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Role of Acupuncture on Gut Microbiome Modulation: A Systematic Review of Randomized Controlled Trials

Venkatalakshmi Saravanan, A. Mooventhan, E. Dharani, Sathiyavathi Gopi, N. Mangaiarkarasi

Acupuncture & Electro-Therapeutics Research: International Journal of Integrated Medicine, 2025

457 participants · 2 citations

Abstract

Importance: The gut microbiome, composed of nonpathogenic bacteria, protozoa, and viruses, plays a critical role in human health through various regulatory mechanisms. Dysbiosis has been linked to multiple diseases. Acupuncture, a widely practiced complementary therapy, has been explored for its effects on microbial balance, but systematic reviews in this area remain limited. Objective: This systematic review aims to report acupuncture's role in gut microbiome modulation. Evidence Reviews: A systematic search of PubMed/Medline and Cochrane databases was conducted up to January 30, 2024, using terms including “acupuncture,” “gut,” “intestinal flora,” and “electroacupuncture.” Of 383 articles identified, five randomized controlled trials (RCTs) met inclusion criteria, focusing on bacterial taxonomic changes measured by 16S rRNA sequencing (16S ribosomal ribonucleic acid). Findings: Five RCTs (n = 457) investigated acupuncture's effects on gut microbiota in patients with Crohn's disease (n = 96), functional constipation (n = 108), antipsychotic-related constipation (n = 133), Parkinson's disease (n = 30), and knee osteoarthritis (n = 90), along with healthy individuals (n = 88). Across studies, acupuncture was associated with improved microbial diversity and increased beneficial bacterial abundance. These changes may involve modulation of the gut–brain axis, vagus nerve activation, and anti-inflammatory neuroendocrine pathways. No meta-analysis was performed due to…

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 457 participants or records.

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