肠道菌群移植治疗溃疡性结肠炎的有效性和安全性:系统评价和Meta分析
Efficacy and safety of fecal microbiota transplantation in the treatment of ulcerative colitis:a systematic review and Meta-analysis
贺海艳 1何舰 1王馨祎 1孟捷2
作者信息
- 1. 北京中医药大学,北京 100105
- 2. 北京中医药大学东方医院脾胃肝胆科
- 折叠
摘要
目的 通过荟萃分析来评价肠道菌群移植(fecal microbiota transplantation,FMT)治疗溃疡性结肠炎(ulcerative colitis,UC)的有效性和安全性.方法 运用计算机检索在 PubMed、EmBase、The Cochrane Library、Web of Science 四个数据库中检索关于 FMT治疗 UC的 RCTs文献,时间范围为数据库建库至 2024 年 2 月.运用 RevMan 5.3 软件进行 Meta 分析.结果 检索到文献 2 304篇,筛选后最终纳入 14 篇文献进行 Meta分析,共 726 例患者.分析结果显示:FMT 治疗组的临床反应率要显著高于对照组(MD=2.08,95％CI:1.45～3.00,P<0.0001);FMT治疗组的临床缓解率显著高于对照组(MD=2.67,95％CI:1.88～3.79,P<0.00001);FMT治疗组的内镜缓解率显著高于对照组(MD=2.19,95％CI:1.42～3.36,P=0.0004);FMT治疗组的不良反应发生率与对照组相比,差异无统计学意义(MD=1.27,95％CI:0.84～1.92,P=0.26).结论 FMT 治疗 UC 可以显著提高患者的临床反应率、临床缓解率和内镜缓解率,且其安全性与对照组相比并无明显差异.但由于纳入文章的数量有限,未来需要更多高质量的 RCTs来进一步证实其可靠性.
Abstract
Objective To evaluate the efficacy and safety of fecal microbiota transplantation(FMT)for the treat-ment of ulcerative colitis(UC)by Meta-analysis.Methods A computerized search was used to retrieve literature on RCTs of FMT for UC in four databases:PubMed,EmBase,The Cochrane Library and Web of Science,with a timeframe from the beginning of the database construction to Feb.2024.Meta-analysis was performed using RevMan 5.3 software.Results The literature was retrieved from 2 304 articles,and after screening,14 articles were finally included in the Meta-analysis,with a total of 726 patients.The results of the analysis showed that the clinical response rate in the FMT treatment group was significantly higher than that in the control group(MD=2.08,95% CI:1.45-3.00,P<0.0001);the clinical remission rate in the FMT treatment group was significantly higher than that in the control group(MD=2.67,95% CI:1.88-3.79,P<0.00001);and the endoscopic remission rate was significantly higher in the FMT treat-ment group than in the control group(MD=2.19,95% CI:1.42-3.36,P=0.0004);and the incidence of adverse reactions in the FMT treatment group was not statistically different from that in the control group(MD=1.27,95% CI:0.84-1.92,P=0.26).Conclusion The use of FMT for the treatment of UC significantly increased the clinical re-sponse rate,clinical remission rate and endoscopic remission rate of patients,and its safety is not significantly different from that of the control group.However,due to the limited number of included articles,more high-quality RCTs are needed in the future to further confirm the reliability of this Meta-analysis.
关键词
肠道菌群移植/溃疡性结肠炎/荟萃分析Key words
Fecal microbiota transplantation/Ulcerative colitis/Meta-analysis引用本文复制引用
基金项目
北京市科技计划项目(Z161100000516058)
第四批全国中医(临床、基础)优秀人才研修项目(国中医药人教发[2017]24号)
出版年
2024
NETL
NSTL
万方数据