IBD Unit, St Mark's Hospital, Harrow, London, UK.
Aliment Pharmacol Ther. 2011 Aug;34(4):409-15. doi: 10.1111/j.1365-2036.2011.04737.x. Epub 2011 Jun 20.
Evidence is emerging regarding the relationship between a dysbiosis of the human gut microbiota and a number of gastrointestinal diseases as well as diseases beyond the gut. Probiotics have been investigated in many gastrointestinal disease states, with variable and often modest outcomes. Faecal transplantation is an alternative approach to manipulate the gut microbiota.
To review the use of faecal transplantation therapy for the management of gastrointestinal disorders.
Available articles on faecal transplantation in the management of gastrointestinal disorders were identified using a Pubmed search and bibliographies of review articles on the subject were collated.
A total of 239 patients who had undergone faecal transplantation were reported. Seventeen of 22 studies of faecal transplantation were in fulminant or refractory Clostridium difficile. Studies of faecal transplantation are heterogeneous regarding the patients, donors, screening, methods of administration and definition of response. Faecal transplantation for C. difficile has been demonstrated to be effective in 145/166 (87%) patients. Small numbers of patients are reported to have undergone successful faecal transplantation for irritable bowel syndrome and inflammatory bowel disease.
Faecal transplantation has been reported with good outcomes for fulminant and refractory C. difficile. No adverse effects of faecal transplantation have been reported. However, there are no level 1 data of faecal transplantation and reports to date may suffer from reporting bias of positive outcomes and under-reporting of adverse effects. This therapy holds great promise, where a dysbiosis of the gut microbiota is responsible for disease and further studies are necessary to explore this potential.
越来越多的证据表明，人类肠道微生物群落的失调与许多胃肠道疾病以及肠道以外的疾病有关。益生菌已在许多胃肠道疾病中进行了研究，但结果各不相同，且往往效果有限。粪便移植是一种操纵肠道微生物群的替代方法。
综述粪便移植治疗在胃肠道疾病中的应用。
使用 Pubmed 搜索和综述文章的参考文献来确定关于胃肠道疾病中粪便移植的可用文章。
共报道了 239 例接受粪便移植的患者。22 项关于粪便移植治疗艰难梭菌的研究中，有 17 项为暴发性或难治性艰难梭菌。粪便移植治疗的研究在患者、供体、筛查、给药方法和反应定义方面存在异质性。粪便移植治疗艰难梭菌在 166 例患者中的 145 例（87%）有效。有少数患者成功接受了粪便移植治疗肠易激综合征和炎症性肠病。
报告了粪便移植治疗暴发性和难治性艰难梭菌的良好结果。粪便移植未报告有不良反应。然而，目前尚无粪便移植的一级数据，且迄今为止的报告可能存在阳性结果的报告偏倚和不良反应的漏报。这种治疗方法具有很大的潜力，因为肠道微生物群的失调是疾病的原因，需要进一步的研究来探索这种潜力。
