To analyze the efficacy of Buzhong Yiqi decoction combined with auricular point pressing seed therapy in treating post-stroke constipation and its impact on serum levels of neurotransmitters including motilin, vasoactive intestinal peptide (VIP), and 5-hydroxytryptamine (5-HT).

This was a prospective randomized controlled trial. A total of 100 patients with post-stroke constipation who were treated in the Cangzhou People's Hospital from January to December 2024 were randomly enrolled and divided into an observation group and a control group, with 50 cases in each group. The control group received lactulose treatment, while the observation group received Buzhong Yiqi decoction combined with auricular point pressing seed therapy. The following outcomes were compared between the two groups: improvement of constipation symptoms, time to improvement, changes in stool characteristics, clinical efficacy, adverse reactions, and recurrence rate, as well as changes in motilin, VIP, and 5-HT levels before and after treatment.

Before intervention, no statistically significant differences were observed in defecation time, interval between defecations, or defecation difficulty scores between the two groups (P>0.05). After intervention, scores decreased in both groups compared to baseline, but the observation group had significantly lower scores than the control group (P<0.05). Before intervention, no significant difference was found in Bristol stool form scale classification between the two groups (P>0.05). After intervention, statistically significant differences were observed (P<0.05), with the observation group showing lower proportions of type 1 (4.00%) and type 2 (10.00%) stools compared to the control group (14.00% and 40.00%, respectively). The total effective rate in the observation group was 92.00%, higher than the control group's 76.00% (P<0.05). The observation group exhibited shorter durations of defecation time, interval between defecations, and relief time for defecation difficulty compared to the control group (P<0.05). No significant differences in pre-treatment serum motilin, VIP, and 5-HT levels were observed between the two groups (P>0.05), but post-treatment levels differed significantly from baseline (P<0.05). The observation group had higher motilin, VIP and 5-HT levels than the control group (P<0.05). The incidence of adverse reactions was 4.00% in the observation group, lower than the control group's 22.00%, and the recurrence rate was 10.00%, lower than the control group's 38.00% (both P<0.05).

Buzhong Yiqi decoction combined with auricular point pressing seed therapy for post-stroke constipation not only improves symptoms, shortens the duration of symptom relief, enhances efficacy, and reduces adverse reactions but also modulates serum motilin, VIP, and 5-HT levels.