肠易激综合征的粪便微生物群移植：系统评价和荟萃分析。
Fecal microbiota transplantation in irritable bowel syndrome: A systematic review and meta-analysis.
机构信息
Department of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Laboratorio de Hígado, Páncreas y Motilidad (HIPAM)-Unit of Research in Experimental Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico.
出版信息
United European Gastroenterol J. 2019 Oct;7(8):1033-1041. doi: 10.1177/2050640619866990. Epub 2019 Jul 30.
Abstract
BACKGROUND
Modulating gut microbiota is a potential treatment for irritable bowel syndrome (IBS). This meta-analysis explored whether fecal microbiota transplantation (FMT) is successful in treating IBS.
METHODS
A systematic review was performed to find trials on FMT in IBS. Ratios and relative ratios (RR) of improvement for single-arm trials (SATs) and randomized controlled trials (RCTs) were calculated, respectively. Changes in IBS Severity Scoring System (IBS-SSS) and IBS Quality of Life (IBS-QOL) instrument compared to baseline in FMT versus placebo groups were pooled.
RESULTS
In SATs, 59.5% (95% confidence interval (CI) 49.1-69.3) of IBS patients showed significant improvement. In RCTs, there were no differences between FMT and control in improvement (RR=0.93 (95% CI 0.50-1.75)) or changes in the IBS-SSS and IBS-QOL.
CONCLUSIONS
FMT was not effective in IBS. Variations in FMT methods and patient factors may contribute to the heterogeneous results of the trials.
摘要
背景
调节肠道微生物群是治疗肠易激综合征（IBS）的一种潜在方法。本荟萃分析探讨了粪便微生物群移植（FMT）治疗 IBS 是否有效。
方法
系统检索了关于 FMT 治疗 IBS 的试验。分别计算了单臂试验（SAT）和随机对照试验（RCT）的改善率比值和相对比值（RR）。比较 FMT 组与安慰剂组治疗前后 IBS 严重程度评分系统（IBS-SSS）和 IBS 生活质量（IBS-QOL）量表的变化。
结果
在 SAT 中，59.5%（95%置信区间（CI）49.1-69.3）的 IBS 患者有显著改善。在 RCT 中，FMT 与对照组在改善率（RR=0.93（95% CI 0.50-1.75））或 IBS-SSS 和 IBS-QOL 量表的变化方面无差异。
结论
FMT 对 IBS 无效。FMT 方法和患者因素的差异可能导致试验结果存在异质性。
相似文献
1
Fecal microbiota transplantation in irritable bowel syndrome: A systematic review and meta-analysis.肠易激综合征的粪便微生物群移植：系统评价和荟萃分析。
United European Gastroenterol J. 2019 Oct;7(8):1033-1041. doi: 10.1177/2050640619866990. Epub 2019 Jul 30.
2
A meta-analysis of randomized controlled trials evaluating the effectiveness of fecal microbiota transplantation for patients with irritable bowel syndrome.一项荟萃分析随机对照试验评估粪便微生物群移植治疗肠易激综合征患者的有效性。
BMC Gastroenterol. 2024 Jul 5;24(1):217. doi: 10.1186/s12876-024-03311-x.
3
Efficacy of Fecal Microbiota Transplantation in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.粪便微生物移植治疗肠易激综合征的疗效：系统评价和荟萃分析。
Am J Gastroenterol. 2019 Jul;114(7):1043-1050. doi: 10.14309/ajg.0000000000000198.
4
Efficacy of Fecal Microbiota Transplantation in Irritable Bowel Syndrome: A Meta-Analysis of Randomized Controlled Trials.粪菌移植治疗肠易激综合征的疗效：一项随机对照试验的荟萃分析。
Front Cell Infect Microbiol. 2022 Feb 28;12:827395. doi: 10.3389/fcimb.2022.827395. eCollection 2022.
5
Fecal microbiota transplantation for irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials.肠易激综合征的粪便微生物群移植：随机对照试验的系统评价和荟萃分析。
Front Immunol. 2023 May 18;14:1136343. doi: 10.3389/fimmu.2023.1136343. eCollection 2023.
