Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Int J Colorectal Dis. 2020 Jun;35(6):1025-1034. doi: 10.1007/s00384-020-03599-7. Epub 2020 May 9.
Ulcerative colitis (UC) is a chronic, recurrent and destructive disease of the gastrointestinal tract. Faecal microbiota transplantation (FMT) is a therapeutic measure in which faecal microbiota from healthy people is transplanted into patients.
To systematically evaluate the safety and effectiveness of treating UC with different modes of FMT.
Seven databases were searched by two independent researchers and studies related to randomized controlled trials were included in the analysis.
Seven studies on UC involving 431 patients were included in the analysis. The results showed that FMT had better efficacy than placebo (OR = 2.29, 95% CI 1.48-3.53, P = 0.0002). Subgroup analyses of influencing factors showed that frozen faeces from multiple donors delivered via the lower gastrointestinal tract had a better curative effect than placebo (OR = 2.76, 95% CI 1.59-4.79, P = 0.0003; OR = 2.93, 95% CI 1.67-5.71, P = 0.0002; and OR = 2.70, 95% CI 1.67-4.37, P < 0.0001); the difference in efficacy between mixed faeces from a single donor transplanted through the upper gastrointestinal tract and placebo was not significant(P = 0.05, P = 0.09 and P = 0.98). The analysis of side effects showed no significant difference between FMT and placebo (P = 0.43).
It may be safe and effective to transplant frozen faeces from multiple donors through the lower gastrointestinal tract to treat UC.
溃疡性结肠炎（UC）是一种慢性、复发性和破坏性的胃肠道疾病。粪便微生物群移植（FMT）是一种治疗措施，即将健康人的粪便微生物群移植到患者体内。
系统评价不同方式的 FMT 治疗 UC 的安全性和有效性。
两名独立研究员检索了 7 个数据库，并纳入了与随机对照试验相关的研究进行分析。
纳入了 7 项关于 UC 的研究，涉及 431 名患者。结果表明，FMT 比安慰剂更有效（OR=2.29，95%CI 1.48-3.53，P=0.0002）。影响因素的亚组分析表明，来自多个供体的冷冻粪便通过下消化道给药比安慰剂有更好的疗效（OR=2.76，95%CI 1.59-4.79，P=0.0003；OR=2.93，95%CI 1.67-5.71，P=0.0002；OR=2.70，95%CI 1.67-4.37，P<0.0001）；来自单个供体的混合粪便通过上消化道移植与安慰剂的疗效差异无统计学意义（P=0.05，P=0.09 和 P=0.98）。不良反应分析显示，FMT 与安慰剂之间无显著差异（P=0.43）。
通过下消化道移植来自多个供体的冷冻粪便可能是安全有效的 UC 治疗方法。
