[Modern mechanisms of acupuncture and moxibustion in treatment of functional gastrointestinal diseases based on holistic view].

Based on the holistic view of traditional Chinese medicine, the paper reviews the common methods of acupuncture and moxibustion in the treatment of functional gastrointestinal disorders (FGIDs) and analyzes the clinical advantages of acupuncture and moxibustion to the comorbidities of FGIDs and bidirectional regulation of gastrointestinal function. In association with the brain-gut axis theory, it deeply explores the regulatory mechanisms of acupuncture and moxibustion on the neuro-endocrine-immune network and intestinal microbiota. ①Nervous system: Acupuncture and moxibustion may regulate the activities of relevant central brain regions, repair the function of the enteric nervous system, and bidirectionally modulate neurotransmitters such as 5-hydroxytryptamine and their receptors, as well as gastrointestinal function and emotions. ②Endocrine system: Acupuncture and moxibustion may inhibit the overactivation of the hypothalamic-pituitary-adrenal axis, regulate gastrointestinal-related hormones such as motilin and gastrin, and improve gastrointestinal motility and the mucosal barrier. ③Immune system: Acupuncture and moxibustion may alleviate chronic low-grade intestinal inflammation, inhibit the abnormal activation of immune cells, and repair intestinal mucosal tight junctions. ④Intestinal microbiota: Acupuncture and moxibustion may reconstruct the microbial community structure, increase the abundance of probiotics and reduce pathogenic bacteria, elevate beneficial metabolites such as short-chain fatty acids, and mediate intestinal mucosal protection. Besides, the paper explores the future research directions, aiming to provide the approaches to the research on acupuncture and moxibustion for treatment of FGIDs.