6
Fecal microbiota transplantation for the treatment of irritable bowel syndrome: A systematic review and meta-analysis.粪便微生物群移植治疗肠易激综合征：系统评价和荟萃分析。
World J Gastroenterol. 2023 May 28;29(20):3185-3202. doi: 10.3748/wjg.v29.i20.3185.
7
Faecal microbiota transplantation alters gut microbiota in patients with irritable bowel syndrome: results from a randomised, double-blind placebo-controlled study.粪便微生物群移植改变肠易激综合征患者的肠道微生物群：一项随机、双盲、安慰剂对照研究的结果。
Gut. 2018 Dec;67(12):2107-2115. doi: 10.1136/gutjnl-2018-316434. Epub 2018 Jul 6.
8
Randomised clinical trial: faecal microbiota transplantation versus autologous placebo administered via colonoscopy in irritable bowel syndrome.随机临床试验：通过结肠镜检查给予粪便微生物群移植与自体安慰剂治疗肠易激综合征。
Aliment Pharmacol Ther. 2020 Jun;51(12):1321-1331. doi: 10.1111/apt.15740. Epub 2020 Apr 28.
9
Systematic review with meta-analysis: efficacy of faecal microbiota transplantation for the treatment of irritable bowel syndrome.系统评价与荟萃分析：粪便微生物群移植治疗肠易激综合征的疗效。
Aliment Pharmacol Ther. 2019 Aug;50(3):240-248. doi: 10.1111/apt.15330. Epub 2019 May 28.
10
The kinetics of gut microbial community composition in patients with irritable bowel syndrome following fecal microbiota transplantation.肠易激综合征患者粪便微生物移植后肠道微生物群落组成的动力学。
PLoS One. 2018 Nov 14;13(11):e0194904. doi: 10.1371/journal.pone.0194904. eCollection 2018.
引用本文的文献
1
Microbial Metabolite Effects on Vasculogenic Mimicry in Metastatic Cancers.微生物代谢产物对转移性癌症中血管生成拟态的影响
Cells. 2025 May 30;14(11):811. doi: 10.3390/cells14110811.
2
Impact of Microbiota on Irritable Bowel Syndrome Pathogenesis and Management: A Narrative Review.微生物群对肠易激综合征发病机制及治疗的影响：一项叙述性综述
Medicina (Kaunas). 2025 Jan 13;61(1):109. doi: 10.3390/medicina61010109.
3
FMT and TCM to treat diarrhoeal irritable bowel syndrome with induced spleen deficiency syndrome- microbiomic and metabolomic insights.FMT 和 TCM 治疗脾虚型腹泻型肠易激综合征的微生物组学和代谢组学研究。
BMC Microbiol. 2024 Oct 26;24(1):433. doi: 10.1186/s12866-024-03592-y.
4
Changes in Fecal Short-Chain Fatty Acids in IBS Patients and Effects of Different Interventions: A Systematic Review and Meta-Analysis.肠易激综合征患者粪便短链脂肪酸的变化及不同干预措施的影响：系统评价和荟萃分析。
Nutrients. 2024 May 31;16(11):1727. doi: 10.3390/nu16111727.
5
Exploring the role of gut microbiota in advancing personalized medicine.探索肠道微生物群在推进个性化医疗中的作用。
Front Microbiol. 2023 Nov 30;14:1274925. doi: 10.3389/fmicb.2023.1274925. eCollection 2023.
6
The gut microbiome dysbiosis and regulation by fecal microbiota transplantation: umbrella review.肠道微生物群失调与粪便微生物群移植的调节：伞状综述
Front Microbiol. 2023 Nov 3;14:1286429. doi: 10.3389/fmicb.2023.1286429. eCollection 2023.
7
Fecal Microbiota Transplantation in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.肠易激综合征的粪便微生物群移植：随机对照试验的系统评价和荟萃分析。
Int J Mol Sci. 2023 Sep 26;24(19):14562. doi: 10.3390/ijms241914562.
8
Alterations in fecal β-defensin-3 secretion as a marker of instability of the gut microbiota.粪便 β-防御素-3 分泌的改变作为肠道微生物组不稳定的标志物。
Gut Microbes. 2023 Jan-Dec;15(1):2233679. doi: 10.1080/19490976.2023.2233679.
