粪菌移植治疗肠道微生态失调所致疾病的研究进展
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摘要
肠道中数以亿计的微生物构成肠道微生态。肠道微生态在失衡时会引起多种肠道内外疾病。粪菌移植作为一种有效的治疗方法在传统中医中早有应用,近年来重新引起广泛关注。由于该治疗方法可以纠正肠道微生态紊乱,所以在治疗肠道相关疾病中效果最为突出。临床医师和科研人员的不断研究发现,粪便移植不仅能治疗肠道相关疾病,而且在代谢性、心血管、神经性等疾病的治疗上渐露头角。本文从粪菌移植的历史、相关疾病、治疗措施及未来前景等方面结合国内外最新研究进展进行综述,为粪菌移植相关研究和临床应用提供借鉴。
Intestinal microecology consists of billions of gut microorganisms. Gut dysbiosis is thought to play a key role in the development of a variety of diseases. Fecal microbiota transplantation, as an effective treatment that has long been used in traditional Chinese medicine, has recently attracted widespread attention again. With the effect of correcting gut dysbiosis, it is the most effective treatment of gut-associated diseases. The studies by clinicians and researchers have found that fecal microbiota transplantation can not only treat gut-associated diseases, but also be helpful in the treatment of metabolic, cardiovascular,and neurological diseases. This article reviews the history, related diseases, therapeutic measures, and prospect of fecal microbiota transplantation, as well as the latest research advances in this field, providing a reference for the study and clinical application of fecal microbiota transplantation.
Intestinal microecology consists of billions of gut microorganisms. Gut dysbiosis is thought to play a key role in the development of a variety of diseases. Fecal microbiota transplantation, as an effective treatment that has long been used in traditional Chinese medicine, has recently attracted widespread attention again. With the effect of correcting gut dysbiosis, it is the most effective treatment of gut-associated diseases. The studies by clinicians and researchers have found that fecal microbiota transplantation can not only treat gut-associated diseases, but also be helpful in the treatment of metabolic, cardiovascular,and neurological diseases. This article reviews the history, related diseases, therapeutic measures, and prospect of fecal microbiota transplantation, as well as the latest research advances in this field, providing a reference for the study and clinical application of fecal microbiota transplantation.
引文
[1]白焕焕,周长丽,刘立坤,等.粪便微生物移植与胃肠外相关疾病的研究进展[J].中国老年学杂志,2016,36(4):1005-1008.
[2]刘云燕,丁百静.粪微生态移植治疗难辨梭状芽孢杆菌感染的研究现状[J].胃肠病学和肝病学杂志,2015,24(10):1257-1259.
[3]葛俊辰,陈志彪.现代医学中粪菌移植的历史溯源[J].临床医药文献电子杂志,2015,2(12):2453.
[4]李时珍.本草纲目[M].北京:华夏出版社,2011:1921-1923.
[5] EISEMAN B, SILEN W, BASCOM G S, et al. Fecal enema as anadjunct in the treatment of pseudomembranous enterocolitis[J]. Surgery, 1958, 44(5):854-859.
[6] BANKS W A. Evidence for a cholecystokinin gut-brain axis with modulation by bombesin[J]. Peptides,1980,1(4):347-351.
[7] BORODY T J, NOWAK A, FINLAYSON S. The GI microbiome and its role in chronic fatigue syndrome:a summary of bacteriotherapy[J]. J AustralasCollNutrEnv Med, 2012,31(1):3.
[8] FREMONT M, COOMANS D, MASSART S, et al. High-throughput16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients[J]. Anaerobe,2013,22:50-56.
[9]高燕.1例双侧额叶脑挫裂伤合并反复腹泻行粪菌移植患者的护理[J].中西医结合心血管病电子杂志,2018(1):197-198.
[10] OGLODEK E, SZOTA A, JUST M, et al. The role of the neuroendocrine and immune systems in the pathogenesis of depression[J]. Pharmacol Rep, 2014,66(5):776-781.
[11] TURNBAUGH P J, LEY R E, MAHOWALD M A, et al. An obesity-associated gut microbiome with increased capacity for energy harvest[J]. Nature,2006,444(7122):1027-1031.
