向　杰　张发明　黄光明

南京医科大学第二临床医学院　南京医科大学第二附属医院消化医学中心(210011)



粪菌移植的方法学及其治疗炎症性肠病的研究进展

向杰*张发明黄光明#

南京医科大学第二临床医学院南京医科大学第二附属医院消化医学中心(210011)

摘要炎症性肠病(IBD)是一组病因尚不明确的慢性非特异性肠道炎症性疾病，越来越多的证据表明肠道微生态在IBD发病中起有重要作用。粪菌移植(FMT)作为重建肠道菌群的微生态治疗方法，对多种胃肠道和代谢性疾病的治疗有效。本文主要针对FMT的方法学研究及其在IBD治疗中的应用进展作一综述。

关键词粪菌移植；方法；肠道微生态；炎症性肠病；治疗

Advances in Methodology of Fecal Microbiota Transplantation and its Application in Treatment of Inflammatory Bowel Disease

XIANGJie,ZHANGFaming,HUANGGuangming.TheSecondClinicalMedicalCollegeofNanjingMedicalUniversity;MedicalCenterforDigestiveDiseases,theSecondAffiliatedHospitalofNanjingMedicalUniversity,Nanjing(210011)

Correspondence to: HUANG Guangming, Email: hgming681@163.com

AbstractInflammatory bowel disease (IBD) is a group of chronic and nonspecific intestinal inflammatory diseases of unknown etiology. A growing body of evidence indicated that the intestinal microflora might play an important role in the pathogenesis of IBD. As a microecological therapy, fecal microbiota transplantation (FMT) has been used in various of gastrointestinal and metabolic diseases for reconstruction of intestinal flora and achieved favorable results. This article mainly reviewed the progress of technical innovation in FMT and its application in the treatment of IBD.

Key wordsFecal Microbiota Transplantation;Methods;Intestinal Microbiota;Inflammatory Bowel Disease;

Therapy

炎症性肠病(inflammatory bowel disease, IBD)是一组病因尚不十分明确的慢性非特异性肠道炎症性疾病，主要包括溃疡性结肠炎(ulcerative colitis, UC)和克罗恩病(Crohn’s disease, CD)。近年来，随着环境和饮食结构的改变、抗菌药物的广泛使用、社会和心理压力等多种因素的影响以及诊断技术的提高，IBD患病率逐年升高[1]。目前，越来越多的证据表明肠道微生态在IBD发病中起有重要作用，肠道菌群失调和肠黏膜屏障功能受损为IBD的发病特征，因此维持肠道菌群稳态、保护肠上皮屏障完整性成为IBD预防和治疗的关键[2]。

粪菌移植(fecal microbiota transplantation, FMT)是一种从健康捐赠者粪便中分离功能菌群，将其移植至患者消化道，从而重建患者肠道菌群的微生态治疗方法，已被用于多种胃肠道和代谢性疾病的治疗，如难治性艰难梭菌感染(Clostridiumdifficileinfection, CDI)、IBD等[3-7]，被认为可在短时间内改变患者的肠道菌群组成[8]。……