9
How the interplay among the tumor microenvironment and the gut microbiota influences the stemness of colorectal cancer cells.肿瘤微环境与肠道微生物群之间的相互作用如何影响结肠癌细胞的干性。
World J Stem Cells. 2023 May 26;15(5):281-301. doi: 10.4252/wjsc.v15.i5.281.
10
Fecal microbiota transplantation for irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials.肠易激综合征的粪便微生物群移植：随机对照试验的系统评价和荟萃分析。
Front Immunol. 2023 May 18;14:1136343. doi: 10.3389/fimmu.2023.1136343. eCollection 2023.
本文引用的文献
1
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.粪便微生物群移植可减轻部分以腹胀为主的肠易激综合征患者的症状：一项安慰剂对照随机试验的短期和长期结果
Gastroenterology. 2021 Jan;160(1):145-157.e8. doi: 10.1053/j.gastro.2020.07.013. Epub 2020 Jul 15.
2
The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study.异体与自体粪便微生物群移植对肠易激综合征症状、内脏感知及粪便和黏膜微生物群的影响：一项随机对照研究。
Clin Transl Gastroenterol. 2019 Apr;10(4):e00034. doi: 10.14309/ctg.0000000000000034.
3
Fecal microbiota transplantation for treatment of recurrent C. difficile infection: An updated randomized controlled trial meta-analysis.粪便微生物群移植治疗复发性艰难梭菌感染：一项更新的随机对照试验荟萃分析。
PLoS One. 2019 Jan 23;14(1):e0210016. doi: 10.1371/journal.pone.0210016. eCollection 2019.
4
A randomized double-blind placebo-controlled trial showing rifaximin to improve constipation by reducing methane production and accelerating colon transit: A pilot study.一项随机双盲安慰剂对照试验表明，利福昔明可通过减少甲烷生成和加速结肠转运来改善便秘：一项初步研究。
Indian J Gastroenterol. 2018 Sep;37(5):416-423. doi: 10.1007/s12664-018-0901-6. Epub 2018 Nov 8.
5
Safety and preliminary efficacy of orally administered lyophilized fecal microbiota product compared with frozen product given by enema for recurrent Clostridium difficile infection: A randomized clinical trial.口服冻干粪便微生物群产品与灌肠冷冻产品治疗复发性艰难梭菌感染的安全性和初步疗效比较：一项随机临床试验。
PLoS One. 2018 Nov 2;13(11):e0205064. doi: 10.1371/journal.pone.0205064. eCollection 2018.
6
Fecal microbiota transfer for bowel disorders: efficacy or hype?粪便微生物群移植治疗肠道疾病：疗效还是炒作？
Curr Opin Pharmacol. 2018 Dec;43:72-80. doi: 10.1016/j.coph.2018.08.012. Epub 2018 Sep 12.
7
Fecal Microbiota Transplantation: Current Status in Treatment of GI and Liver Disease.粪便微生物移植：在胃肠道和肝脏疾病治疗中的现状。
Clin Gastroenterol Hepatol. 2019 Jan;17(2):353-361. doi: 10.1016/j.cgh.2018.07.026. Epub 2018 Jul 25.
8
Faecal microbiota transplantation alters gut microbiota in patients with irritable bowel syndrome: results from a randomised, double-blind placebo-controlled study.粪便微生物群移植改变肠易激综合征患者的肠道微生物群：一项随机、双盲、安慰剂对照研究的结果。
Gut. 2018 Dec;67(12):2107-2115. doi: 10.1136/gutjnl-2018-316434. Epub 2018 Jul 6.
9
Dysbiosis in Functional Bowel Disorders.功能性肠病中的肠道菌群失调。
Ann Nutr Metab. 2018;72(4):296-306. doi: 10.1159/000488773. Epub 2018 Apr 25.
10
Fecal microbiota transplantation as a possible treatment of irritable bowel syndrome.粪便微生物群移植作为肠易激综合征的一种可能治疗方法。
Ann Transl Med. 2017 Dec;5(24):506. doi: 10.21037/atm.2017.09.13.
Zotero 插件