[12] VRIEZE A, VAN NOOD E, HOLLEMAN F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabol-ic syndrome[J]. Gastroenterology, 2012,143(4):913-916.
[13]郭上齐,武华,翟春宝,等.粪菌移植对营养性肥胖大鼠血脂及肠道屏障的影响[J].中国现代医生,2016,54(4):25-27,33.
[14] BRANDT L J, ARONIADIS O C,MELLOW M, et al. Longterm follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection[J]. Am J Gastroenterol,2012,107(7):1079-1087.
[15] SURAWICZ C M, BRANDT I J, BINION D G, et al. Guidelines fordiagnosis, treatment, and prevention of Clostridium difficile infections[J]. Am J Gastroenterol, 2013,108(4):478-498.
[16] VAN NOOD E, VRIEZE A, NIEUWDORP M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile[J]. N Engl J Med, 2013, 368(5):407-415.
[17] LOUIE T J, MILLER M A, MULLANE K M, et al. OPT-80-003Clinical Study Group,Fidaxomicin versus vancomycin for Clostridium difficile infection[J]. N Engl J Med, 2011, 364(5):422-431.
[18]林乐,李为民,汤斌斌,等.粪便移植治疗炎症性肠病疗效的系统评价及单个率的Meta分析[J].医学研究杂志,2016,45(6):118-126.
[19] BENNET J D, BRINKMAN M. Treatment of ulcerative colitis by implantation of normal colonic flora[J]. Lancet, 1989, 1(8630):164.
[20] BORODY T J,WARREN E F, LEIS S, et al. Treatment of ulcerative colitis using fecal bacteriotherapy[J]. J ClinGastroenterol, 2003,37(1):42-47.
[21] ANDERSON J L, EDNEY R J,WHELAN K. Systematic review:faecal microbiota transplantation in the magnagement of inflammatory bowel disease[J]. Aliment Pharmacol Tber,2012,36(6):503-516.
[22]龙承星,贺璐,郭抗萧,等.超微七味白术散与酵母菌联用对菌群失调腹泻小鼠肠道细菌多样性的影响[J].中国中西医结合杂志,2018,38(1):66-70.
[23]菌群对食物过敏的影响[J].中国妇幼健康研究,2017,28(12):1767.
[24]王琳琳.双歧杆菌对便秘的影响及其作用机理研究[D].无锡:江南大学,2017.
[25] SOFI M H, GUDI R, KARUMUTHIL-MELETHIL S, et al, pH of drinking water influences the composition of gut microbeome and type 1 diabetes incidence[J]. Diabetes,2014,63(2):632-644.
[26] ROBERTSON D J, DOMINITZ J A. Stool DNA and colorectalcancerscreening[J]. Nengl J Med, 2014,370(14):1350-1351.
[27] CLARKE G, GRENHAM S, SCULLY P, et al. The microbiome-gutbrain axis during early life regulates the hippocampalserotonergic system in a sex-dependent manner[J]. Mol Psychiatry,2013,18(6):666-673.
[28]杨云生,王子恺.粪菌移植的研究进展[J].胃肠病学,2014,19(1):1-5.
[2]刘云燕,丁百静.粪微生态移植治疗难辨梭状芽孢杆菌感染的研究现状[J].胃肠病学和肝病学杂志,2015,24(10):1257-1259.
[3]葛俊辰,陈志彪.现代医学中粪菌移植的历史溯源[J].临床医药文献电子杂志,2015,2(12):2453.
[4]李时珍.本草纲目[M].北京:华夏出版社,2011:1921-1923.
[5] EISEMAN B, SILEN W, BASCOM G S, et al. Fecal enema as anadjunct in the treatment of pseudomembranous enterocolitis[J]. Surgery, 1958, 44(5):854-859.
[6] BANKS W A. Evidence for a cholecystokinin gut-brain axis with modulation by bombesin[J]. Peptides,1980,1(4):347-351.
