1.Research progress on the mechanisms of traditional Chinese medicine in treating functional constipation based on the gut microbiota-bile acid axis
Xiangrui KONG ; Qimeng ZHANG ; Yue ZOU ; Yong LIANG ; Yu SHI ; Yang ZHANG ; Hongxi ZHANG
China Pharmacy 2026;37(2):244-249
Functional constipation (FC) is a common functional disorder of the intestines, mainly characterized by reduced bowel movement frequency, difficulty in defecation, a sensation of incomplete evacuation, and hard stools, which severely affect patients’ quality of life. Research indicates that the pathogenesis of FC is closely related to gut microbiota dysbiosis and abnormal bile acid secretion. Bile acids, as endogenous natural laxatives, promote bowel movements by enhancing colonic secretion and regulating intestinal motility; meanwhile, gut microbiota influence colonic transit function by regulating the enteric nervous system, immune system, and their metabolic products. Based on an overview of the relationship between gut microbiota and bile acid metabolism, this article systematically reviews the current research status on the mechanisms of traditional Chinese medicine (TCM) in treating FC by regulating the balance of the gut microbiota-bile acid axis. It is found that single Chinese medicinal herbs (such as Atractylodes macrocephala), isolated compounds (such as Platycodon grandiflorum polysaccharides), herbal formulas (such as Shanger huang pill), acupuncture, and moxibustion can up-regulate the abundance of beneficial bacteria, reshape the microbial structure, correct bile acid metabolism, and activate the Takeda G-protein receptor 5/farnesoid X receptor pathway to treat FC.
2.Research progress on traditional Chinese medicine regulation of MAPK signaling pathway in intervening slow transit constipation
Xiangrui KONG ; Qimeng ZHANG ; Yue ZOU ; Yong LIANG ; Yu SHI ; Yang ZHANG ; Ke MENG ; Hongxi ZHANG
China Pharmacy 2026;37(11):1508-1514
low transit constipation (STC) is a common functional intestinal disorder caused by impaired colonic transit function, characterized by reduced bowel movement frequency, hard stools, and difficulty in defecation. The mitogen-activated protein kinase (MAPK) signaling pathway, which mainly includes extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 subtypes, plays a critical regulatory role in the occurrence and development of STC. This paper systematically reviews the multiple pathogenic mechanisms of the MAPK signaling pathway in STC and the research progress of traditional Chinese medicine (TCM) intervention.At the mechanistic level, the MAPK signaling pathway promotes the progression of STC through the following links:(1) Activation of p38 upregulates the expression of aquaporin 3 (AQP3)/AQP4 in the colon, leading to excessive reabsorption of water in the intestinal lumen; (2) It forms a positive feedback loop with nuclear factor-κB (NF-κB) to maintain low-grade intestinal inflammation, releases inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), and inhibits smooth muscle contraction; (3) Overactivation of p38 downregulates the expression of occludin and mucin 2 while upregulates the expression of claudin-2, thereby disrupting the mucosal barrier; (4) The JNK/p38 signaling pathway activates the caspase cascade to induce apoptosis of intestinal epithelial cells, neurons, and interstitial cells of Cajal; (5) Abnormal ERK signaling and excessive activation of p38/JNK inhibit intestinal smooth muscle contraction and reduce 5-hydroxytryptamine secretion, ultimately resulting in impaired colonic transit function.At the intervention level, TCM compound formulas and single herbs have been proven to improve STC by regulating the MAPK signaling pathway. Their effects are syndrome type-dependent:yin-nourishing formulas (Zengye Chengqi Tang, Tongbian Tang) mainly regulate the ERK/AQP axis; yang-warming formulas (Jichuan Jian) target both ERK/JNK and anti-apoptosis; heat-clearing formulas (Sanren Tang) focus on p38/NF-κB anti-inflammation. A single drug can simultaneously cover multiple aspects including water metabolism, inflammation, barrier function, apoptosis, and intestinal motility.Current relevant studies still have limitations such as mechanisms mostly remaining at the correlational level and a lack of disease-syndrome integrated research models. Future studies should combine specific inhibitors or gene knockout to identify core targets, establish disease-syndrome integrated STC models, and use network pharmacology and molecular docking techniques to deeply analyze the fine mechanism of “component-target-phenotype”, so as to provide high-quality evidence for the precise regulation of the MAPK signaling pathway by TCM in the intervention of STC.
