粪菌移植的现状及其伦理学思考
|
摘要
粪菌移植给许多疾病的治疗开辟了新领域,但其仍处于初期发展阶段,面临着交叉感染隐患、临床应用不规范、厌恶心理、患者信息泄漏等问题。从医学伦理学基本原则的角度对这些问题作了思考,提出了如下建议:消除交叉感染隐患、规范临床应用、消除大众对粪茵移植的厌恶心理、保护患者个人隐私,以期促进该技术的规范发展。
Fecal microbiota transplantation opens new fields for treatment of many diseases.However,it is still immature and faces with many problems including probability of infection,unstandardized clinical application,aversion,and patient information leakage and other issues.This article analyzed these problems to make following suggestions for clinical application of fecal microbiota transplantation from basic ethical principle perspective,decrease the potential risk of cross infection,standardize the clinical application,eliminate the public aversion,protect the privacy of patients,and thereby promote standardized development of this technology.
Fecal microbiota transplantation opens new fields for treatment of many diseases.However,it is still immature and faces with many problems including probability of infection,unstandardized clinical application,aversion,and patient information leakage and other issues.This article analyzed these problems to make following suggestions for clinical application of fecal microbiota transplantation from basic ethical principle perspective,decrease the potential risk of cross infection,standardize the clinical application,eliminate the public aversion,protect the privacy of patients,and thereby promote standardized development of this technology.
引文
[1]Borody T.J,Khoruts A.Fecal microbiota transplantation and emerging applications[J].Nat Rev Gastroenterol Hepatol,2011,9(2):88-96.
[2]Surawicz C.M,Brandt L.J,Binion D.G,et al.Guidelines for diagnosis,treatment,and prevention of Clostridium difficile infections[J].Am J Gastroenteml,2013,108(4):478-498.
[3]Khoruts A.Fecal microbiota transplantation in 2013:developing human gut microbiota as a class of therapeutics[J].Nat Rev Gastroenterol Hepatol,2014,11(2):79-80.
[4]张发明.粪茵移植:1700年的医学史及其临床应用[J].湖北民族学院学报(医学版),2012,29(3):1-4.
[5]彭丽华,杨云生.肠道微生态与非消化道疾病[J].中华消化杂志,2013,33(12):819-821.
[6]Gough E,Shaikh H,Manges A.R.Systematic Review of Intestinal Microbiota Transplantation(Fecal Bacteriotherapy)for Recurrent Clostridium difficile Infection[J].Clinical Infectious Diseases,2011,53(10):994-1002.
[7]Surawicz C.M,Brandt L.J,Binion D.G,et al.Guidelines for diagnosis,treatment,and prevention of Clostridium difficile infections[J].Am J Gastroenterol,2013,108(4):478-498.
[8]梁珏,丁岩冰.一个新兴的治疗措施:粪菌移植[J].中华消化杂志,2014,34(7):498-499.
[9]Petrof E.O,Gloor G.B,Vanner S.J,et al.Stool substitute transplant therapy for the eradication of Clostridium difficile infection;"RePOOPulating"thegut[J].Microbiome,2013,1(1):3.
[10]廖诗乐,陈白莉,曾志荣.粪菌移植治疗炎症性肠病的现状和问题[J].新医学,2014,45(9):569-572.
[11]戴张晗,郑青,冉志华.粪便茵群移植在炎症性肠病治疗中的应用[J].中华消化杂志,2014,34(4):283-285.
[12]Bakken J.S,Borody T,Brandt L.J,et al.Treating Clostridium difficile infection with fecal microbiota transplantation[J].Clin Gastroenterol Hepatol,2011,9(12);1044-1049.
[13]杨灿,郭鑫,谢军.基因治疗技术的伦理思考[J].中国医学伦理学,2013,26(3):331-333.
[2]Surawicz C.M,Brandt L.J,Binion D.G,et al.Guidelines for diagnosis,treatment,and prevention of Clostridium difficile infections[J].Am J Gastroenteml,2013,108(4):478-498.
[3]Khoruts A.Fecal microbiota transplantation in 2013:developing human gut microbiota as a class of therapeutics[J].Nat Rev Gastroenterol Hepatol,2014,11(2):79-80.
[4]张发明.粪茵移植:1700年的医学史及其临床应用[J].湖北民族学院学报(医学版),2012,29(3):1-4.
[5]彭丽华,杨云生.肠道微生态与非消化道疾病[J].中华消化杂志,2013,33(12):819-821.
[6]Gough E,Shaikh H,Manges A.R.Systematic Review of Intestinal Microbiota Transplantation(Fecal Bacteriotherapy)for Recurrent Clostridium difficile Infection[J].Clinical Infectious Diseases,2011,53(10):994-1002.
[7]Surawicz C.M,Brandt L.J,Binion D.G,et al.Guidelines for diagnosis,treatment,and prevention of Clostridium difficile infections[J].Am J Gastroenterol,2013,108(4):478-498.
[8]梁珏,丁岩冰.一个新兴的治疗措施:粪菌移植[J].中华消化杂志,2014,34(7):498-499.
[9]Petrof E.O,Gloor G.B,Vanner S.J,et al.Stool substitute transplant therapy for the eradication of Clostridium difficile infection;"RePOOPulating"thegut[J].Microbiome,2013,1(1):3.
[10]廖诗乐,陈白莉,曾志荣.粪菌移植治疗炎症性肠病的现状和问题[J].新医学,2014,45(9):569-572.
[11]戴张晗,郑青,冉志华.粪便茵群移植在炎症性肠病治疗中的应用[J].中华消化杂志,2014,34(4):283-285.
[12]Bakken J.S,Borody T,Brandt L.J,et al.Treating Clostridium difficile infection with fecal microbiota transplantation[J].Clin Gastroenterol Hepatol,2011,9(12);1044-1049.
[13]杨灿,郭鑫,谢军.基因治疗技术的伦理思考[J].中国医学伦理学,2013,26(3):331-333.