Tian H L, Chen Q Y, Yang B, Ma C L, Lin Z L, Zhang X Y, Zhou S L, Qin H L, Li N
Department of Colorectal Disease Specialty, Intestinal Microecology Diagnosis and Treatment Center, the Tenth People's Hospital, Tongji University, Shanghai 200072, China.
Department of Colorectal Disease Specialty, Intestinal Microecology Diagnosis and Treatment Center, the Tenth People's Hospital, Tongji University, Shanghai 200072, China; Institute of Intestinal Diseases, Tongji University, Shanghai 200072, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Jul 10;23(Z1):63-68. doi: 10.3760/cma.j.cn.441530-20200415-00212.
To evaluate the efficacy and safety of the fecal microbiota transplantation (FMT) in the different route administration for slow transit constipation (STC). A retrospective cohort study was conducted. The clinical data of 270 STC patients who voluntarily received FMT treatment in the Tenth People's Hospital of Tongji University from May 2018 to May 2019 were collected. Non-relative healthy adult standard donors were applied. The treatment routes of bacterial flora transplantation included nasojejunal tube (nasal enteral tube group, 120 cases), oral enterobacterial capsule treatment (oral capsule group, 120 cases), and colonoscopy infusion (colonoscopy group, 30 cases). The efficacy and safety of treatment among the three groups were compared. Transplanted bacteria of three groups were extracted from 100 g of fresh feces. All the patients successfully completed the transplantation. The waiting time for the nasal enteral tube group, oral capsule group and colonoscopy group was (1.5±0.5) d, (0.4±0.3) d and (3.6±0.8) d respectively; the cost of establishing the transplantation path was (495±20) yuan, (25±10) yuan and (1420±45) yuan respectively, whose differences were statistically significant (=9.210, =0.03; =10.600,=0.01). The clinical improvement rates at 1 month after FMT treatment in the nasojejunal tube group, oral capsule group and colonoscopy group were 74.2% (89/120), 60.0% (72/120) and 53.3% (16/30) respectively, whose difference was statistically significant (χ(2)=5.990, <0.05). The clinical improvement rates at 3 months after treatment were 71.1% (69/97), 53.6% (45/84), and 44.0% (11/25) respectively, whose difference was statistically significant (χ(2)=7.620, <0.05). The incidence of adverse reactions in the colonoscopy group was 76.7% (23/30), which was higher than that in the nasal nasojejunal group (39.2%, 47/120) and oral capsule group (21.7%, 26/120). The most common adverse reactions in the nasojejunal tube group, oral capsule group and colonoscopy group were respiratory discomfort (17.5%, 21/120), nausea and vomiting (10.0%, 12/120), and diarrhea (36.7%, 11/30). During the 3-month follow-up after treatment, no FMT-related adverse reactions were reported. The nasojejunal tube route has stable clinical efficacy and operability, while the oral capsule route has shorter waiting time and less cost. However, the adverse reactions caused by different transplantation methods are different, thus personalized transplantation method should be recommended.
评估不同途径给药的粪便微生物群移植（FMT）治疗慢传输型便秘（STC）的疗效和安全性。进行了一项回顾性队列研究。收集了2018年5月至2019年5月在同济大学第十人民医院自愿接受FMT治疗的270例STC患者的临床资料。采用非亲属健康成年标准供体。菌群移植的治疗途径包括鼻空肠管（鼻肠管组，120例）、口服肠菌胶囊治疗（口服胶囊组，120例）和结肠镜输注（结肠镜组，30例）。比较三组治疗的疗效和安全性。三组移植细菌均取自100g新鲜粪便。所有患者均成功完成移植。鼻肠管组、口服胶囊组和结肠镜组的等待时间分别为（1.5±0.5）天、（0.4±0.3）天和（3.6±0.8）天；建立移植路径的费用分别为（495±20）元、（25±10）元、（1420±45）元，差异有统计学意义（F = 9.210，P = 0.03；F = 10.600，P = 0.01）。FMT治疗后1个月，鼻肠管组、口服胶囊组和结肠镜组的临床改善率分别为74.2%（89/120）、60.0%（72/120）和53.3%（16/30），差异有统计学意义（χ² = 5.990，P < 0.05）。治疗后3个月的临床改善率分别为71.1%（69/97）、53.6%（45/84）和44.0%（11/25），差异有统计学意义（χ² = 7.620，P < 0.05）。结肠镜组不良反应发生率为76.7%（23/30），高于鼻肠管组（39.2%，47/本应120）和口服胶囊组（21.7%，26/120）。鼻肠管组、口服胶囊组和结肠镜组最常见的不良反应分别为呼吸不适（17.5%，21/120）、恶心呕吐（10.0%，12/120）和腹泻（36.7%，11/30）。治疗后3个月随访期间，未报告与FMT相关的不良反应。鼻肠管途径临床疗效稳定且具有可操作性，而口服胶囊途径等待时间较短且费用较低。然而不同移植方法引起的不良反应不同，因此应推荐个性化的移植方法。 （注：原文中“=9.210, =0.03; =10.600,=0.01”以及“χ(2)=5.990, <0.05”等表述可能有误，推测应是类似F值、P值、χ²值及对应P值等正确统计学术语表述，这里按正确理解翻译，但需注意原文可能存在错误表述影响准确性。）
