Gut Microbiota in the Treatment of Migraine with Acupuncture: A Review.

Migraine is one of the most common nervous system diseases in the world, which is characterized by recurrent severe headache, accompanied by gut microbiota imbalance and gut-brain axis dysfunction, seriously affecting the quality of life of patients. The existing treatment methods have some limitations, such as low diagnostic rate and drug dependence, so we should pay attention to the potential value of acupuncture, a traditional Chinese medicine therapy. This paper systematically reviews the mechanisms underlying the association between gut microbiota and migraine, and the pathways by which acupuncture intervention in migraine regulates gut microbiota. Studies have shown that patients with migraine generally have the phenomenon that the diversity of gut microbiota decreases, the abundance of beneficial bacteria decreases, and the proportion of harmful bacteria increases. The imbalance of gut microbiota promotes the disorder of intestinal metabolites, the destruction of the intestinal barrier and blood-brain barrier, the activation of trigeminal neurovascular system and central inflammation, and induces or aggravates migraine. Studies have found that acupuncture can regulate the diversity of gut microbiota and the abundance of beneficial bacteria through multiple targets, reduce the production of harmful metabolites, and protect the integrity of the intestinal barrier and blood-brain barrier. Acupuncture can relieve stress and negative emotion, and reduce the inducement of migraine. This review provides a theoretical basis for clarifying the mechanism of "microbiota-gut-brain axis (MGBA)" in acupuncture treatment of migraine, and also provides a new idea for the clinical standardized treatment of migraine.