With the deepening understanding of the role of gut microbiota in human health and disease, fecal microbiota transplantation has gained widespread attention as an emerging therapeutic approach in recent years. This technique involves the transplantation of microbial communities from the feces of healthy donors into patients to reconstruct or improve the gut microbiota structure, thereby achieving therapeutic goals. Fecal microbiota transplantation has become an effective method for treating recurrent or refractory Clostridium difficile infections and has shown good therapeutic effects and safety in clinical trials for various gastrointestinal diseases, including inflammatory bowel disease, irritable bowel syndrome, slow transit constipation, and chronic diarrhea. Moreover, its application has been extended to research in metabolic diseases and neurological disorders, which are not directly related to the gut. However, the clinical efficacy of fecal microbiota transplantation still needs improvement, and there are many challenges regarding specific application strategies that remain to be addressed. This article discusses the current progress and challenges of fecal microbiota transplantation strategies and reviews cutting-edge interventional methods such as small intestine microbiota intervention and bacteriophage therapy, aiming to provide reference for further research in fecal microbiota transplantation.
肠菌移植通过将健康供体粪便中的微生物群移植到患者体内，旨在重建或改善患者的肠道微生物结构，从而达到治疗目的。肠菌移植已经成为治疗复发性或难治性艰难梭菌感染的有效方法，并且在治疗炎性肠病、肠易激综合征、慢传输型便秘和慢性腹泻等肠道疾病的临床试验中均显示出了良好的治疗效果和安全性，并被扩展用于代谢性疾病、神经系统疾病等非肠道相关疾病的治疗方案探索。但同时，肠菌移植的临床应用有效率仍有待提升，其具体应用策略还有许多难点等待解开。本文就目前肠菌移植策略的进展与难点展开讨论，同时综述了小肠菌群干预和噬菌体移植等前沿的肠菌的干预方法，以期对肠菌移植的进一步研究提供参考思路。针对肠菌移植策略所面临的难点，本文从缺少统一的全流程标准、尚未充分了解粪便微生物的组成，以及供体受体缺少精准匹配的方法等方面进行了总结和讨论，并展望了小肠菌群干预和基于噬菌体的疗法在肠菌移植治疗中的应用前景，以补充目前相关领域的经验与信息。.