粪菌移植治疗溃疡性结肠炎的现状和挑战

Challenge and present status of fecal microbiota transplantation in the treatment of ulcerative colitis

溃疡性结肠炎（UC）是炎症性肠病的一种亚型,其发病原因不清,发病机制复杂,且病情反复发作、迁延不愈,是一种难治性疾病,目前其发病率及复发率呈逐年增加趋势.现阶段采用糖皮质激素、氨基水杨酸制剂、免疫抑制剂及生物制剂等为主要治疗措施.然而生物制剂的出现很大程度上提高了疗效,但还有少量难治性的病例在临床治疗上出现许多棘手的问题,需要联合非药物治疗方法的综合干预达到疗效.近年粪菌移植（FMT）引起了人们的关注,对UC尤其是难治性复发的活动期UC的治疗显示出一定的疗效.

Ulcerative colitis （UC） is a subtype of inflammatory bowel disease. Its pathogenesis is not clear and the pathogenesis is complex. Moreover, it is recurrent and its healing is delayed. It is a kind of refractory disease. Its incidence and recurrence rate showed a trend of increasing year by year in our country at present. At the present stage, the main treatment focuses on glucocorticoids, aminosalicylic acid, immunosuppressor and biological agent. Although biological agent can greatly improve the efficacy, there are many problems in clinical treatment for a small amount of refractory patients. The comprehensive intervention combined with non-drug treatment should be performed, so as to achieve the curative effect. Fecal microbiota transplantation （FMT） has attracted people′s attention in recent years. It displays a certain therapeutic effect on the treatment of UC in the active stage, especially refractory recurrent UC. Therefore, the domestic and overseas FMT treatment are summarized in the paper.