粪便菌群移植治疗腹泻型肠易激综合征12例临床疗效观察

Efficacy of fecal microbiota transplantation for treatment of diarrhea-predominant irritable bowel syndrome:An observation on 12 cases

目的观察粪便菌群移植(fecal microbiota transplantation,FMT)治疗腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)的疗效。方法 2015年4月至2016年9月南京大学医学院附属金陵医院普通外科肠道微生态治疗中心的12例符合罗马Ⅲ诊断标准的IBS-D患者,均给予FMT治疗,记录移植治疗前后患者腹部疼痛评分、排便次数、大便性状Bristol粪便评分、全球IBS评分和IBS-QOL评分及相关不良反应。治疗后随访12周。结果采用Cochran′s Q秩和检验比较FMT治疗前与治疗后第12周状况(P50,P25~P75):腹部疼痛明显缓解[(5.00,4.25~6.75)vs(3.00,2.25~3.00),P=0.003];粪便性状改善[(6.00,5.00~7.00)vs(4.00,3.25~5.00),P=0.003];排便次数下降[(3.50,3.00~5.00)vs(2.00,1.00~3.00),P=0.003],差异均具有统计学意义(P<0.05)。随访期间疗效稳定,患者未发生严重不良反应。结论 FMT能够改善IBS-D患者腹泻症状,缓解腹部症状,12周内治疗效果良好。

Objective To observe the clinical effects and safety of fecal microbiota transplantation （FMT） on diarrhea-predominant irritable bowel syndrome （IBS-D）. Methods 12 patients with IBS-D in the Intestinal Microecological Treatment Center of Jinling Hospital Clinical Medicine School of Nanjing University were enrolled and given FMT for 6 days, and followed up for 12 weeks after treatment. The score for abdominal pain, defecation frequency, stool consistency by Bristol Stool Form Scale, IBS global score, and IBS-QOL questionnaire score as well as adverse reactions were evaluated at each study visit. Results Compared with pre-FMT treatment, the abdominal pain was relieved significantly （5.00, 4.25 - 6.75 vs 3.00, 2.25 - 3.00; P=0.003） after 12 weeks of treatment. Meanwhile, Bristol scale （6.00, 5.00 - 7.00 vs 4.00, 3.25 - 5.00; P=0.003） and defecation frequency demonstrated a significant reduction （3.50, 3.00 - 5.00 vs 2.00, 1.00 - 3.00; P=0.003）. Those differences were significant statistically （P〈0.05）. The efficacy was consistent and no serious adverse events occurred during the whole follow-up period. Conclusion FMT is safe and effective for the treatment of IBS-D with satisfactory short-term therapeutic effect.