粪菌移植对顽固性便秘患者肠道功能、免疫功能及炎症反应的改善效果  

The improvement effects of fecal microbiota transplantation on intestinal function,immune function and inflammation response in patients with refractory constipation

作　　者：于丹丹[1] 刘亚坡 洪文[1] 杨博[1] 张媛[2] Yu Dandan;Liu Yapo;Hong Wen;Yang Bo;Zhang Yuan(Department of Proctology,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;Department of Anorectal Surgery,Changji Branch,First Affiliated Hospital of Xinjiang Medical University,Changji 831100,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院肛肠科,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院昌吉分院肛肠科,新疆昌吉831100

出　　处：《结直肠肛门外科》2024年第5期578-583,共6页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨粪菌移植对顽固性便秘患者肠道功能、免疫功能和炎症反应的改善效果。方法纳入2022年3月至2023年3月在新疆医科大学第一附属医院肛肠科就诊的顽固性便秘患者56例,采用随机数字表法将患者分为对照组(采用常规药物治疗,n=28)和观察组(在对照组基础上加用粪菌移植治疗,n=28)。比较两组治疗前和治疗后1个月的症状积分、临床疗效和不良反应,菌群值及B/E值,肠道功能(血管活性肠肽、生长抑素和胃动素)、免疫功能(干扰素-γ和白细胞介素-4)及炎症反应指标(白细胞介素-6和肿瘤坏死因子-α)水平。结果治疗后1个月,两组症状积分均较治疗前低,观察组评分较对照组低,差异有统计学意义(P<0.05);对照组的总有效率为71.43%,观察组的总有效率为92.86%,总有效率比较差异有统计学意义(P<0.05),两组均未出现严重不良反应。观察组酵母菌、双歧杆菌和乳酸杆菌的菌群值较治疗前增加,肠杆菌、肠球菌、拟杆菌和梭菌的菌群值下降,B/E值升高,差异有统计学意义(P<0.05);对照组各种菌群的菌群值及B/E值与治疗前比较差异无统计学意义(P>0.05)。同对照组相比,治疗前观察组各种菌群的菌群值及B/E值的差异无统计学意义(P>0.05),治疗后1个月观察组酵母菌、双歧杆菌和乳酸杆菌的菌群值更高,肠杆菌、肠球菌、拟杆菌和梭菌的菌群值更低,B/E值更高,差异有统计学意义(P<0.05)。两组血清血管活性肠肽、生长抑素和胃动素水平均较治疗前增加,观察组水平高于对照组,差异有统计学意义(P<0.05)。两组血清干扰素-γ和白细胞介素-4水平均较治疗前增加,观察组水平高于对照组,差异有统计学意义(P<0.05)。两组血清IL-6和TNF-α水平均较治疗前降低,观察组水平低于对照组,差异有统计学意义(P<0.05)。结论粪菌移植对顽固性便秘患者的肠道功能、免疫功能和炎症反应具有良好的改善效果,能Objectives To investigate the improvement effects of fecal microbiota transplantation(FMT)on intestinal function,immune function,and inflammatory response in patients with refractory constipation.Methods Fifty-six patients with refractory constipation who visited the Department of Proctology of the First Affiliated Hospital of Xinjiang Medical University from March 2022 to March 2023 were enrolled and randomly divided into a control group(receiving conventional drug therapy,n=28)and an observation group(receiving FMT in addition to conventional drug therapy,n=28).The symptom scores,clinical efficacy,adverse reactions,microbial community values(including Yeast,Bifidobacteria,Lactobacilli,Escherichia coli,Enterococcus,Bacteroides,Clostridium,and the B/E ratio),intestinal function indicators(vasoactive intestinal peptide,somatostatin,and motilin),immune function indicators(interferon-γ and interleukin-4),and inflammatory response indicators(interleukin-6 and tumor necrosis factor-α)were compared between the two groups before and one month after treatment.Results One month after treatment,the symptom scores in both groups were lower than those before treatment,with the observation group showing significantly lower scores compared to the control group(P<0.05).The total clinical effective rate was 71.43%in the control group and 92.86%in the observation group,with a statistically significant difference(P<0.05).No serious adverse reactions occurred in either group.In the observation group,the microbial community values of yeast,bifidobacteria,and lactobacilli increased,while those of Escherichia coli,Enterococcus,Bacteroides,and Clostridium decreased,and the B/E ratio increased significantly compared to before treatment(P<0.05).There were no significant changes in the microbial community values or B/E ratio in the control group(P>0.05).Before treatment,there were no significant differences in the microbial community values or B/E ratio between the two groups(P>0.05).One month after treatment,the microbial community val

关 键 词：顽固性便秘 粪菌移植 免疫 炎症反应 

分 类 号：R574.6[医药卫生—消化系统]