3.Bioinformatics and Animal Experiments Reveal Mechanism of Shouhui Tongbian Capsules in Treating Constipation
Yong LIANG ; Qimeng ZHANG ; Bin GE ; Yang ZHANG ; Yu SHI ; Yue LU ; Hongxi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):150-157
ObjectiveTo explore the mechanism of Shouhui Tongbian capsules in treating constipation based on the research foundation of its active components combined with network pharmacology and animal experiments. MethodsThe drug components were imported into SwissTargetPrediction to predict the targets of Shouhui Tongbian capsules, and constipation-related targets were collected from disease databases. A protein-protein interaction (PPI) network was constructed for the common targets shared by Shouhui Tongbian capsules and constipation to screen key targets, which was followed by gene ontology (GO) function and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses. A "bioactive component-target-pathway" network was constructed, and the core components of Shouhui Tongbian capsules in treating constipation were screened based on the topological parameters of this network. Molecular docking was employed to predict the binding affinity of core components to key targets. A mouse model of constipation was constructed to screen the key pathways and targets of the drug intervention in constipation. ResultsThe PPI network revealed six key constipation-related targets: protein kinase B (Akt1), B-cell lymphoma-2 (Bcl-2), glycogen synthase kinase-3β (GSK-3β), cyclooxygenase-2 (PTGS2), estrogen receptor 1 (ESR1), and epidermal growth factor receptor (EGFR). The KEGG pathway analysis showed that the phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway was the most enriched. The topological parameter analysis of the "bioactive component-target-pathway" network screened out the top 10 core components: auranetin, isosinensetin, naringin, diosmetin, quercetin, apigenin, luteolin, hesperidin, isorhapontigenin, and chrysophanol. Molecular docking results showed that the 10 core components had strong binding affinity with the 6 key targets. Animal experiments showed that after intervention with different doses of Shouhui Tongbian capsules, the time to the first black stool excretion was reduced and the fecal water content and small intestine charcoal propulsion rate of mice were improved. After treatment with Shouhui Tongbian capsules, the colonic mucosal injury and glandular arrangement were alleviated, and the muscle layer thickness was increased. Western blot results showed that Shouhui Tongbian capsules recovered the expression of apoptosis-related molecules mediated by the PI3K/Akt pathway in the colonic tissue of constipated mice. Terminal-deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) results showed that the cell apoptosis rate of the colon significantly reduced after intervention with Shouhui Tongbian capsules. ConclusionThe results of network pharmacology and animal experiments confirmed that Shouhui Tongbian capsules can treat constipation through multiple targets and pathways. The capsules can effectively intervene in loperamide-induced constipation in mice by regulating the constipation indicators and reducing cell apoptosis in the colon tissue via activating the PI3K/Akt signaling pathway.
4.Exploring the differentiation and treatment of apoplexy based on"treating the elderly by focusing on the fu":a perspective from"six fu viscera-xuanfu-collaterals"
Di ZHAO ; Xiao LIANG ; Jingjing WEI ; Lina MIAO ; Yunfan ZHANG ; Hongxi LIU ; Yue LIU ; Liuding WANG ; Qi ZHANG ; Yunling ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(5):690-695
The incidence of apoplexy remains persistently high among the older population.Based on the traditional Chinese medicine principle of"treating the elderly by focusing on the fu",this paper explores the holistic connotation of"fu".It proposes that the onset of apoplexy in the elderly is characterized by obstruction,stagnation,depression,and sluggishness,which should be treated from six fu viscera,xuanfu,and collaterals.The interconnected hierarchical network of these three systems,serving as macro-and micro-channels for qi and fluid metabolism,plays a central role in both disease development and treatment.The failure of the six fu viscera to descend and the upward invasion of turbid yin are identified as prerequisites for apoplexy onset,whereas yang qi stagnation and xuanfu blockage act as key pathogenic drivers,and the core mechanisms involve phlegm-stasis-toxin accumulation,and dysfunction of the collaterals and fu.In the treatment,acute phase requires unblocking fu viscera and restoring xuanfu patency;chronic phase focuses on dredging collaterals and opening xuanfu;and recovery phase emphasizes tonifying combined with regulating xuanfu.The understanding of"treating the elderly by focusing on the fu"emphasizes that the pathogenesis of the disease should be changed to individual conditions;"six fu viscera-xuanfu-collaterals"exhibits a pathological mechanism characterized by the transmission and reception of pathogenic factors,as well as progressive mutual involvement;in clinical practice,treatment should meticulously assess the severity and nuances of the condition,prioritizing method that emphasizes unobstructed flow;additionally,therapy should be essential to protect stomach qi and integrate therapeutic attacks within a framework of supplementation.These principles offer valuable reference for the differentiation and treatment of apoplexy.
