Research Progress on the Mechanism of Acupuncture in Treating Functional Constipation
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i1.5073
Abstract
Functional constipation (FC) is a common functional bowel disorder, categorized under "constipation" in Traditional Chinese Medicine (TCM) theory. As a key therapeutic modality in TCM, acupuncture has long demonstrated efficacy in managing constipation. In recent years, a growing body of modern medical research has provided supporting evidence for its use. This article reviews the effects of acupuncture on brain-gut axis dysfunction, intestinal motility disorders, visceral hypersensitivity, gut microbiota imbalance, abnormal intestinal secretion, pelvic floor muscle dysfunction, and psychological factors, exploring the mechanisms and theoretical basis of acupuncture for FC.
Keywords
acupuncture; functional constipation; brain-gut axis; visceral hypersensitivity; gastrointestinal motility disorder; gut microbiota
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[31] Jia Rui, Xing Haijiao, Zhang Xuanping, et al. Effects of different acupuncture and moxibustion methods on plasma nitric oxide, nitric oxide synthase and colonic vasoactive intestinal peptide in functional constipation rats [J]. Acupuncture Research, 2017, 42(01): 50-55. (in Chinese)
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[34] Hueita-Franco M R, Vargas-Luna M, Montes-Frausto J B, et al. Effect of psychological stress on gastric motility assessed by electrical bio-impedance [J]. World J Gastroenterol, 2012, 18(36): 5027-5033.
[2] Barberio B, Judge C, Savarino EV, et al. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis [J]. Lancet Gastroenterol Hepatol, 2021, 6(8): 638-648.
[3] Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: results of a multinational survey [J]. Aliment Pharmacol Ther, 2007, 26(2): 227-236.
[4] Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation [J]. Gastroenterology, 2013, 144(1): 218-238.
[5] Scott SM, Simrén M, Farmer AD, et al. Chronic constipation in adults: Contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation [J]. Neurogastroenterol Motil, 2021, 33(6): e14050.
[6] YIN P, GAO N Y, DONG B, et al. Efficacy and safety of acupuncture on the treatment of functional constipation: Study protocol for a randomized controlled trial [J]. World J Acupunct Moxibust, 2019, 29(2): 145-152.
[7] LIANG C, WANG K, XU B, et al. Electroacupuncture at acupoint ST 37 (Shangjuxu) improves function of the enteric nervous system in a novel mouse constipation model [J]. BMC Complement Altern Med, 2016, 16(1): 392.
[8] Li Yanqiu, Yao Junpeng, Yan Xiangyun, et al. Research progress on the mechanism of acupuncture in treating functional constipation [J]. Acupuncture Research, 2024, 49(1): 79-87. (in Chinese)
[9] Xu Mingmin. Study on the effect mechanism of acupuncture improving gastrointestinal transit function in FC mice based on gut microbiota [D]. Sichuan: Chengdu University of Traditional Chinese Medicine, 2020. (in Chinese)
[10] Zhu L, Gao H, Li Q, et al. Shaoyao Gancao decoction alleviates functional constipation by inhibiting Escherichia-Shigella expansion, modulating gut microbiota, and suppressing dysbiosis-induced endocannabinoid production: evidence from a self-controlled pilot study [J]. Front Cell Infect Microbiol. 2025, 15: 1705271.
[11] Li Lu, Meng Shan, Li Mingzhao, et al. Clinical research progress of acupuncture and moxibustion in treating functional constipation [J]. Primary Traditional Chinese Medicine, 2024, 3(7): 102-108. (in Chinese)
[12] Li Xiuxue, Han Mengke, Dai Ming. Research progress on external treatment of traditional Chinese medicine regulating "brain-gut axis" in the treatment of functional constipation [J]. Shandong Journal of Traditional Chinese Medicine, 2024, 43(09): 1046-1052. (in Chinese)
[13] Lu Yeqing, Huang Jiaying, Zhou Liqian, et al. The role of acupuncture based on "brain-gut axis" theory in functional dyspepsia [J]. Jilin Medical Journal, 2023, 44(11): 3149-3152. (in Chinese)
[14] Duan Wan'e, Zhang Qijuan, Li Wanying, et al. Clinical study of Jianpi Shugan acupuncture method for constipation-predominant irritable bowel syndrome (qi stagnation constitution type) and its effect on levels of 5-HT, VIP, and NPY [J]. Hubei Journal of Traditional Chinese Medicine, 2024, 46(1): 36-39. (in Chinese)
[15] Wang Haiyan, Li Shuo, Ma Aituan. Effects of three acupuncture techniques at Houhai acupoint on intestinal neurotransmitters in constipated rats [J]. Chinese Journal of Veterinary Science, 2021, 41(09): 1817-1822. (in Chinese)
[16] Shao Wenchao, Lu Dianqiang. Clinical analysis of 60 cases of functional constipation treated with brain-gut axis acupuncture [J]. Ningxia Medical Journal, 2019, 41(08): 751-753. (in Chinese)
[17] Zhao JM, Lu JH, Yin XJ, et al. Comparison of Electroacupuncture and Mild-Warm Moxibustion on Brain-Gut Function in Patients with Constipation-Predominant Irritable Bowel Syndrome: A Randomized Controlled Trial [J]. Chin J Integr Med, 2018, 24(5): 328-335.
