6/15),临床缓解率为53.3%(8/15),第12周病人排便次数明显增加[(2.2±1.5)vs.(3.1±2.1)次/周],Bristol评分改善[(6.7±1.3)vs.(5.1±1.8)分],Wexner便秘评分明显下降[(13.7±3.5)vs.(10.1±2.3)分],GIQLI评分升高[(87.2±14.6)vs.(110.9±10.5)分],差异均有统计学意义(P<0.05)。随访期间未发生严重不良反应。结论粪菌胶囊治疗慢传输型便秘安全有效,短期观察疗效较好。

Objective To evaluate the efficacy and safety of capsulized fecal microbiota transplantation （FMT） for slow-translt constipation （STC）. Methods A total of 15 patients with STC in Jinling Hospital, Medical School of Nanjing University were enrolled in the study,who received capsulized FMT for 3 days, and followed up for 12 weeks after treatment. Rate of Clinical remission, Bristol Stool Form Scale, Wexner constipation scale, and bowel movement per week were evaluated at each study visit. Results Compared with pre-FMT treatment, the rate of clinical cure and remission based on clinical activity at week 12 was 40% （6/15） and 53.3% （8/15） , respectively. The patients＇ stool frequency increased significantly [（2.2 ± 1.5） times/week vs. （3.1 ± 2.1） times/week] after 12 weeks of treatment. Meanwhile, Bristol scale [（6.7±1.3） vs. （5.1±1.8）], Wexner constipation scores demonstrated a significant reduction [（13.7 ± 3.5） vs. （10.1 ± 2.3）] and GIQLI score increased remarkably [（87.2 ± 14.6） vs. （110.9 ± 10.5）]. Those differences were significant statistically （P 〈 0.05）. Capsulized FMT efficacy was stable and no serious adverse events occurred during the whole follow-up. Conclusion Capsulized FMT is safe and effective for the treatment of STC, and short-term treatment effect is good.