5.Reconsideraton of Stroke with Syndrome of Combined Blood Stasis and Toxin from the Perspective of Xiang Thinking
Yunfan ZHANG ; Di ZHAO ; Lina MIAO ; Hongxi LIU ; Jingjing WEI ; Xiao LIANG ; Liuding WANG ; Xueru ZHANG ; Yunmeng CHEN ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2025;66(13):1305-1310
Xiang thinking is a cognitive approach that reflects the relationships between phenomena and their underlying principles by analyzing their external manifestations through methods such as analogy, reasoning, deduction, and symbolism. This article applied xiang thinking to analyze the etiology and pathogenesis of "wind, fire, phlegm, and blood stasis" in stroke, thereby exploring its impact on the principles of syndrome differentiation and treatment of this condition. Meanwhile, the article traced the construction process of xiang thinking, and interpreted the concept of "toxin pathogen" in traditional Chinese medicine from four perspectives, state, attribute, origin, and law. Furthermore, the relationship between the process of constructing xiang thinking and the origin of etiology, identification methods, pathogenesis evolution, and treatment strategies for stroke with syndrome of combined blood stasis and toxin was explored, so as to provide insights into research on the etiology and pathogenesis of stroke, as well as clinical diagnosis and treatment approaches.
6.Exploring the differentiation and treatment of apoplexy based on"treating the elderly by focusing on the fu":a perspective from"six fu viscera-xuanfu-collaterals"
Di ZHAO ; Xiao LIANG ; Jingjing WEI ; Lina MIAO ; Yunfan ZHANG ; Hongxi LIU ; Yue LIU ; Liuding WANG ; Qi ZHANG ; Yunling ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(5):690-695
The incidence of apoplexy remains persistently high among the older population.Based on the traditional Chinese medicine principle of"treating the elderly by focusing on the fu",this paper explores the holistic connotation of"fu".It proposes that the onset of apoplexy in the elderly is characterized by obstruction,stagnation,depression,and sluggishness,which should be treated from six fu viscera,xuanfu,and collaterals.The interconnected hierarchical network of these three systems,serving as macro-and micro-channels for qi and fluid metabolism,plays a central role in both disease development and treatment.The failure of the six fu viscera to descend and the upward invasion of turbid yin are identified as prerequisites for apoplexy onset,whereas yang qi stagnation and xuanfu blockage act as key pathogenic drivers,and the core mechanisms involve phlegm-stasis-toxin accumulation,and dysfunction of the collaterals and fu.In the treatment,acute phase requires unblocking fu viscera and restoring xuanfu patency;chronic phase focuses on dredging collaterals and opening xuanfu;and recovery phase emphasizes tonifying combined with regulating xuanfu.The understanding of"treating the elderly by focusing on the fu"emphasizes that the pathogenesis of the disease should be changed to individual conditions;"six fu viscera-xuanfu-collaterals"exhibits a pathological mechanism characterized by the transmission and reception of pathogenic factors,as well as progressive mutual involvement;in clinical practice,treatment should meticulously assess the severity and nuances of the condition,prioritizing method that emphasizes unobstructed flow;additionally,therapy should be essential to protect stomach qi and integrate therapeutic attacks within a framework of supplementation.These principles offer valuable reference for the differentiation and treatment of apoplexy.
