抗炎饮食联合粪便移植对溃疡性结肠炎患者肠道菌群多样性及耐受性的影响

Effect of anti-inflammatory diet combined with fecal transplantation on the diversity and tolerance of intestinal flora in patients with ulcerative colitis

目的探讨抗炎饮食联合粪便移植对溃疡性结肠炎(ulcerative colitis,UC)患者肠道菌群多样性及耐受性的影响。方法纳入2022年3月至2023年4月新疆医科大学第一附属医院150例UC患者,采用随机数字表法将患者分为饮食组、移植组和联合组,每组50例。饮食组予以抗炎饮食干预,移植组予以粪便移植治疗,联合组予以抗炎饮食联合粪便移植干预。8周后,比较三组UC缓解情况及肠道菌群多样性,并比较移植组与联合组粪便移植耐受性。结果联合组临床缓解为40.0%、内镜缓解率为32.0%,均显著高于饮食组、移植组(P<0.05),但黏膜愈合率三组间比较差异无统计学意义(P>0.05)。治疗后,联合组ace、chao、shannon指数均高于饮食组、移植组(P<0.05),且移植组均高于饮食组(P<0.05)。联合组粪便移植不良耐受性反应发热、食欲不振发生率低于移植组,腹痛联合组高移植组,但差异均无统计学意义(P>0.05)。结论抗炎饮食与粪便移植联合应用可有效提高UC患者肠道菌群多样性,促进患者临床及内镜缓解,且不增加粪便移植不耐受性反应。

Objective To explore the effect of anti-inflammatory diet combined with fecal transplantation on the diversity and tolerance of intestinal flora in patients with ulcerative colitis(UC).Methods 150 UC patients in our hospital from March 2022 to April 2023 were included as the research object,and the patients were randomly divided into diet group,transplantation group and combined group,with 50 cases in each group.The diet group was given anti-inflammatory diet intervention,the transplantation group was given fecal transplantation treatment,and the combined group was given anti-inflammatory diet combined with fecal transplantation intervention.After 8 weeks,the remission of UC and the diversity of intestinal flora in the three groups were compared,and the tolerance of fecal transplantation in the transplantation group and the combined group was compared.Results The clinical remission rate and endoscopic remission rate in the combined group were 40.0%and 32.0%,which were significantly higher than those in the diet group and the transplantation group(P<0.05),but there was no significant difference in the mucosal healing rate among the three groups(P>0.05).After treatment,the ace,chao and shannon indexes of the combined group were higher than those of the diet group and the transplantation group(P<0.05),and the transplantation group was higher than that of the diet group(P<0.05).The incidence of fever and loss of appetite caused by adverse tolerance reaction of fecal transplantation in the combined group was lower than that in the transplantation group and the abdominal pain combined group with high transplantation group,but the difference was not statistically significant(P>0.05).Conclusion The combination of anti-inflammatory diet and fecal transplantation can effectively promote the clinical and endoscopic remission of UC patients,improve the diversity of intestinal flora,and do not increase the intolerance of fecal transplantation.