The combination of Polygonatum sibiricum and Poria cocos, as a medicine-food homology combination, prevents constipation due to Pi deficiency through modulation of the gut microbiota

Constipation due to Pi deficiency (Pi-xu) is a common Traditional Chinese Medicine (TCM) syndrome characterized by impaired Qi regulation and body fluid distribution disturbances from Pi deficiency. Polygonatum sibiricum and Poria cocos are representative medicine-food homology herbs traditionally used to fortify the Pi, nourish Yin, and regulate water metabolism. Their traditional functions are highly consistent with the pathogenesis of constipation due to Pi deficiency. This study explored the Polygonatum sibiricum and Poria cocos combination's potential and mechanisms for preventing constipation due to Pi deficiency. Mice were assigned to normal, model, and Polygonatum sibiricum and Poria cocos groups. General signs, fecal characteristics, gastrointestinal hormone levels (5-HT, CCK, MTL, and VIP), oxidative stress indicators (MDA and SOD), colonic histopathology, and gut microbiota profiles were evaluated. Compared with the model group, the combination significantly improved fecal properties and fecal water content (P < 0.05), reduced hepatic MDA levels, and increased SOD activity (P < 0.01). It also partially normalized gastrointestinal hormone imbalance and alleviated colonic mucosal damage. 16S rRNA sequencing revealed that the combination modulated gut microbiota composition and functional potential, characterized by reduced Proteobacteria abundance, enrichment of beneficial taxa with SFCA-producing potential, and preservation of core metabolic pathways. Correlation analysis suggested that gut microbiota modulation was closely associated with improvements in oxidative stress status, gut-brain axis-related factors, and intestinal barrier integrity. Overall, these findings indicate that the Polygonatum sibiricum and Poria cocos combination exerts preventive effects on constipation due to Pi deficiency through microbiota-mediated, multi-pathway regulation. This study provides experimental support for the TCM concept of "preventing disease before it arises" and highlights the potential of medicine-food homology products in preventive health strategies.