粪菌移植在左半结肠型轻中度溃疡性结肠炎中的疗效观察

Efficacy and safety of fecal microbiota transplantation for mild to moderate ulcerative colitis in left-hemicolon

[目的]观察粪菌移植对左半结肠型轻中度溃疡性结肠炎的临床疗效.[方法]采用前瞻性研究方法随机将34例左半结肠型轻中度溃疡性结肠炎患者分成对照组(仅使用5-ASA或激素治疗)和研究组(5-ASA或激素治疗同时使用粪菌灌肠治疗),8周后通过改良Mayo评分系统评估其治疗效果.[结果]研究组、对照组患者治疗8周后均未出现不良反应.治疗8周后,对照组患者腹泻次数、便血程度及改良Mayo评分较治疗前均有明显下降(P<0.01),而内镜下评分及医师总体评分与治疗前比较差异无统计学意义(P>0.05);研究组治疗8周后腹泻次数、便血程度、医师总体评分、改良Mayo评分均较治疗前有明显下降(P<0.01);2组治疗后内镜表现均较治疗前无明显改善(P>0.05).2组患者临床疗效评估结果显示,8周后研究组较对照组有效率明显增高(75.0%∶20.0%),P<0.01,且改良Mayo评分有显著下降[(2.6±1.3)∶(1.4±0.8)],P<0.01.治疗过程中2组患者均未出现不良反应.[结论]短期研究结果提示,对轻中度左半结肠型溃疡性结肠炎患者采用粪菌灌肠治疗是安全的,在进行5-ASA或激素治疗的基础上采用粪菌移植治疗可以明显增强其治疗效果.

[Objective]To observe the efficacy and safety of fecal microbiota transplantation for mild to moderate ulcerative colitis in left-hemicolon.[Methods]A prospect study was conducted in 34 patients with mild to moderate ulcerative colitis located in the left colon.The patients were divided into control group and study group.The control group was treated with 5-ASA or glucocorticord hormone and the study group was treated with 5-ASA or hormone plus fecal microbiota transplantation.Eight weeks later,the therapeutic effects of the two groups were evaluated by modified Mayo score.[Results]There were no adverse reactions in both groups.Compared with the baseline,the stool blood level,diarrhea frequency and modified Mayn srore hnth in the ontrol group and study group after the treatment(P<0.01).The efficiency of the study group was significantly higher than that of the control group after 8 weeks treatment(70%vs 20%,P<0.01).The modified Mayo score of the study group decreased more than that of the control group([2.6±1.3]vs[1.4±0.8],P<0.01).[Conclusion]In short time,fecal microbiota transplantation is safe for patients with mild to moderate ulcerative colitis.Fecal microbiota transplantation can enhance the therapeutic effect in patients with mild to moderate ulcerative colitis treated with 5-ASA or glucocorticoid.