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Exploration of facial and intestinal microbiota characteristics in acne patients with defecation difficulty
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DOI   10.11656/j.issn.1673-9043.2026.04.05
Key Words   defecation difficulty;acne;traditional Chinese medicine syndrome differentiation;microbiota
Author NameAffiliationE-mail
MU Qi Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China  
CHEN Jing Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Department of Dermatology, The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China 
gracejingchen@163.com 
Abstract
    [Objective] To explore the facial and intestinal microecological characteristics in acne patients with defecation difficulty across different traditional Chinese medicine(TCM) syndrome types. [Methods] A retrospective study was conducted. Acne patients with defecation disorders were classified into four TCM syndrome types via TCM syndrome differentiation:Lung Meridian Wind-Heat Syndrome,Spleen-Stomach Damp-Heat Syndrome,Chong-Ren Disharmony Syndrome,and Phlegm-Stasis Coagulation Syndrome. The severity of skin lesions was evaluated according to the modified Pillsbury International Acne Grading System. The distribution of Cutibacterium acnes(formerly Propionibacterium acnes) on the face was quantitatively detected using a combination of dermoscope,Wood’s lamp,and VISIA skin image analysis system. Intestinal microecology was assessed by determining the ratio of gram-positive bacilli(G+B) to gram-negative bacilli(G-B) in feces. By integrating the defecation disorder status of acne patients,comparisons were made among patients with different TCM syndrome types in terms of skin lesion severity,quantitative value of facial C. acnes,and abnormal ratio of intestinal flora. [Results] A total of 101 acne patients with defecation disorders were enrolled. There was a statistically significant difference in defecation status among patients with different TCM syndrome types(P<0.05). Specifically,dry and hard stools were the main manifestation in patients with Lung Meridian Wind-Heat Syndrome,while sticky stools were more prominent in those with Spleen-Stomach Damp-Heat Syndrome. The Spleen-Stomach Damp-Heat Syndrome group had the highest abnormal ratio of intestinal flora(51.52%),but this difference was not statistically significant compared with other syndrome types(P>0.05). The quantitative values of facial C. acnes in patients with Lung Meridian Wind-Heat Syndrome and Spleen-Stomach Damp-Heat Syndrome were significantly higher than those in patients with Chong-Ren Disharmony Syndrome and Phlegm-Stasis Coagulation Syndrome(P<0.01). The acne severity in patients with Phlegm-Stasis Coagulation Syndrome was significantly higher than that in patients with the other three syndrome types(P<0.01). [Conclusion] Patients with acne and defecation disorders of different TCM syndrome types exhibit differences in facial and intestinal microecological characteristics.

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