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随机、双盲、安慰剂对照的初步研究:粪便微生物群移植治疗慢性疲劳综合征的疗效。

Randomized, double-blinded, placebo-controlled pilot study: efficacy of faecal microbiota transplantation on chronic fatigue syndrome.

机构信息

Department of Medicine, Tampere University Hospital, BOX 2000, FIN, 33521, Tampere, Finland.

Department of Gastroenterology, Tampere University Hospital, Tampere, Finland.

出版信息

J Transl Med. 2023 Jul 29;21(1):513. doi: 10.1186/s12967-023-04227-y.

Abstract

BACKGROUND

Chronic fatigue syndrome (CFS) is a disabling illness of unknown aetiology. Disruption of gut microbiota may play a role in several neurological disorders. In this study, the effect of faecal microbiota transplantation (FMT) on fatigue severity and health-related quality of life (HRQOL) in patients with CFS was evaluated.

METHODS

Randomized, placebo-controlled pilot trial. Patients and researchers were blinded to treatment assignment. 11 patients with CFS (10 female and 1 male, mean age 42.2 years and mean duration of CFS 6.3 years) were randomly assigned to receive either FMT from a universal donor (n = 5) or autologous FMT (n = 6) via colonoscopy. Patients' HRQOL was assessed by using visual analog scale (VAS) and self-reporting questionnaires Modified Fatigue Impact Scale (MFIS), 15D and EQ-5D-3L. Patients' HRQOL was evaluated at baseline, and 1 and 6 months after the FMT.

RESULTS

The baseline VAS scores in the FMT and placebo groups were 62.4 and 76.0 (p = 0.29). 1-month scores were 60.0 and 73.7 and 6-months scores 72.8 and 69.5, respectively. Total MFIS scores in the FMT and placebo groups were 59.6 and 61.0 at the baseline (p = 0.80), 53.5 and 62.0 at 1 month and 58.6 and 56.2 at 6 months. Compared to the baseline scores, differences at 1 and 6 months were statistically insignificant both in VAS and in MFIS. The 15D and EQ-5D-3L profiles did not change after the FMT or placebo. FMT-related adverse events were not reported.

CONCLUSION

FMT was safe but did not relieve symptoms or improve the HRQOL of patients with CFS. Small number of study subjects limits the generalizability of these results. Trial Registration ClinicalTrials.gov Identifier NCT04158427, https://register.

CLINICALTRIALS

gov , date of registration 08/08/2019.

摘要

背景

慢性疲劳综合征(CFS)是一种病因不明的致残性疾病。肠道微生物群的破坏可能在几种神经紊乱中发挥作用。在这项研究中,评估了粪便微生物群移植(FMT)对 CFS 患者疲劳严重程度和健康相关生活质量(HRQOL)的影响。

方法

随机、安慰剂对照的初步试验。患者和研究人员对治疗分配均不知情。11 名 CFS 患者(10 名女性和 1 名男性,平均年龄 42.2 岁,CFS 平均病程 6.3 年)被随机分配接受来自通用供体的 FMT(n=5)或通过结肠镜检查接受自体 FMT(n=6)。使用视觉模拟量表(VAS)和自我报告问卷修改后的疲劳影响量表(MFIS)、15D 和 EQ-5D-3L 评估患者的 HRQOL。在 FMT 前、1 个月和 6 个月后评估患者的 HRQOL。

结果

FMT 和安慰剂组的基线 VAS 评分分别为 62.4 和 76.0(p=0.29)。1 个月时的评分分别为 60.0 和 73.7,6 个月时的评分分别为 72.8 和 69.5。FMT 和安慰剂组的总 MFIS 评分在基线时分别为 59.6 和 61.0(p=0.80),1 个月时分别为 53.5 和 62.0,6 个月时分别为 58.6 和 56.2。与基线评分相比,VAS 和 MFIS 在 1 个月和 6 个月时的差异均无统计学意义。15D 和 EQ-5D-3L 评分在 FMT 或安慰剂后均无变化。未报告与 FMT 相关的不良事件。

结论

FMT 安全,但不能缓解 CFS 患者的症状或改善其 HRQOL。研究对象数量少限制了这些结果的普遍性。试验注册临床Trials.gov 标识符 NCT04158427,https://register.

CLINICALTRIALS.gov,注册日期 2019 年 8 月 8 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bb1/10386223/a57e4bc545c0/12967_2023_4227_Fig1_HTML.jpg

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