[18] Wang J J, Liu X D, Qin M, et al. Electro-acupuncture of Tsusanli and Shangchuhsu regulates gastric activity possibly through mediation of the vagus-solotary complex [J]. Hepatogastroenterology, 2007, 54 (78): 1862-1867.
[19] Lu M, Chen C, Li W, et al. EA at PC6 promotes gastric motility: role of brainstem vagovagal neurocircuits [J]. Evid Based Complement Alternat Med, 2019, 2019: 7457485.
[20] Lu M J, Yu Z, He Y, et al. Electroacupuncture at ST36 modulates gastric motility via vagovagal and sympathetic reflexes in rats [J]. World J Gastroenterol, 2019, 25 (19): 2315-2326.
[21] Chen Yi. Study on brain structural characteristics of depression with constipation and the intervention mechanism of combined acupuncture and medication [D]. Nanjing University of Chinese Medicine, 2025. (in Chinese)
[22] ZHAO Y, JIANG H L, SHI Y, et al. Electroacupuncture Alleviates Visceral Hypersensitivity in IBS-D Rats by Inhibiting EGCs Activity through Regulating BDNF/TrkB Signaling Pathway [J]. Evid Based Complement Alternat Med, 2022, 2022: 2497430.
[23] XIAO B L. Mechanisms of mechanotransduction and physiological roles of PIEZO channels [J]. Nat Rev Mol Cell Biol, 2024, 25(11): 886-903.
[24] Gao S, Zhu L, Yao H, et al. Effect of electroacupuncture versus prucalopride for ultra-severe chronic constipation: Secondary analysis of a randomized controlled trial [J]. Integr Med Res. 2026 , 15(1): 101253.
[25] Liu Xiaoqian, Wang Zhi, Zhou Peihua, et al. Study on the effect of fecal microbiota transplantation based on 16S rDNA detection on slow transit constipation [J]. Journal of Clinical Medicine in Practice, 2023, 27(9): 82-87. (in Chinese)
[26] Wang Wenyan, Liang Fengxia, Song Aiqun, et al. Current status and thoughts on acupuncture and moxibustion regulating gut microbiota [J]. Acupuncture Research, 2019, 44(1): 71-74. (in Chinese)
[27] XIAO Y, XU F, LIN L, et al. Transcutaneous Electrical Acustimulation Improves Constipation by Enhancing Rectal Sensation in Patients With Functional Constipation and Lack of Rectal Sensation [J]. Clin Transl Gastroenterol, 2022, 13(5): e00485.
[28] Wang Lu, Sui Nan. Effect of Zhuyang Tongbian Ointment on the VIP-cAMP-PKA-AQP3 pathway in colon tissue of constipation model mice based on the theory of 'the large intestine governing fluids' [J]. Chinese Archives of Traditional Chinese Medicine, 2022, 40(05): 147-151+277-278. (in Chinese)
[29] Zheng Y F, Liu C F, Lai W F, et al. The laxative effect of emodin is attributable to increased aquaporin 3 expression in the colon of mice and HT-29 cells [J]. Fitoterapia, 2014, 96: 25-32.
[30] Zhou Yongxue, Wang Yujin, Yan Shuguang, et al. Effect of Xiaofu Tongjie Formula on VIP-cAMP-PKA-AQP3 signaling pathway in colon tissue of functional constipation rats [J]. Chinese Journal of Experimental Traditional Medical Formulae, 2016, 22(24): 99-104. (in Chinese)
[31] Jia Rui, Xing Haijiao, Zhang Xuanping, et al. Effects of different acupuncture and moxibustion methods on plasma nitric oxide, nitric oxide synthase and colonic vasoactive intestinal peptide in functional constipation rats [J]. Acupuncture Research, 2017, 42(01): 50-55. (in Chinese)
[32] Afyouni AS, Khanmammadova N, Bozorgi A, et al. Urologic Manifestations of Nonrelaxing Pelvic Floor Dysfunction: Insights on Clinical Workup and Management [J]. Curr Urol Rep. 2025; 26(1): 66.
[33] Lu Yu. Clinical observation on warm acupuncture combined with biofeedback in the treatment of pelvic floor relaxation type constipation (spleen-kidney yang deficiency type) [D]. Anhui University of Chinese Medicine, 2025. (in Chinese)
[34] Hueita-Franco M R, Vargas-Luna M, Montes-Frausto J B, et al. Effect of psychological stress on gastric motility assessed by electrical bio-impedance [J]. World J Gastroenterol, 2012, 18(36): 5027-5033.
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