Fecal Microbiota Transplantation for Symptom Improvement in Patients With Irritable Bowel Syndrome: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

We updated a prior meta-analysisof randomized controlled trials (RCTs) determining this issue.

我们更新了先前关于随机对照试验（RCTs）的荟萃分析，以确定这个问题。

Methods

We searched CENTRAL, MEDLINE, and Embase (via Ovid) from inception to February 20, 2026, to identify potential studies.

我们从开始到2026年2月20日，通过CENTRAL、MEDLINE和Embase（通过Ovid）进行了检索，以确定潜在的研究。

We included RCTs that reported the proportion of patients with IBS symptom improvement assessed between 4 and 24 weeks after FMT.

我们纳入了报告在FMT后4至24周评估的IBS症状改善患者比例的RCTs。

For primary outcome, we estimated risk ratios (RR) of proportion of patients with IBS symptoms not improved.

对于主要结果，我们估计了未改善IBS症状患者比例的风险比（RR）。

Data were pooled using a random effects model.

数据使用随机效应模型进行汇总。

The certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation.

使用推荐、评估、发展和评估的证据分级方法评估了证据的确定性。

Results

Thirteen RCTs involving 693 patients were eligible for this review.

本综述共有13个RCTs，涉及693名患者符合要求。

For the intention-to-treatanalysis, FMT may reduce IBS symptoms at 12 weeks compared with placebo, but the evidence is very uncertain (RR of symptom not improved with FMT compared with placebo = 0.72; 95% confidence interval[CI], 0.50-1.03).

在意向治疗分析中，与安慰剂相比，FMT可能在12周时减少IBS症状，但证据非常不确定（与安慰剂相比，未改善症状的FMT的相对风险为0.72；95%置信区间[CI]，0.50-1.03）。

However, in the per-protocol analysis, FMT was statistically significant at improving symptoms (RR, 0.67; 95% CI, 0.46-0.97).

然而，在按方案分析中，FMT在改善症状方面具有统计学意义（相对风险，0.67；95%置信区间，0.46-0.97）。

Overall adverse events were not different in both groups (RR, 0.98; 95% CI, 0.75-1.29).

两组总体不良事件无差异（相对风险，0.98；95%置信区间，0.75-1.29）。

The subgroup analysis reported IBS symptom improvement using a single dose of FMT (RR, 0.62; 95% CI, 0.41-0.93), and when IBS was diagnosed by Rome IV criteria (RR, 0.38; 95% CI, 0.17-0.86).

亚组分析报告了使用单剂量FMT改善IBS症状（相对风险，0.62；95%置信区间，0.41-0.93），以及当IBS根据罗马IV标准诊断时（相对风险，0.38；95%置信区间，0.17-0.86）。

Conclusions

This systematic reviewsuggested there was very low certainty of evidence that FMT improved IBS symptoms.

这项系统评价表明，FMT改善IBS症状的证据非常不确定。

FMT was effective in some subgroup analyses and in the overall per-protocol analysis, but this needs to be interpreted with caution.

在某些亚组分析和整体按方案分析中，FMT是有效的，但这需要谨慎解释。

(Registration number: PROSPERO CRD420251086189.).

（注册号：PROSPERO CRD420251086189）。