Clinical Efficacy Of Fecal Microbiota Transplantation For In Flammatory Bowel Disease: A Meta Analysis

Objective:Inflammatory bowel disease(IBD),including ulcerative colitis(UC)and Crohn's disease(CD),is group of a chronic and inflammatory disorders in intestine and colon.Aberrant immunity together with genetic and environmental factors contributes to the pathogenesis of IBD,albeit the etiology of IBD is still uncertain.IBD is closely related to intestinal flora.Abnormal intestinal flora may cause the imbalance of intestinal mucosal immune and the damage of intestinal mucosa by inducing abnormal intestinal mucosal immune response and increasing intestinal permeability,leading to the onset of IBD.Fecal microbiota transplantation,functional bacteria of the healthy people is transplanted into the gastrointestinal tract of patients to rebuild new intestinal flora.Recent studies have found that fecal microbiota transplantation can treat infectious diseases by regulating intestinal flora and intestinal immune function,such as clostridium difficile bacteria infection.Studies and clinic cases confirm that FMT has been used to the treatment of inflammatory bowel disease.Methods:A search of PubMed,EMBASE and CBMdisc is performed to identify about fecal microbiota transplantation for the treatment of inflammatory bowel disease in randomized controlled trials(RCT),non random experimental researches,we choose informations recording inclusion criteria and exclusion criteria,StatsDirect 3 andReview Manager 5.2 are used for this Meta-analysis.Results:We choose 19 studies,including 446 cases of patients,3 RCT,16 non randomexperimental studies including 1 cohort study.In the 4 control studies,the effective case is 62 in FMT group,44 in control group,p = 0.008;In the 4 Control studies,the remission case is 40 in FMT group,20 in control group,p = 0.004;There are 5 serious adverse events in FMT group,3 serious adverse events in the control group,p = 0.50;Total effective rate of IBD patients with FMT treatment is 57%(95%CI = [0.39,0.74])and the global clinical remission fate is 28%(95%CI= [0.12,0.46]).The complete effective rate of CD patients is 78%(95%CI= [0.53,0.95])and complete remission is 51%(95%CI= [0.27,0.75]).The complete effective rate of UC patients is 53%(95%CI= [0.33,0.73])and the remission rate is 19%%(95%CI=[0.07,0.34]).The serious adverse reaction rate is 3%(95%CI= [0.01,0.07]).This Meta-analysis suggests that remission rate and effective rate of fecal microbiota transplantation are higher than the control group in the treatment of UC,there is no different in their incidence of serious adverse reactions.Fecal microbiota transplantation is valid,and serious adverse effect is rare.Clinical adverse reactions are mild and self-limiting,including fever,abdominal distension,abdominal pain,diarrhea.Conclusions:Currently,the treatment of fecal transplants is valuable in inflammatory bowel disease,its side effects are few.However more RCT studies are needed.The analysis also find standardized treatment and ethical issues of fecal microbiota transplantation need to be solved in clinic.