Qi Bo

Liang, Huang

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.

Ren, Yang, Wu, Xing, Ren, Tu, Wang

Targeting gut microbial metabolism with Chinese herbal medicine in ulcerative colitis: A narrative review

Alterations in gut microbial metabolism constitute a major mechanistic bridge connecting dysbiosis to mucosal inflammation and barrier injury in ulcerative colitis (UC). Although previous reviews have addressed microbial composition or global metabolite changes, they frequently group diverse molecules as “microbial metabolites,” obscuring the metabolic steps targeted by Chinese herbal medicine (CHM). To address this gap, we established a three-category framework comprising microbiota-derived metabolites, host–microbiota co-metabolites, and microbiota-modulated host metabolites. Using this framework, we integrated evidence across four metabolic axes: short-chain fatty acids (SCFAs); bile acids; tryptophan; and amino acids, polyamines, and nitrogen metabolism. Current evidence suggests that CHM remodels intestinal metabolism through three complementary modes: provision of microbiota-accessible substrates, microbial biotransformation of CHM constituents, and restoration of the host mucosal metabolic environment. Evidence maturity varies across these axes. SCFA studies increasingly validate microbiota dependence and specific microbial strains. Research on bile acids and tryptophan links metabolites with host receptors. In contrast, amino acid, polyamine, and nitrogen metabolism studies remain dominated by correlative omics analyses and pathway inferences. Microbiota-associated metabolites may be the mechanism linking CHM exposure, microbial function, and host responses. They may also inform metabolite supplementation, reconstruction of endogenous metabolic networks, and combination therapies. However, current evidence is derived mainly from animal models. Few studies report causal associations among CHM composition, functional microbes or enzymes, specific metabolites, and host effects. To transition from compositional associations toward clinically translatable and mechanistically verifiable insights, future studies should integrate standardized CHM preparations, longitudinal multicompartment sampling, targeted absolute quantification, stable-isotope tracing, and staged causal interventions.

Cai, Liang, Li, Du, Dong, He, Wang, Zhang, Zhao