A Meta-analysis Of The Efficacy Of Fecal Transplantation Combined With Conventional Protocols In The Treatment Of Chronic Constipation

Objective:To systematically evaluate the efficacy and safety of fecal microbiota transplantation(FMT)in the treatment of chronic constipation.Methods:Computer searches of PubMed,Embase,Cochrane Library,China Knowledge Network,Wanfang database,Vipshop database,and China Biomedical Literature Database were conducted to collect randomized controlled trials(RCTs)on the treatment of chronic constipation by FMT published at home and abroad,and two evaluators screened,extracted and performed data according to inclusion and exclusion criteria.methodological quality evaluation,and Meta-analysis was performed using RevMan 5.4.Results:Ten RCTs with a total of 864 patients were finally included.Meta-analysis showed that the efficiency of the FMT combined with conventional treatment group for chronic constipation was higher than that of the single conventional treatment group[RR=1.45,95% CI(1.26,1.67),P<0.05];in terms of improvement of stool properties,the FMT combined with conventional treatment regimen treated In terms of improvement in fecal traits,patients with chronic constipation had 0.94 higher fecal trait grade scores after FMT combined with conventional treatment than after conventional treatment alone[MD=0.94,95% CI(0.72,1.15),P<0.05];in a subgroup analysis of symptom improvement scores associated with constipation,the KESS subgroup [MD=-5.26,95%CI(-6.57,-3.96),P<0.05] and the Wexner subgroup [MD=-3.05,95% CI(-4.98,-1.13),P<0.05] suggested that the experimental group was significantly more effective than the conventional treatment in improving the symptoms associated with chronic constipation patients;in terms of quality of life associated with constipation patients,the experimental group was also significantly more effective than the control group [MD=-22.74,95%CI(-26.95,-18.54).26.95,-18.54),P < 0.05].Comparing the improvement of anxiety before and after treatment in both groups,the analysis also suggested that after treatment with FMT combined with conventional treatment protocol,the anxiety status of patients with chronic constipation improved significantly compared to the single conventional treatment group,and the efficacy was significantly better than that of the control group(SMD=-1.22,95% CI(-1.96,-0.48),p = 0.001).Conclusion:Whether the overall treatment efficiency of constipated patients,or the post-treatment observation of their stool properties,constipation-related clinical symptoms,and quality of life of constipated patients,the FMT combined with conventional treatment group was superior to the single conventional treatment group,and it can be used as an effective as a complementary means to conventional treatment into clinical implementation.