42例慢性疲劳综合征患者的回顾性结果研究，其中30例患有肠易激综合征。其中一半采用口腔入路治疗，一半采用粪便微生物组移植治疗

Q1 Medicine

Human Microbiome Journal Pub Date : 2019-08-01 DOI:10.1016/j.humic.2019.100061

J.N. Kenyon , Shelly Coe , Hooshang Izadi

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引用次数: 13

摘要

肠道微生物组包括肠道内的微生物群落。研究表明，微生物组的改变可能在包括肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)在内的多种疾病中发挥作用。方法将42例ME/CFS合并肠易激综合征(IBS)患者分为两组，其中21例接受标准口服治疗，包括各种营养药物、益生菌、益生元、饮食建议和生活方式建议。第二组大多采用口服方法失败，采用粪便微生物组移植(FMT)治疗。每位患者接受10个植入物，每个来自不同的筛选供体，植入物在厌氧条件下处理。移植通过一根儿科直肠导管进行，该导管通过肛门插入乙状结肠的下部。治疗前后以百分率评价结果，0%为无改善，100%为最大改善。采用精确的非参数曼-惠特尼(单侧)检验比较FMT组与仅接受口服入路组的中位数。根据多年的临床经验，由于没有慢性疲劳综合征的测试，判断慢性疲劳综合征改善的唯一方法是我的临床评估。结果FMT组的中位数明显高于口服治疗组(Mann-Whitney U = 111.5,p = .003)。因此，FMT组改善程度更大(z = −2.761)。结论FMT治疗CFS合并IBS是一种安全且有前景的治疗方法。应该进行足够有力的随机对照试验来评估FMT对CFS和IBS患者的有效性。

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A retrospective outcome study of 42 patients with Chronic Fatigue Syndrome, 30 of whom had Irritable Bowel Syndrome. Half were treated with oral approaches, and half were treated with Faecal Microbiome Transplantation

The gut microbiome comprises the community of microorganisms in the intestinal tract. Research suggests that an altered microbiome may play a role in a wide range of disorders including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Methods

42 participants with ME/CFS with Irritable Bowel Syndrome (IBS) were allocated into one of two groups, 21 were treated with standard oral approaches, which centred around various nutritional remedies, probiotics, prebiotics, dietary advice and lifestyle advice. The second group who had mostly failed using oral approaches, were treated with Faecal Microbiome Transplantation (FMT). Each patient received 10 Implants, each from a different screened donor, and the Implants were processed under anaerobic conditions. The transplant is delivered via a paediatric rectal catheter, which is inserted through the anus to reach the lower part of the sigmoid colon.

The results were assessed on a percentage basis before and after treatment, 0% being no improvement, 100% being maximum improvement. An exact non-parametric Mann-Whitney (one-tailed) test was used to compare medians from those on FMT compared with those receiving oral approaches only. On clinical experience over many years, the only way to judge improvement in Chronic Fatigue Syndrome as there is no test for Chronic Fatigue Syndrome, is my clinical assessment.

Results

The median for the FMT group was found to be significantly higher compared to the oral treatment group (Mann-Whitney U = 111.5, p = .003). Therefore, the FMT group improved to a greater extent (z = −2.761).

Conclusion

This study shows that FMT is a safe and a promising treatment for CFS associated with IBS. Adequately powered randomised controlled trials should be carried out to assess the effectiveness of FMT in patients with CFS and IBS.

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来源期刊

Human Microbiome Journal Medicine-Infectious Diseases

自引率

0.00%

发文量

期刊介绍： The innumerable microbes living in and on our bodies are known to affect human wellbeing, but our knowledge of their role is still at the very early stages of understanding. Human Microbiome is a new open access journal dedicated to research on the impact of the microbiome on human health and disease. The journal will publish original research, reviews, comments, human microbe descriptions and genome, and letters. Topics covered will include: the repertoire of human-associated microbes, therapeutic intervention, pathophysiology, experimental models, physiological, geographical, and pathological changes, and technical reports; genomic, metabolomic, transcriptomic, and culturomic approaches are welcome.