Combined acupuncture and herb treatment improves intestinal flora inabdominally obese subjects based on 16s rRNA sequencing: a randomized controlled trial

OBJECTIVE:: To investigate Acupuncture-herb therapy modulates gut microbiota in abdominal obesity. METHODS:: A randomized controlled trial was designed in accordance with standard protocols. Abdominally obese subjects were randomized into four groups: A2 (Control): double placebo, A1 (Needle): press needle + placebo herb, A3 (herb): herbal medicine (Huatan Lishi Fang化痰利湿方) + placebo needle, A4 (Combination): press needle + herbal medicine. After 12 weeks of treatment, groups were relabeled B1-B4. Weight, waist circumference, and body mass index were measured monthly. Gut microbiota was analyzed via 16S rRNA sequencing for diversity and abundance. RESULTS:: Combined needle-herb therapy significantly reduced waist circumference (P < 0.05). All treatments altered gut microbiota composition. The combination group showed significant changes in diversity (Chao1, Shannon, Simpson; P < 0.05). Needle therapy increased Bacteroidia; herbs reduced Lachnospiraceae and Megamonas. All results were significant (P < 0.05). CONCLUSION:: Combined needle-herb treatment modulated 25 key gut flora across multiple taxonomic levels in abdominal obesity. It reduced Firmicutes and Bacteroidota. Bacteroidota, Actinobacteriota, and Prevo-tellaceae may suppress obesity, whereas Proteobacteria, Lachnospiraceae, and Megamonas may promote it. The combination specifically altered Bacteroidaceae, Lachno-spiraceae, Bacteroidia, and Megamonas.