7.Exploring the Disease Mechanism and Treatment of Ischemic Stroke Based on Ascending and Descending of Qi Movement from the Perspective of Xiang Thinking
Liuding WANG ; Xiao LIANG ; Yifan CHEN ; Yue LIU ; Hongxi LIU ; Di ZHAO ; Yunfan ZHANG ; Yunmeng CHEN ; Xueru ZHANG ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2024;65(14):1443-1448
Xiang thinking is the key way of thinking to construct the life model of human body in traditional Chinese medicine (TCM), and the theory of ascending and descending of qi movement is an important manifestation of xiang thinking in the theory of TCM. Based on the theory of qi movement, this paper interpreted the mechanism of ischemic stroke through the perspective of xiang thinking "earth weakness - wood constraint - fire hyperactivity", as "earth weakness in the central and dampness accumulated to phlegm" "wood constraint and stirring wind led to blood stasis" and "fire hyperactivity and fire toxin showed flaming upward" due to disorder of qi movement. Combined with the "xiang of medicinal properties and therapy methods" to discuss the treatment and prescriptions of ischaemic stroke, applying wind medicinals to elevate ji-earth (己土) and yi-wood (乙木), so that phlegm and stasis can be eliminated, and cold medicinals to descend jia-wood (甲木) and wu-earth (戊土) so that fire toxin can be cleared, with a view to restore ascending and descending of qi movement for ischaemic stroke.
8.Regulation of Constipation-related Signaling Pathways by Traditional Chinese Medicine: A Review
Yong LIANG ; Bin GE ; Yu SHI ; Yang ZHANG ; Hongxi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(20):230-240
Chronic constipation (CC) is one of the common and frequent functional gastrointestinal diseases in clinic. At present, the overall therapeutic effect of CC is still not satisfactory in China and abroad, which seriously affects the quality of life of patients. The pathophysiological mechanism of constipation has not been fully elucidated, and studies have mainly focused on the dysfunction of the enteric nervous system (ENS), abnormalities of Cajal interstitial cells (ICCs), alterations in mucosal immune function (low-grade intestinal inflammation, intestinal barrier damage, and immune activation), abnormalities of gastrointestinal hormones, dysregulation of intestinal flora, and dysfunctions of intestinal dynamics. Traditional Chinese medicine (TCM) is a unique and precious resource in China with good efficacy and safety. TCM and its active ingredients can effectively treat constipation, and its mechanism of action needs to be further investigated. Signaling pathways are involved in the development of constipation, which is one of the main targets in the study of pathological mechanisms of constipation and the pharmacological study of therapeutic drugs. Therefore, the authors searched PubMed, China National Knowledge Infrastructure (CNKI), and other literature databases with the keywords of ''constipation'', ''signaling pathway'', and ''traditional Chinese medicine'' to systematically summarize the signaling pathways related to constipation regulated by TCM. The comprehensive analysis shows that TCM mainly plays a role in regulating autophagy, apoptosis, and proliferation and ensuring anti-oxidative stress, anti-inflammation, and protection of intestinal barrier of ICCs by modulating signaling pathways such as stem cell factor/tyrosine kinase receptor (SCF/c-kit), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), 5-hydroxytryptophan (5-HT), mitogen-activated protein kinases (MAPK), and Toll-like receptors (TLRs). TCM regulates neurotransmitter secretion and intestinal water metabolism to improve constipation. This demonstrates the advantages of multi-level, multi-target, and multi-level effects of TCM, and in-depth research can provide new ideas for exploring the pathogenesis of constipation and developing new drugs.
