粪菌移植对克罗恩病的疗效观察:基于系统评价和单个率的meta分析  

Efficacy of Fecal Microbiota Transplantation for Treating Crohn’s Disease:A Systematic Review and Meta-analysis of Single Rate

作　　者：叶惠红 胡珊珊 陈德玲 汤丽平[1] YE Huihong;HU Shanshan;CHEN Deling;TANG Liping(Department of Gastroenterology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016)

机构地区：[1]重庆医科大学附属第一医院消化内科,400016

出　　处：《胃肠病学》2020年第10期594-600,共7页Chinese Journal of Gastroenterology

摘　　要：背景:粪菌移植(FMT)是一种针对肠道微生物的治疗手段,近年开始用于治疗克罗恩病(CD),但其疗效和安全性尚未明确。目的:系统评价FMT对CD的疗效和安全性。方法:系统检索Embase、Medline(via PubMed)、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、中文科技期刊数据库、中国生物医学文献数据库中应用FMT治疗CD患者的相关研究,检索时限均从各数据库建库至2020年5月1日。由2名研究者独立筛选文献、提取资料,并采用MINORS评估研究质量。应用RevMan 5.3软件对所纳入的文献进行meta分析。结果:共纳入7篇研究、256例CD患者。Meta分析结果显示FMT对CD患者的应答率为72%(95%CI:0.66~0.77),缓解率为60%(95%CI:0.51~0.69)。常见不良反应包括腹痛、腹泻、腹胀等,无严重不良反应发生。结论:FMT治疗CD的有效性和安全性较高,但未来仍需更多的高质量随机对照试验进行验证。Background:Fecal microbiota transplantation(FMT)is a therapeutic approach targeting at intestinal microorganisms and is used in recent years for the treatment of Crohn’s disease(CD),however,its efficacy and safety remain unclear.Aims:To systematically evaluated the efficacy and safety of FMT in CD patients.Methods:Studies of FMT in the treatment of CD were retrieved from Embase,Medline(via PubMed),Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP,CBM from their inception to May 1,2020.Literatures were independently screened by two reviewers,data were extracted and the quality of included studies was assessed by MINORS.Meta-analysis was conducted by RevMan 5.3 software.Results:Seven studies involving 256 CD patients were enrolled.Meta-analysis showed that total response rate of CD patients treated with FMT was 72%(95%CI:0.66-0.77),while remission rate was 60%(95%CI:0.51-0.69).The common adverse reactions were abdominal pain,diarrhea,abdominal bloat;no severe adverse reactions were found.Conclusions:The efficacy and safety of FMT for the treatment of CD are quite high as indicated in this study,however,high-quality randomized controlled trials are need to confirm this finding.

关 键 词：粪菌移植 CROHN病 治疗 安全 META分析 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]