To explore the effect of acupoint application combined with Yichang Tongmi Decoction on gastrointestinal hormones and intestinal flora in patients with slow-transit constipation (STC).

A prospective randomized controlled trial design was used. A total of 180 patients with STC of spleen-kidney yang deficiency type admitted to Shanghai Pudong New Area Zhoupu Hospital (Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences) from June 2023 to June 2025 were selected as the research subjects. According to the block randomization method, the patients were divided into three groups, with 60 patients in each group. The patients in the acupoint application group received acupoint application, the patients in the traditional Chinese medicine group received Yichang Tongmi Decoction, and the patients in the combined group received acupoint application combined with Yichang Tongmi Decoction. The clinical efficacy, symptom scores before and after treatment, patient assessment of constipation quality of life questionnaire (PAC-QOL), levels of gastrointestinal hormones (gastrin and pepsinogen Ⅰ and Ⅱ), and changes in intestinal flora were compared.

The overall response rate in the combined group was 90%, which was significantly higher than that in the acupoint application group (70%) and the traditional Chinese medicine group (75%). The symptom scores and PAC-QOL score of the patients in the combined group were significantly lower than those in the acupoint application group and the traditional Chinese medicine group (all P<0.05). The levels of pepsinogen Ⅰ and gastrin in the combined group were significantly higher while the level of pepsinogen Ⅱ was lower than those in the acupoint application group and the traditional Chinese medicine group (all P<0.05). Bifidobacteria and lactobacillus in the combined group were higher while Escherichia coli and Enterococcus were significantly lower than those in the acupoint application group and the traditional Chinese medicine group (all P<0.05).

Acupoint application combined with Yichang Tongmi Decoction effectively treats STC, alleviating clinical symptoms, improving colonic transit function, and balancing intestinal flora and gastrointestinal hormone levels.