[7] BORODY T J, NOWAK A, FINLAYSON S. The GI microbiome and its role in chronic fatigue syndrome:a summary of bacteriotherapy[J]. J AustralasCollNutrEnv Med, 2012,31(1):3.
[8] FREMONT M, COOMANS D, MASSART S, et al. High-throughput16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis/chronic fatigue syndrome patients[J]. Anaerobe,2013,22:50-56.
[9]高燕.1例双侧额叶脑挫裂伤合并反复腹泻行粪菌移植患者的护理[J].中西医结合心血管病电子杂志,2018(1):197-198.
[10] OGLODEK E, SZOTA A, JUST M, et al. The role of the neuroendocrine and immune systems in the pathogenesis of depression[J]. Pharmacol Rep, 2014,66(5):776-781.
[11] TURNBAUGH P J, LEY R E, MAHOWALD M A, et al. An obesity-associated gut microbiome with increased capacity for energy harvest[J]. Nature,2006,444(7122):1027-1031.
[12] VRIEZE A, VAN NOOD E, HOLLEMAN F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabol-ic syndrome[J]. Gastroenterology, 2012,143(4):913-916.
[13]郭上齐,武华,翟春宝,等.粪菌移植对营养性肥胖大鼠血脂及肠道屏障的影响[J].中国现代医生,2016,54(4):25-27,33.
[14] BRANDT L J, ARONIADIS O C,MELLOW M, et al. Longterm follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection[J]. Am J Gastroenterol,2012,107(7):1079-1087.
[15] SURAWICZ C M, BRANDT I J, BINION D G, et al. Guidelines fordiagnosis, treatment, and prevention of Clostridium difficile infections[J]. Am J Gastroenterol, 2013,108(4):478-498.
[16] VAN NOOD E, VRIEZE A, NIEUWDORP M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile[J]. N Engl J Med, 2013, 368(5):407-415.
[17] LOUIE T J, MILLER M A, MULLANE K M, et al. OPT-80-003Clinical Study Group,Fidaxomicin versus vancomycin for Clostridium difficile infection[J]. N Engl J Med, 2011, 364(5):422-431.
[18]林乐,李为民,汤斌斌,等.粪便移植治疗炎症性肠病疗效的系统评价及单个率的Meta分析[J].医学研究杂志,2016,45(6):118-126.
[19] BENNET J D, BRINKMAN M. Treatment of ulcerative colitis by implantation of normal colonic flora[J]. Lancet, 1989, 1(8630):164.
[20] BORODY T J,WARREN E F, LEIS S, et al. Treatment of ulcerative colitis using fecal bacteriotherapy[J]. J ClinGastroenterol, 2003,37(1):42-47.
[21] ANDERSON J L, EDNEY R J,WHELAN K. Systematic review:faecal microbiota transplantation in the magnagement of inflammatory bowel disease[J]. Aliment Pharmacol Tber,2012,36(6):503-516.
[22]龙承星,贺璐,郭抗萧,等.超微七味白术散与酵母菌联用对菌群失调腹泻小鼠肠道细菌多样性的影响[J].中国中西医结合杂志,2018,38(1):66-70.
[23]菌群对食物过敏的影响[J].中国妇幼健康研究,2017,28(12):1767.
[24]王琳琳.双歧杆菌对便秘的影响及其作用机理研究[D].无锡:江南大学,2017.
[25] SOFI M H, GUDI R, KARUMUTHIL-MELETHIL S, et al, pH of drinking water influences the composition of gut microbeome and type 1 diabetes incidence[J]. Diabetes,2014,63(2):632-644.
[26] ROBERTSON D J, DOMINITZ J A. Stool DNA and colorectalcancerscreening[J]. Nengl J Med, 2014,370(14):1350-1351.
[27] CLARKE G, GRENHAM S, SCULLY P, et al. The microbiome-gutbrain axis during early life regulates the hippocampalserotonergic system in a sex-dependent manner[J]. Mol Psychiatry,2013,18(6):666-673.
[28]杨云生,王子恺.粪菌移植的研究进展[J].胃肠病学,2014,19(1):1-5.