| Objective: To explore the clinical effect of acupuncture and moxibustion on functional constipation after stroke and the changes of intestinal flora.Methods: 80 patients who met the criteria for functional constipation after stroke were included,and then were randomly divided into 2 groups.Acupuncture group were treated at the left Shuidao,left Guilai,Waishuidao,Waiguilai,while moxibustion group were treated at Shenque.All patients were treated once a day and rested on Sunday for 3 weeks.The PAC-QOL,Bristol Stool Form Scale and constipation symptoms scale was evaluated before and after treatment,while the medical history and physical examination were collected before treatment.At the end of project,compared in the efficacy of functional constipation after stroke.To analyze the differences of intestinal flora,we took stool samples from two groups before and after treatment for 16 S r DNA Amplicon Sequencing and Operational Taxonomic Units.58 qualified stool samples were collected,including 22 samples from the acupuncture group(A1 and A2),30 samples from the moxibustion group(A1 and A2)and 6 samples from patients without constipation after stroke(BC)were collected for reference.Results:1.No adverse events occurred in 80 patients which treated for 18 times,6 times a week,a total of 3 weeks;2.There are no significant difference not only in gender,age,PHI and medical history between the two groups,but also in the PAC-QOL,Bristol Stool Form Scale and constipation symptoms scale before treatment.After comparison,it was found that the severity of constipation was positively correlated with age,but there was no significant correlation in gender,stroke type,NIHSS score and previous medical history;3.Both groups had improved constipation after treatment;There was no significant difference in PAC-QOL scores between the two groups after treatment;The improvement of moxibustion group was better than acupuncture group in Bristol stool form scale,constipation symptoms scale,constipation symptoms and treatment satisfaction;Patients in both groups experienced increased bowel sounds during treatment,and the moxibustion group was more obvious;There was no significant change in the number of bowel sounds after treatment;4.When analyzed chao1,we found that there were significant differences between the before treatment groups(A1,B1)and the BC group,but no significant differences between the after treatment groups(A2,B2)and the BC group;After analyzing the Beta diversity index of the two groups,there were significant changes after treatment;The Beta diversity index of A1,A2,B1 and B2 were different from BC group;5.When analyzed the differential species,we found that the Enterobacter,Enterococcus,Proteobacteria was reduced in the moxibustion group after treatment,while these species didn't changed significantly in acupuncture group;After treatment,the relative abundance of Clostridia decreased in both groups(A2,B2),and the relative abundance of Firmicutes,Tenericutes,Bacteroides did not change significantly;The relative abundance of Prevotellaceae was increased after treatment(A2,B2),but it was still lower than the BC group;The abundance of Bifidobacterium in group B2 was higher than that in group A2,and was basically the same as that in group BC;The abundance of Lactobacillaceae and SCFAs bacteria in group B2 was significantly higher than that in group A2.Conclusion:Acupuncture and moxibustion can improve functional constipation after stroke and regulate the structure of intestinal flora;Acupuncture increase the abundance of Prevotellaceae and decrease the abundance of Methanogenic-bacteria in patients with functional constipation after stroke;Moxibustion plays a more significant role in increasing the abundance of SCFAsbacteria,Lactobacillaceae,Bifidobacterium,and reducing the abundance of Enterobacter,Enterococcus,Clostridia;The severity of constipation was positively correlated with age;Both acupuncture and moxibustion can promote intestinal motility in patients with functional constipation after stroke. |
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