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供体-受体匹配的粪便微生物群移植治疗腹泻型肠易激综合征患者的疗效:一项单中心、随机、双盲、安慰剂对照研究。

Efficacy of Donor-Recipient-Matched Faecal Microbiota Transplantation in Patients with IBS-D: A Single-Centre, Randomized, Double-Blind Placebo-Controlled Study.

作者信息

Zhang Yanli, Wang Shuai, Wang Huifen, Cao Man, Wang Miao, Zhang Bangzhou, Xiao Chuanxing, Zhu Huiting, Du Shiyu

机构信息

Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China.

Center for Research and Development, Xiamen Treatgut Biotechnology Co., Ltd., Xiamen, China.

出版信息

Digestion. 2024;105(6):457-467. doi: 10.1159/000540420. Epub 2024 Jul 31.

Abstract

INTRODUCTION

The imbalance in gut microbiota is contributing to the development and progression of IBS. FMT can improve the gut microbiota, and donor-recipient-matched FMT can help develop individualized treatment plans according to different enterotypes. This study aimed to explore the efficacy of donor-recipient-matched FMT in IBS with predominant diarrhoea (IBS-D) and evaluate its effects on gut microbiota.

METHODS

Twenty-seven patients with IBS-D were randomly divided into donor-recipient-matched FMT group (group P), random-donor FMT group (group R), and placebo group (group B). All participants received corresponding FMT treatment after filling in IBS-S, IBS-QoL, GSRS, and HADS questionnaires and having their stool samples collected at 4, 8, and 12 weeks after treatment. The improvement in the symptoms and the changes in the bacterial flora were analysed for three groups.

RESULTS

The IBS-SSS, IBS-QoL, GSRS, and anxiety scores of group P were significantly lower after treatment (p < 0.05). The IBS-QoL scores of group R were significantly lower after treatment (p < 0.05). Beta diversity analysis showed that the gut microbiota of group P had an obvious trend of classification after treatment. Seven bacterial genera were related to the differences in the IBS-SSS scores before and after treatment.

CONCLUSION

Donor-recipient-matched FMT significantly improved the clinical symptoms, quality of life, and anxiety scores of the patients with IBS-D than random-donor FMT.

摘要

引言

肠道微生物群失衡促进了肠易激综合征的发生和发展。粪菌移植(FMT)可改善肠道微生物群,供体-受体匹配的FMT有助于根据不同的肠型制定个性化治疗方案。本研究旨在探讨供体-受体匹配的FMT对腹泻型肠易激综合征(IBS-D)的疗效,并评估其对肠道微生物群的影响。

方法

27例IBS-D患者被随机分为供体-受体匹配的FMT组(P组)、随机供体FMT组(R组)和安慰剂组(B组)。所有参与者在填写IBS-S、IBS-QoL、GSRS和HADS问卷,并在治疗后4周、8周和12周采集粪便样本后,接受相应的FMT治疗。分析三组患者症状的改善情况和菌群的变化。

结果

治疗后P组的IBS-SSS、IBS-QoL、GSRS和焦虑评分显著降低(p<0.05)。治疗后R组的IBS-QoL评分显著降低(p<0.05)。β多样性分析显示,P组治疗后肠道微生物群有明显的分类趋势。7个细菌属与治疗前后IBS-SSS评分的差异有关。

结论

与随机供体FMT相比,供体-受体匹配的FMT显著改善了IBS-D患者的临床症状、生活质量和焦虑评分。

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