9.Study on Zhang Yunling's Medication Law in Treating Headache Based on Data Mining
Hongxi LIU ; Xiao LIANG ; Jingzi SHI ; Jingjing WEI ; Wei SHEN ; Guojing FU ; Yue LIU ; Liuding WANG ; Yunling ZHANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):59-64
Objective To study the medication law of Professor Zhang Yunling in the treatment of headache based on data mining technology;To provide ideas for the clinical treatment of headache.Methods Professor Zhang Yunling's outpatient TCM prescription data for the treatment of headache from Sep.2017 to Dec.2020 were collected,and the Ancient and Modern Medical Record Cloud Platform 2.3.5 was used to mine the selected TCM prescriptions for herbal medicine frequency statistics,property,taste and meridian tropism statistics,herbal medicine efficacy statistics,correlation analysis,clustering analysis,complex network analysis,etc.Results Through collection and screening,totally 332 prescriptions were included,involving 178 kinds of Chinese materia medica,with a total frequency of 5 380 times.The top 10 kinds of Chinese materia medica were Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Testudinis Carapax et Plastrum,Bambusae Caulis in Taenia,Glycyrrhizae Radix et Rhizoma,Astragali Radix,Amomi Fructus Rotundus,Pinelliae Rhizoma Praeparatum,and Polygalae Radix.They were mainly warm,mild and slightly cold in properties,sweet,pungent and bitter in tastes,and liver,lung,spleen meridian in meridian tropism.In the statistics of herbal medicine efficacy,expelling wind and relieving pain,suppressing liver yang,promoting blood circulation and qi,clearing heart and relieving restlessness,clearing heat and detoxifying,softening liver and relieving pain were used more frequently.The combinations in herbal medicines association included"Atractyodis Macrocephalae Rhizoma-Chuanxiaong Rhizoma","Testudinis Carapax et Plastrum-Paeoniae Radix alba","Glycyrrhizae Radix et Rhizoma-Paeoniae Radix alba","Testudinis Carapax et Plastrum-Chuanxiaong Rhizoma","Bambusae Caulis in Taenia-Chuanxiaong Rhizoma".Herbal medicines clustering clustered 32 kinds of high-frequency herbal medicines used more than 60 times into 6 categories.Complex network analysis screened out the core formula for the treatment of headache:Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Bambusae Caulis in Taenia,Pinelliae Rhizoma Praeparatum,Testudinis Carapax et Plastrum,Astragali Radix,Amomi Fructus Rotundus,and Glycyrrhizae Radix et Rhizoma.Conclusion In the treatment of headache,Professor Zhang Yunling holds that the pathogenesis of headache is deficiency in origin and excess in superficiality,deficiency of qi and blood,loss of nourishment of brain collaterals,stagnation of phlegm and dampness,disturbance of wind pathogen,obstruction of brain collaterals,and the location of the disease is related to the five viscera and involves the stomach.Focuses on tonifying deficiency and reducing excess,treats exterior and interior separately,and gives consideration to both the symptoms and the root causes,which often uses drugs to treat headache,such as dispelling wind and relieving pain,promoting blood circulation and relieving pain,relieving spasm and relieving pains,eliminating phlegm and dampness,invigorating qi and spleen,nourishing blood and yin,eliminating dampness and regulating stomach,relieving depression and restlessness,which can provide some reference for the clinical treatment of headache.
10.Study of methods to optimise the use of chloral hydrate sedation
Journal of Practical Radiology 2024;40(2):278-280,296
Objective To analyze the effects of different age groups of children and different routes of administration on the sedation effect of chloral hydrate.Methods A retrospective analysis was performed on 10 671 children who underwent MRI examination.Children sedated with chloral hydrate were selected and divided into four groups according to their age:group A(0-1 month),group B(>1 month-1 year old),group C(>1-2 years old),group D(>2-6 years old),and each group was further divided into oral administration and enema administration.The success rate of sedation in each group was recorded.Data were analyzed using SPSS 22.0 software.Results(1)The sedation success rate of chloral hydrate in group A was 82.5%,including 87.5%by oral administration and 85.1%by enema administration;(2)The sedation success rate of chloral hydrate in group B was 71.8%,including 78.5%by oral administration and 71.2%by enema administration;(3)The sedation success rate of chloral hydrate in group C was 87.7%,including 89.6%by oral administration and 82.2%by enema administration;(4)The sedation success rate of chloral hydrate in group D was 89.6%,including 89.5%by oral administration and 90.8%by enema administration.There was a difference in the sedation success rate between group B and groups A,C and D,and there was a difference in the sedation success rate between group D and groups A,B,and C.There was a difference in the sedation success rate of oral administration versus enema administration between groups B and D.The differences were statistically significant(P<0.05).Conclusion The sedation success rate of chloral hydrate is different in different age groups,the sedation success rate in the same age group is also different due to different administration methods.Therefore,it is necessary to choose the appropriate sedation strategy according to the age of children.

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