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目的孤独症(autism spectrum disorders,ASD)发病机制不明,患病率逐渐增多,缺乏客观诊断指标,常规治疗主要依靠教育和行为训练,但效果十分有限。本研究通过胃肠镜粪微生态制品移植(fecal microbiota transplantation,FMT)治疗儿童孤独症1例,探索其疗效和可行性。方法参照本课题组报道的方法,收集通过严格筛选的供体粪便,体外制备粪微生态制品。孤独症患儿,男性,8岁,确诊孤独症5年余,合并功能性消化不良症状。静脉麻醉下,分别经胃镜、肠镜行粪微生态制品大肠和小肠注入。以临床评价、患儿的生活行为观察(来自患儿主要照顾者),孤独症行为评定检查表(autism behaviorchecklist,ABC),儿童期孤独症评定量表(childhood autism rating scale,CARS)进行治疗前后评估和对比。结果治疗前患儿ABC量表评分为112分,CARS量表积分为38分;治疗后8周,ABC量表评分降低至76分,CARS量表积分降低至32分,积分改善非常显著。语言、沟通、感觉、运动、自我照顾的各项能力整体提高,同时患儿在睡眠障碍、胃肠道症状、情绪方面有明显改善,尤其是胃肠道症状(呃逆)显著缓解。结论粪微生态制品移植对该例孤独症患儿的治疗,疗效明显,未见明显副反应,提示粪微生态制品移植对孤独症患儿可能是一种潜在的新疗法,但其长期疗效、不良反应有待多样本的深入研究。
Objective The pathogenesis of autism spectrum disorders (ASD) is unknown. The prevalence is gradually increasing. There is no objective diagnostic criteria. Conventional treatment mainly relies on education and behavioral training, but the effect is very limited. In this study, 1 case of autism in children was treated with fecal microbiota transplantation (FMT), and its efficacy and feasibility were explored. Methods With reference to the methods reported by our group, we collected donor stools that had passed the rigorous screening and prepared excrement microecological products in vitro. Children with autism, male, 8 years old, diagnosed with autism more than 5 years, combined with functional dyspepsia symptoms. Under intravenous anesthesia, respectively, endoscopy, colonoscopy manure microecological colon and small intestine injection. Before and after treatment with clinical evaluation, observation of living behavior of children (from the main caregiver of children), autism behavior checklist (ABC) and childhood autism rating scale (CARS) Evaluation and comparison. Results Before treatment, children’s ABC scale score was 112 points and CARS scale score was 38 points. After 8 weeks of treatment, the ABC scale score was reduced to 76 points and the CARS scale score was reduced to 32 points, the integral improvement was significant. The ability of language, communication, feeling, exercise and self-care improved as a whole. At the same time, children’s ability to sleep disorders, gastrointestinal symptoms and emotions were significantly improved, especially gastrointestinal symptoms (hiccups) were significantly alleviated. Conclusion Fecal microbiological transplantation in this case of children with autism treatment obvious curative effect, no obvious side effects, suggesting that fecal microbiological transplantation in children with autism may be a potential new treatment, but its long-term efficacy, Adverse reactions to be studied in more samples.