| Background:Fecal microbiota transplantation(FMT)is a new method for the treatment of ulcerative colitis(UC)has been widely reported.Some studies show that FMT has no effect on UC,while the others hold the view that FMT has positive effects on patients with UC,and the therapy can alleviate clinical symptoms and improve the quality of life of the patients.A recent meta-analysis shows that the prospects of FMT treatment for active UC are bright in terms of clinical efficacy and safety.Studies have shown that the therapy of combined antibiotics and fecal microbiota transplantation(A-FMT)is superior to antibiotics in the treatment of UC,while and the effect of A-FMT on UC is not clear.This article will study the effect of FMT for UC based on evidence-seeking medical research.Objective:The main purpose of this article is to evaluate the therapeutic effect of FMT on UC,and to evaluate the efficacy of A-FMT in the treatment of UC patients,and to find a method to improve the efficacy of FMT in the treatment of UC.Method:PubMed,the Cochrane Library and Embase were searched from beginning through March 2019.All the studies that reported the outcome of the FMT treatment for active UC were included to perform a meta-analysis.The data were divided into two groups according to whether antibiotic pretreatment were used before FMT was performed for subgroup analysis.The clinical response rate and clinical remission rate of A-FMT in the treatment of UC were compared with that of FMT in the treatment of UC.The transplanted feces were grouped into fresh feces and frozen feces,and subgroup analysis was performed to obtain the clinical response rate and clinical remission rate of fresh feces and frozen feces,and then compered to get a higher one.Results:We finally get 14 clinical non-randomized controlled trials and 7 clinical randomized controlled trials,and the results were as follows:1.The radio of clinical response of FMT in the treatment of UC compared with placebo for RR=1.55(95%CI 1.09 to 2.20),and the radio of clinical remission RR=2.56(95%CI 1.70 to 3.86).2.The clinical response rate of FMT in the treatment of UC was 54%(95%CI 42%to 66%),and the clinical remission rate was 30%(95%CI 18%to 41%).The clinical response rate of A-FMT was 59%(95%CI 35%to 83%),and the clinical remission rate was 29%(95%CI 17%to 40%).3.The clinical response rate of transplantation using frozen feces was 61%(95%CI 45%to 77%),and the clinical remission rate was 31%(95%CI 21%to 42%);the rate of clinical response for transplantation using fresh feces was 53%(95%CI 32%to 75%)and the clinical remission rate was 30%(95%CI 7%to 54%).Conclusions:FMT is safe and effective to patients with UC.Although in the treatment of UC by FMT,A-FMT helps UC patients to achieve clinical response,but it affects UC patients to achieve clinical remission.Therefore,antibiotics are not recommended for pretreatment of UC patients when FMT is used to treat UC.When perform a FMT,the use of frozen feces is more helpful for UC patients to achieve clinical response and clinical remission compared to the use of fresh feces.Even though more research need to be performed to support the conclusion,it can give a suggestion for the future clinical work... |
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