Brain-gut-microbiota axis: An effective target of abdominal acupuncture therapy for post-stroke functional constipation.

BACKGROUND

Functional constipation is one of the most common complications among stroke patients, significantly impacting their quality of life. This study examined the effects of abdominal acupuncture on constipation symptoms, gut microbiota, and neurological function in post-stroke patients with functional constipation, based on the brain-gut-microbiota axis, to improve patient prognosis.

METHOD: Seventy-five patients with post-stroke functional constipation were randomly assigned either to the abdominal acupuncture (AA) group or the routine treatment (RT) group. Both groups received standard medication and rehabilitation for stroke. While the routine therapy was administered to both groups of patients, the AA group patients underwent AA. Constipation symptom scores, fecal intestinal flora, National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Modified Barthel Index (MBI), and Limits of Stability (LOS) were evaluated in both groups before and after treatment. Resting-state functional near-infrared spectroscopy was also assessed before and after treatment.

RESULTS

When compared with pre-treatment, both groups displayed improvements in their constipation symptom scores, NIHSS, FMA, MBI, and LOS after treatment. Levels of Escherichia coli and Enterococcus in feces decreased, while the levels of Bifidobacterium, Lactobacillus, and Bacteroides increased. These improvements were significantly greater in the AA group than in the RT group (P < 0.01 or P < 0.05). Furthermore, a significant difference was noted in cortical functional activity between the two groups after treatment.

CONCLUSION

AA can effectively relieve functional constipation after stroke, regulate intestinal flora, enhance neurological function, and lower the disability rate. International Traditional Medicine Clinical Trial Registry (ITMCTR):http://itmctr.ccebtcm.org.cn/, ITMCTR2025001532.