Gastroenterology:粪菌群移植可减轻以肠腹胀为主的肠易激综合征患者的症状

2020-07-19 MedSci原创 MedSci原创

肠易激综合症(IBS)是与肠功能异常有关的功能性胃肠疾病。有报道,粪便微生物菌群移植(FMT)在治疗以腹胀为症状的肠易激患者中有希望,因此,本项研究旨在研究了该治疗的疗效。

背景与目标

肠易激综合症(IBS)是与肠功能异常有关的功能性胃肠疾病。有报道,粪便微生物菌群移植(FMT)在治疗以腹胀为症状的肠易激患者中有希望,因此,本项研究旨在研究了该治疗的疗效。

 

方法

本项研究为一项双盲研究,研究人员将难治性IBS的患者随机分配为供体粪便(n = 43)或自体粪便(n = 19)的单剂量鼻空肠给药,并持续了1年。使用每日症状日记评估与IBS相关的症状,以1至6级来评估一般的腹部不适,腹胀,腹痛和肠胃气胀。还记录每日排便次数,粪便的稠度和腹围。患者完成了针对IBS的生活质量问卷。主要终点是IBS症状改善情况。次要终点是IBS症状评分和生活质量的变化。

 

结果

在第12周,接受供体粪便的患者中有56%的人的两个主要终点指标均得到改善,而接受安慰剂的患者只有26%的患者获得了缓解(P= .03)。给予供体粪便的患者在不适水平上有显着改善(平均降低19%; FMT前中位数评分为3.98;范围为2.13–6.00;FMT之后中位数评分为3.1;范围为951.29–5.90),大便次数(平均降低) 13%,FMT前中位数评分2.10; FMT后中位数评分0.77-14.29; FMT后中位数评分1.7; 0.71-4.29范围FMT后0.37;范围0.00-1.00),腹痛(平均降低26%; FMT前中位数评分3.88; 1.57-5.17范围; FMT后中位数2.80;范围1.14-4.94),肠胃气胀(平均降低10%; FMT前平均得分3.42;范围0.71-6.00; FMT之后平均得分3.07;范围0.79-4.23)和生活质量(平均增加16%;FMT前平均得分32.6; 范围11–119;FMT后平均得分为43.1;范围32.25–99)。给予供体粪便的女性比例(69%)明显高于男性(29%)( P = .01)。与未反应者粪便样本相比,来自反应者粪便样本的供体材料微生物组多样性更高( P = .04)和基线组成不同( P = .04),但没有特异性标记物分类与反应相关。

 

结论

与安慰剂(自体移植)相比,FMT缓解了症状,尽管效果在一年内下降了,但是第二次FMT也可以恢复患者的先前反应。

 

原始出处:

Tom Holvoet. Et al. Fecal Microbiota Transplantation Reduces Symptoms in Some Patients With Irritable Bowel Syndrome with Predominant Abdominal Bloating: Short- and Long-Term Results from a Placebo-Controlled Randomized Trial. Gastroenterology。2020.

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    2020-10-12 许安
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    2020-07-21 qindq
  5. [GetPortalCommentsPageByObjectIdResponse(id=2065110, encodeId=aff42065110f2, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Aug 30 20:57:50 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712490, encodeId=f30b1e124905d, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Jun 01 21:57:50 CST 2021, time=2021-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073058, encodeId=4b2520e305850, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Oct 12 10:57:50 CST 2020, time=2020-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313312, encodeId=9cfd1313312cf, content=<a href='/topic/show?id=697a85583cf' target=_blank style='color:#2F92EE;'>#腹胀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85583, encryptionId=697a85583cf, topicName=腹胀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d64f419, createdName=qindq, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431884, encodeId=9971143188413, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505044, encodeId=a7ad150504424, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803265, encodeId=48878032654a, content=<a href='/topic/show?id=cfdee634063' target=_blank style='color:#2F92EE;'>#粪菌移植#</a>说明IBS可能与肠道微生物有关系。, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76340, encryptionId=cfdee634063, topicName=粪菌移植)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jul 19 10:44:52 CST 2020, time=2020-07-19, status=1, ipAttribution=)]
    2020-07-21 zhouqu_8
  6. [GetPortalCommentsPageByObjectIdResponse(id=2065110, encodeId=aff42065110f2, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Aug 30 20:57:50 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712490, encodeId=f30b1e124905d, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Jun 01 21:57:50 CST 2021, time=2021-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073058, encodeId=4b2520e305850, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Oct 12 10:57:50 CST 2020, time=2020-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313312, encodeId=9cfd1313312cf, content=<a href='/topic/show?id=697a85583cf' target=_blank style='color:#2F92EE;'>#腹胀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85583, encryptionId=697a85583cf, topicName=腹胀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d64f419, createdName=qindq, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431884, encodeId=9971143188413, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505044, encodeId=a7ad150504424, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803265, encodeId=48878032654a, content=<a href='/topic/show?id=cfdee634063' target=_blank style='color:#2F92EE;'>#粪菌移植#</a>说明IBS可能与肠道微生物有关系。, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76340, encryptionId=cfdee634063, topicName=粪菌移植)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jul 19 10:44:52 CST 2020, time=2020-07-19, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2065110, encodeId=aff42065110f2, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Aug 30 20:57:50 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712490, encodeId=f30b1e124905d, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Jun 01 21:57:50 CST 2021, time=2021-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073058, encodeId=4b2520e305850, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Oct 12 10:57:50 CST 2020, time=2020-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313312, encodeId=9cfd1313312cf, content=<a href='/topic/show?id=697a85583cf' target=_blank style='color:#2F92EE;'>#腹胀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85583, encryptionId=697a85583cf, topicName=腹胀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d64f419, createdName=qindq, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431884, encodeId=9971143188413, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505044, encodeId=a7ad150504424, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Jul 21 00:57:50 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803265, encodeId=48878032654a, content=<a href='/topic/show?id=cfdee634063' target=_blank style='color:#2F92EE;'>#粪菌移植#</a>说明IBS可能与肠道微生物有关系。, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76340, encryptionId=cfdee634063, topicName=粪菌移植)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sun Jul 19 10:44:52 CST 2020, time=2020-07-19, status=1, ipAttribution=)]
    2020-07-19 lovetcm

    #粪菌移植#说明IBS可能与肠道微生物有关系。

    0

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