Qi Bo

Yongxuan Liang, Yinghua Huang

TCM patterns and brain–gut axis function in functional gastrointestinal disorders: A cross-sectional study of symptom and psychological comorbidity profiles

ObjectiveTo investigate the association between traditional Chinese medicine (TCM) patterns and brain–gut axis function in patients with functional gastrointestinal disorders (FGIDs), with a focus on gastrointestinal symptoms (the gut end) and psychological status (the brain end).MethodsWe enrolled 746 patients with FGIDs diagnosed according to the Rome IV criteria and consolidated their TCM patterns into six standardized categories. Gastrointestinal symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), and psychological status was assessed using standardized scales. Analyses included Kruskal–Wallis tests, Dunn's pairwise comparisons, Spearman's rank correlations, and network analysis.ResultsGSRS total scores differed significantly across TCM patterns (P < .001), with a severity gradient from dampness-heat (most severe) to spleen deficiency (least severe). All five GSRS dimensions showed significant differences across patterns (all P < .05), whereas scores on the psychological scales did not (P > .05). TCM patterns were weakly correlated with GSRS scores (r = 0.105, P < .001) but showed only negligible correlations with scores on the psychological scales (|r| < 0.07), with only the RRS reaching nominal statistical significance (r = 0.068, P = .031). Network analysis showed weak connections between TCM patterns and only the GSRS and Ruminative Response Scale (RRS).ConclusionsTCM patterns in FGIDs effectively differentiate gastrointestinal symptom severity but show weak associations with psychological status. Clinically, pattern differentiation should prioritize gastrointestinal symptoms, while psychological status requires independent assessment.

Xinxin Ma, Zhenghua Xiao, Weiwei Tang, Qianren Tan, Lihang Long, Peng Hu

Effectiveness and safety of acupuncture for functional constipation: An updated overview of systematic reviews

To synthesize updated evidence on the effectiveness and safety of acupuncture for functional constipation (FC), critically appraise the quality and credibility of the available evidence, and assess the overlap of primary studies across systematic reviews (SRs). We searched six databases from inception through June 10, 2026, for SRs and meta-analyses of acupuncture for FC. Two reviewers independently screened studies, extracted data, and assessed methodological quality, risk of bias, reporting quality, and evidence certainty using A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively. We synthesized findings narratively and assessed overlap among primary studies using citation matrices, covered area, and corrected covered area (CCA). Fifteen SRs published between 2013 and 2025 were included. Compared with sham acupuncture, acupuncture consistently improved weekly complete spontaneous bowel movements (CSBMs), Bristol Stool Form Scale (BSFS), total effective rate, Cleveland Clinic Constipation Score (CCCS), and quality of life. Compared with Western medicine, acupuncture consistently improved quality of life, whereas results for weekly CSBMs, spontaneous bowel movements (SBMs), CCCS, and total effective rate were heterogeneous. For the primary studies assessing efficacy outcomes, the CCA was 2.82%, indicating a slight overlap. Adverse events were generally mild; no serious acupuncture-related events were reported. However, only 29.6% (16/54) of the outcome-specific certainty assessments were rated as high or moderate, and most SRs exhibited critically low methodological quality and all were a high risk of bias. Acupuncture may improve several clinically relevant FC outcomes, particularly compared with sham acupuncture; evidence against Western medicine is less consistent. Because the included SRs generally had poor methodological quality and drew predominantly on low-certainty evidence, high-quality randomized controlled trials and methodologically rigorous SRs are warranted.

Changhang Ren, Guang Yang, Mei Wu, Yicheng Xing, Jiale Ren, Jianfeng Tu, Liqiong Wang, Jingwen Yang