Fecal Microbiota Transplantation in Parkinson Disease: A Systematic Review, Meta-Analysis, and Meta-Regression.

Fecal microbiota transplantation (FMT) targets the gut-brain axis, but clinical evidence remains inconsistent.

粪便微生物群移植（FMT）针对肠道-大脑轴，但临床证据仍然不一致。

This study aimed to evaluate the efficacy and safety of FMT in PD.

本研究旨在评估粪菌移植(FMT)在帕金森病(PD)中的疗效和安全性。

Methods

We conducted a systematic reviewand meta-analysisfollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with protocol registration in International Prospective Register of Systematic Reviews (CRD420251142846).

我们遵循系统评价和荟萃分析的首选报告项目(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)指南进行了系统评价和荟萃分析，并在国际前瞻性系统评价注册处(CRD420251142846)进行了方案注册。

MEDLINE, Embase, and the Cochrane Library were searched from inception through September 2025.

从 MEDLINE、Embase 和 Cochrane 图书馆的创建之初至 2025 年 9 月进行了检索。

Randomized controlled trials (RCTs) and observational studies enrolling adults with mild-to-moderate PD who received FMT through any administration route were eligible.

符合条件的包括随机对照试验（RCTs）和观察性研究，这些研究招募了接受通过任何给药途径粪便微生物移植（FMT）的轻度至中度帕金森病（PD）成人患者。

The primary outcome was motor function assessed by the Unified Parkinson's Disease Rating Scale (UPDRS) part III.

主要结果是通过统一帕金森病评定量表（UPDRS）第三部分评估的运动功能。

Secondary outcomes included UPDRS part II, quality of life (Parkinson's Disease Questionnaire-39 [PDQ-39]), constipation severity (Wexner score), and adverse events.

次要结果包括UPDRS第二部分、生活质量（帕金森病问卷-39 [PDQ-39]）、便秘严重程度（Wexner评分）和不良事件。

Random-effects models pooled effect estimates with 95% CIs, and exploratory meta-regression assessed follow-up duration, publication year, and sample size.

随机效应模型汇总了效应估计值，并给出了95%置信区间，探索性的元回归评估了随访时长、出版年份和样本大小。

Results

Eight studies (5 RCTs and 3 observational studies) including 220 participants were analyzed.

分析了八项研究（5项随机对照试验和3项观察性研究），共包括220名参与者。

The mean age ranged from approximately 60 to 70 years, and women comprised about 40% of participants.

平均年龄大约在60到70岁之间，女性约占参与者总数的40%。

FMT was associated with significant improvement in motor function (UPDRS part III: mean difference [MD] -9.67, 95% CI -16.81 to -2.53) and constipation severity (Wexner score: MD -3.91, 95% CI -7.68 to -0.13).

粪菌移植（FMT）与运动功能显著改善相关（UPDRS第三部分：平均差异[MD] -9.67，95%置信区间-16.81至-2.53），以及便秘严重程度的改善（Wexner评分：MD -3.91，95%置信区间-7.68至-0.13）。

Improvements in UPDRS part II and PDQ-39 were observed at 12 weeks but not sustained at 24 weeks.

在12周时观察到帕金森病评定量表（UPDRS）第二部分和帕金森病生活质量问卷（PDQ-39）的改善，但这些改善在24周时未能持续。

In RCT-only analyses, UPDRS part III improvement remained significant (MD -6.82, 95% CI -11.23 to -2.40), whereas other outcomes were not consistently significant.

在仅限随机对照试验（RCT）的分析中，帕金森病评定量表（UPDRS）第三部分的改善仍然显著（平均差异（MD）-6.82，95%置信区间（CI）-11.23至-2.40），而其他结果则没有一致的显著性。

Meta-regression indicated that longer follow-up was associated with greater improvement in UPDRS part II (p = 0.043).

Meta回归分析表明，更长的随访时间与帕金森病统一评分量表（UPDRS）第二部分评分的更大改善相关（p = 0.043）。

FMT was generally well tolerated; however, gastrointestinal adverse events were more frequent in the FMT group (risk ratio 3.12, 95% CI 1.14-8.53), predominantly mild to moderate.

粪菌移植（FMT）通常耐受性良好；然而，FMT组的胃肠道不良事件更为频繁（风险比3.12，95% 置信区间1.14-8.53），主要是轻度至中度。

Discussion

FMT may provide short-term improvements in motor and gastrointestinal symptoms in PD, but effects appear transient.

粪菌移植（FMT）可能在短期内改善帕金森病（PD）患者的运动和胃肠道症状，但这些效果似乎是暂时的。

Small sample sizes, heterogeneity, and limited follow-up restrict conclusions, underscoring the need for larger randomized trials.

样本量小、异质性大以及随访时间有限限制了结论的可靠性，这强调了需要更大规模的随机试验。

Pooled estimates reflected evidence from observational studies and should be interpreted cautiously.

综合估计反映了观察性研究的证据，应谨慎解释。