Approximately 1.7 billion people worldwide suffer from overweight,especially in developed countries.The prevalence of obesity in the United States has reached 30% [1].The World Obesity Federation emphasizes obesity should be considered a chronic,recurrent,and progressive disease [2].It can lead to the onset of a series of diseases including diabetes,hyperlipidemia,cardiovascular disease,metabolic syndrome,etc.

The etiology of obesity is complex in which imbalance of intestinal flora plays a driving role in the development of obesity and obesity-related metabolic disorders [3].Even from the earliest stages of life,the alteration of intestinal flora can affect human's ability to gain and lose weight,which can lead to obesity and other metabolic diseases [4].The underlying mechanisms include mediating the development of low-grade inflammation,regulating intestinal hormone secretion,regulating the metabolism of fasting-induced adipose factor and 5-hydroxytryptamine,regulating the intestinal bile acid pool,etc.Through adjusting diet,lifestyle,behavior and emotional state,physical exercise,introduction of oral medication and probiotics,and weight loss surgery,the body intestinal flora disorder can be improved,which has a profound effect on weight loss.

The earliest record of obesity in traditional Chinese medicine (TCM) can be traced back to an ancient book of TCM Huangdi Neijing (B.C.220~211,Han Dynasty),which calls obesity “Zhiren,” “Gaoren,” or “Rouren.” TCM theory suggests that adiposity is caused by an improper diet as well as excessive consumption of fatty and sweet foods.The theory of treatment from the spleen is generally accepted,invigorating the spleen and stomach as well as dislodging the dampness and phlegm are the basic principle of obesity prevention and treatment [5,6].Because most herbs are orally administered,interplays between herbal constituents and gut microbiota are inevitably and gut microbiota has the potential as the targets of herbs [7].There is emerging evidence that the combination treatment with metformin and Chinese herb Huangqin (Scutellaria baicalensis) extract was found to exerts a better therapeutic effect on maintaining bile acid homeostasis than metformin alone in vivo [8].Electroacupuncture was found to alter the bacterial diversity and metabolic genes to establish a new balance of intestinal microflora in obese mice [9].

Here,this study summarizes and analyzes the therapeutic effects of internal treatment with oral TCM and external treatment with acupuncture,moxibustion,acupoint sticking,and acupoint embedding.It not only provides a scientific basis for the clinical application of TCM in the prevention and treatment of obesity from the perspective of altering the intestinal microflora,but also promotes the development of microbiome-targeted therapies of TCM for obesity.To read more about it,see this article please: Research on the influence of TCM therapy on the intestinal flora in obese patients. Link: https://www.tmrjournals.com/ndt/EN/10.12032/TMRND201902002

Xiong-Zhi Wu

Editor-in-Chief of TMR Non-Drug Therapy

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