ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Intestinal Microbiome
This article is part of the Research TopicExploring the Gut Microbiota-Host Interaction through Omics: From Metabolite Profiling to Therapeutic StrategiesView all 5 articles
Shaoyao Gancao Decoction Alleviates Functional Constipation by Inhibiting Escherichia-Shigella Expansion, Modulating Gut Microbiota, and Suppressing Dysbiosis-Induced Endocannabinoid Production: Evidence from a Self-Controlled Pilot Study
Provisionally accepted
- 1Zhejiang Academy of Agricultural Sciences, Hangzhou, China
- 2The First People's Hospital of Taicang, Taicang, China
- 3Suzhou Chien-Shiung Institute of Technology, Taicang, China
- 4Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
- 5The Second Affiliated Hospital of Baotou Medical College, Baotou, China
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Shaoyao Gancao Decoction (SGD), a classic traditional Chinese medicine formula, has demonstrated significant laxative effects in treating functional constipation (FC). In a self-controlled study (n = 20) conducted over 3-5 days, 90% of patients reported symptom improvement, with 70% experiencing increased stool frequency (>3 times/week). SGD treatment induced notable changes in the gut microbiota, shifting from dysbiosis dominated by Proteobacteria, Enterobacteriaceae, and Escherichia-Shigella, to a more balanced microbiome enriched in Firmicutes, Veillonella, Roseburia, and Ruminococcus. This microbial shift was accompanied by elevated levels of short-chain fatty acids (SCFAs), as well as improvements in stool consistency and frequency, indicating the restoration of gut homeostasis. Functional analysis revealed that SGD inhibited unsaturated fatty acid metabolism, particularly arachidonic acid, and suppressed retrograde endocannabinoid signaling—both pathways linked to slowed intestinal motility. Additionally, post-treatment feature species in responders, such as Ruminococcus sp. N15.MGS-57 and Bacteroides coprophilus, were associated with increased active estrogen levels and enhanced secondary bile acid metabolism, respectively. These findings highlight SGD's potential in treating FC by reducing dysbiosis, modulating the gut microbiota, and targeting pro-constipation pathways, providing new insights into the etiology and treatment of FC.
Keywords: Shaoyao Gancao Decoction, Functional constipation, gut microbiome, Escherichia-Shigella, Dysbiosis, Retrograde endocannabinoid signaling, short-chain fatty acids
Received: 14 Sep 2025; Accepted: 12 Nov 2025.
Copyright: © 2025 Zhu, Gao, Li, Wang, Li, Li, Huang, Wang and Nie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jinshan Nie, doctornjs@126.com
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