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目的观察粪便菌群移植(fecal microbiota transplantation,FMT)治疗腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)的疗效。方法 2015年4月至2016年9月南京大学医学院附属金陵医院普通外科肠道微生态治疗中心的12例符合罗马Ⅲ诊断标准的IBS-D患者,均给予FMT治疗,记录移植治疗前后患者腹部疼痛评分、排便次数、大便性状Bristol粪便评分、全球IBS评分和IBS-QOL评分及相关不良反应。治疗后随访12周。结果采用Cochran′s Q秩和检验比较FMT治疗前与治疗后第12周状况(P50,P25~P75):腹部疼痛明显缓解[(5.00,4.25~6.75)vs(3.00,2.25~3.00),P=0.003];粪便性状改善[(6.00,5.00~7.00)vs(4.00,3.25~5.00),P=0.003];排便次数下降[(3.50,3.00~5.00)vs(2.00,1.00~3.00),P=0.003],差异均具有统计学意义(P<0.05)。随访期间疗效稳定,患者未发生严重不良反应。结论 FMT能够改善IBS-D患者腹泻症状,缓解腹部症状,12周内治疗效果良好。
Objective To observe the efficacy of fecal microbiota transplantation (FMT) in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D). Methods From April 2015 to September 2016, 12 patients with IBS-D who met the diagnostic criteria of Rome Ⅲ in the General Surgical Intestinal Microecology Center of Jinling Hospital affiliated to Nanjing University Medical College were given FMT. The abdomen of patients before and after transplantation was recorded Pain score, defecation frequency, stool stool Bristol stool score, global IBS score and IBS-QOL score and related adverse reactions. After treatment for 12 weeks. Results The Cochran’s Q rank sum test was used to compare the pre-FMT and post-treatment week 12 status (P50, P25-P75): abdominal pain was significantly relieved (5.00, 4.25-6.75) vs (3.00,2.25-3.00), P = 0.003]; the improvement of stool performance [(6.00,5.00 ~ 7.00) vs (4.00,3.25 ~ 5.00), P = 0.003]; the number of defecation decreased [(3.50,3.00 ~ 5.00) vs = 0.003], the differences were statistically significant (P <0.05). The efficacy was stable during the follow-up, and no serious adverse reactions occurred in the patients. Conclusion FMT can improve diarrhea symptoms and relieve abdominal symptoms in patients with IBS-D, and the treatment effect is good within 12 weeks.