Clinical Effect of Yimiling in Treating Qi-deficiency Chronic Constipation Based on Mmicrobiota-gut-brain Axis and Its Impact on Psychosomatic state

ZHANG Qing; WEI Yinting; NIU Yue; WANG Zhongqi; LIU Pei

doi:10.3639/i.issn.2095-3097.2025.02.046

Abstract：Objective To explore the clinical effect of Yimiling on treating Qi-deficiency chronic constipation based on the microbiota-gut-brain axis and its impact on the psychosomatic state.Methods A total of 60 patients with Qi-deficiency chronic constipation admitted in the Lianyungang Traditional Chinese Medicine Hospital from May 2022 to January 2024 were selected.They were randomly divided into the control group and treatment group by random number table method,with 30 patients per group.Patients in the control group were treated with oral lactulose solution and those in the treatment group were treated with Yimiling,all for 4 weeks.Clinical efficacy,adverse events,total scores of traditional Chinese medicine(TCM)symptoms,the Bristol Stool Form Scale(BSFS)score,the Patient Assessment of Constipation-Symptoms(PAC-SYM)score,the Wexner Score for Obstructed Defecation Syndrome(ODS),the Self-Rating Anxiety Scale(SAS)score,the Self-Rating Depression Scale(SDS)score,the Patient Assessment of Constipation Quality of Life(PAC-QOL),abundances of gut microbiota,serum substance P(SP),vasoactive intestinal peptide(VIP),motin(MTL)and gastrin(GAS)before and after treatment were compared.Results The total effective rate of treatment group was higher than that of control group,although no significant difference was detected(96.67％vs.83.33％,P＞0.05).No serious adverse reactions were observed in both groups(P＞0.05).After treatment,the total scores of the TCM syndromes,and BSFS,PAC-SYM,ODS,SAS,SDS,and PAC-QOL scores were significantly reduced in both groups,which were significantly lower in the treatment group than the control group(P＜0.05).After treatment,the abundances of Bifidobacterium,and Lactobacillus were significantly elevated,and those of Saccharomycetes,and Enterobacter were significantly reduced in both groups,which were significantly pronounced in the treatment group than the control group(P＜0.05).After treatment,SP,VIP,MTL and GAS were significantly elevated in both groups,which were significantly higher in the treatment group than the control group(P＜0.05).Conclusion Yimiling has a good efficacy in treating Qi-deficiency chronic constipation based on the microbiota-gut-brain axis,which significantly improves gastrointestinal function,gut microbiota,psychosomatic status,and quality of life,with a reliable and high safety profile.