基于肠道菌群调节治疗溃疡性结肠炎回肠储袋 肛管吻合术后储袋炎的研究进展

Research Progress in Gut Microbiota Modulation for the Treatment of Pouchitis Following Ileal Pouch-Anal Anastomosis in Ulcerative Colitis

摘要: 溃疡性结肠炎(Ulcerative colitis, UC)是一种慢性的结直肠炎性疾病，临床治疗中虽然有多种保守治疗方案，但是大约30%的患者最终仍需接受外科手术治疗。全结直肠切除 + 回肠储袋肛管吻合术(Ileal Pouch-Anal Anastomosis, IPAA)是目前应用最为广泛的手术方式，它在有效治疗疾病的同时，显著提升了患者的生活质量。然而，该手术方式也常伴随着多种并发症，其中以储袋炎最为常见，发病率可高达50%。储袋炎的具体发病机制复杂，涉及多种因素的协同作用，其中肠道菌群失调已被证实是疾病发生发展中的一个关键环节。肠道菌群调节作为一种新兴的辅助治疗手段，因其副作用低且有潜在的预防效果而受到广泛关注。本文旨在总结和详细阐述储袋炎的发病机制及肠道菌群调节治疗的最新进展，以期为肠道菌群调节在储袋炎治疗中的进一步应用提供理论依据。

Abstract: Ulcerative colitis (UC) is a chronic inflammatory disease of the colon and rectum. In clinical practice, although there are various conservative treatment options, about 30% of patients require surgical intervention. Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the most widely used surgical procedure. It effectively treats the disease and can significantly improve patients’ quality of life. However, this kind of operation can cause a variety of complications, the most common is pouchitis, and its incidence rate is even as high as 50%. Specific pathogenesis of pouchitis is quite complex, involving interaction of multiple factors, and imbalance of gut microbiota is considered an important factor leading to its occurrence and development. An emerging adjuvant therapy that modulates gut microbiota has received widespread attention due to its low toxicity side effects and potential preventive effects. This article summarizes and describes pathogenesis of pouchitis and the latest developments in microbiota modulation therapy, providing systematic theoretical support for application of gut microbiota modulation in pouchitis treatment.