粪菌移植治疗肝硬化腹水合并慢性腹泻1例报告

赵丹; 赵佳如; 曹红红; 郭巧利; 吴畏; 张歆易; 许翠萍; 张婕

doi:10.12449/JCH260621

粪菌移植治疗肝硬化腹水合并慢性腹泻1例报告

DOI: 10.12449/JCH260621

赵丹¹,
赵佳如²,
曹红红³,
郭巧利¹,
吴畏³,
张歆易³,
许翠萍¹,
张婕^1, , ,

1.
山西医科大学第一医院消化内科，太原 030001
2.
湖北科技学院临床医学院，湖北咸宁 437100
3.
上海承葛生物科技有限公司，上海 200441

基金项目:

山西省基础研究计划青年科学研究项目 (202303021222347)

伦理学声明：本例报告已获得患者及其家属知情同意。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：赵丹、赵佳如和曹红红负责课题设计，资料分析，撰写论文；郭巧利、吴畏、张歆易和许翠萍参与收集数据，修改论文；张婕负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
张婕， mailjessica@126.com （ORCID： 0009-0006-7644-8591）

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出版历程
- 收稿日期: 2025-09-01
- 录用日期: 2025-11-24
- 出版日期: 2026-06-25

Fecal microbiota transplantation for the treatment of cirrhotic ascites with chronic diarrhea： A case report

1.
Department of Gastroenterology，The First Hospital of Shanxi Medical University，Taiyuan 030001，China
2.
School of Clinical Medicine Sciences，Hubei University of Science and Technology，Xianning，Hubei 437100，China
3.
Shanghai Treatgut Biotechnology Co.，Ltd.，Shanghai 200441，China

Research funding:

Shanxi Province Basic Research Program Youth Science Research Project (202303021222347)

More Information

Corresponding author: ZHANG Jie， mailjessica@126.com （ORCID： 0009-0006-7644-8591）

摘要

摘要: 粪菌移植（FMT）已广泛用于艰难梭菌感染等胃肠道疾病的治疗，但鲜见于肝硬化腹水诊疗中。本文报道1例口服胶囊FMT治疗肝硬化腹水合并慢性腹泻病例，短期疗效显著且无不良反应，以期为FMT应用于肝病治疗提供参考依据。
- 肝硬化 /
- 腹水 /
- 腹泻 /
- 粪便微生物群移植
Abstract: Fecal microbiota transplantation （FMT） has been widely used in the treatment of gastrointestinal disorders， particularly Clostridium difficile infection， while there are few reports of its application in the diagnosis and treatment of cirrhotic ascites. This article reports a case of a patient with cirrhotic ascites and chronic diarrhea who received FMT with oral capsules， demonstrating significant short-term efficacy without any adverse reactions， in order to provide a reference for the application of FMT in the treatment of liver diseases.
- Liver Cirrhosis /
- Ascites /
- Diarrhea /
- Fecal Microbiota Transplantation

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表 1 FMT治疗前后饮食安排

Table 1. Dietary arrangements before and after FMT treatment

时间	饮食要求
FMT前	300 mL/d无脂流食
FMT后
第1天	半流食（小米粥、挂面汤和拌汤等）
第2～7天	逐渐增加食物的稠度，适当增加固体食物（如馒头等）
第1～2周	易消化食物，少食多餐，避免高脂肪、高蛋白饮食和辛辣刺激性食物
第2～4周	逐渐增加食物种类，开始食用肉类（如牛肉、羊肉等），但仍需要注意食物的质地和消化程度，适当摄入膳食纤维、保持饮食清淡
第4周后	均衡饮食，增加益生元摄入，保持良好饮食习惯
注：FMT，粪群移植。

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表 2 患者在FMT治疗前后及随访期间肝功能、腹泻情况

Table 2. Changes in liver function and diarrhea before and after FMT and during follow-up

指标	治疗前	治疗后
指标	治疗前	1周	1个月	2个月
ALT（U/L）	28	25	37	27
AST（U/L）	34	32	29	38
Alb（g/L）	30.7	31.4	34.8	39.1
GGT（U/L）	29	34	46	35
ALP（U/L）	174	221	201	88
钾（mmol/L）	3.36	3.40	4.64	3.90
钠（mmol/L）	133	138	136	140
凝血酶原时间（s）	17.5		15.7	14.6
凝血酶原活动度（%）	65		79	77
大便次数（次/d）	6～10	1～2	1	1
最大腹水深度（cm）	6.9		0	0
粪菌16S rRNA检测	三度菌群失调			一度菌群失调
注：FMT，粪菌移植；ALT，丙氨酸氨基转移酶；AST，天冬氨酸氨基转移酶；Alb，白蛋白；GGT，γ-谷氨酰转移酶；ALP，碱性磷酸酶。

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