Organoid technology， a rapidly advancing three-dimensional （3D） cell culture platform， can closely mimic the microarchitecture and functions of human digestive organs， effectively overcoming the limitations of conventional two-dimensional cell models and animal experiments. By systematically summarizing the distinctive strengths of organoid technology in simulating digestive physiological and pathological states， constructing digestive system disease models， enabling high-throughput drug screening， and facilitating personalized treatment， this review explored the potential applications of organoids in identifying active components of traditional Chinese medicine （TCM） formulas， evaluating in vitro pharmacokinetics and toxicological parameters， and investigating multi-target synergistic mechanisms. By integrating cutting-edge engineering technologies， organoids are expected to provide a more scientific research platform for TCM， accelerate the modernization of its mechanistic studies， and enhance its scientific value and global impact.

ObjectiveTo explore the possible mechanism of Modified Gegen Qinlian Decoction （加味葛根芩连汤， MGQD） in the treatment of ulcerative colitis （UC） based on intestinal mucus barrier. MethodsThirty C57BL/6 mice were randomly divided into a control group， a model group and a MGQD group with 10 mice in each. Dextran Sulfate Sodium Salt （DSS） was used to construct the UC model in all groups except for the control group. Meanwhile， mice in the MGQD group were given 20 g/kg of MGQD decoction by gavage according to their body weight， while those in the control group and model group were given 0.2 ml/20 g of pure water by gavage， once a day for 7 consecutive days. On the day following the last gavage， the body weight， disease activity index （DAI） score， spleen weight， and colon length were compared. The pathological changes of the intestinal mucosal tissues were observed by HE staining； the protein expression levels of mucin 2 （MUC2） and leucine-rich repeat G protein-coupled receptor 5 （Lgr5） in the intestinal mucosal tissues were detected by immunofluorescence； the cuprocytes in the intestinal mucosal tissues were detected by AB/PAS staining； and the expression level of Ki67 in the intestinal mucosal tissues was detected by immunohistochemistry. ResultsHE staining showed that the colon mucosal tissue of the mice in the control group was intact. In the model group， the colon mucosal epithelial structure was severely damaged， with a large amount of inflammatory cell infiltration in the mucosal propria. In the MGQD group， the mucosal tissue structure was partially lost， with a small amount of inflammatory cell infiltration.The body weight and colon length of mice in the model group decreased significantly compared to those in the control group， while DAI scores and spleen weight increased， and the levels of MUC2， Ki67， Lgr5 proteins， and the number of goblet cells were significantly reduced （P＜0.01）. Compared to the model group， the MGQD group had increased body weight of mice， colon length， and decreased DAI scores and spleen weight； the levels of MUC2， Ki67， Lgr5 proteins， and the number of goblet cells were increased （P＜0.05 or P＜0.01）. ConclusionMGQD has a favorable ameliorative effect on UC-related symptoms and pathological tissue damage， and its mechanism of action may be related to the restoration of the prolife-ration and differentiation of intestinal stem cells into goblet cells， thereby promoting the repair of the intestinal mucus barrier.

Objective To analyze the TCM syndrome and treatment rule for the treatment of chronic atrophic gastritis based on data mining;To provide reference for its clinical treatment.Methods With the help of the big data platform of evidence-based literature of TCM covering several dominant diseases in the field of digestion,literature on the experience of famous doctors,theoretical discussion and case reports in the treatment of chronic atrophic gastritis published from 1 January 2000 to 31 July 2022 was retrieved.Medical records were screened according to the inclusion and exclusion criteria.The data of TCM disease names,clinical symptoms,tongue manifestation,pulse manifestation,TCM syndrome,TCM treatment method and other terms in medical records were standardized and statistically analyzed.Results Totally 169 articles were included,including 228 medical cases,involving 228 patients,with a cumulative number of 361 visits,with an average age of(53.17±11.11)years old,with the largest number of 50-60 years old.Chronic atrophic gastritis mostly belonged to the categories of"stomach pain"and"epigastric puffiness"in TCM,and its main symptoms were stomach pain,epigastric puffiness and belching.The common tongue manifestation include dark red tongue,white moss,thin or greasy moss.The common pulse manifestation included wiry slippery pulse,wiry thready pulse and wiry pulse.The high-frequency syndromes included liver-stomach qi stagnation syndrome,spleen-stomach dampness-heat syndrome,liver-qi stagnation and spleen-qi deficiency syndrome.The disease locations were mainly in the stomach,spleen and liver,and the syndrome elements were mainly qi deficiency,qi stagnation,blood stasis,dampness and heat,etc.The complex syndrome elements were more than the single syndrome elements,and the two syndrome elements of qi deficiency + qi stagnation was the most common.The most commonly used treatment methods were supplementing,regulating qi and regulating blood.Conclusion The treatment of chronic atrophic gastritis with TCM mostly focuses on the stomach,spleen and liver.The core syndrome elements are qi deficiency,qi stagnation,and blood stasis.The methods of nourishing qi and strengthening the spleen,soothing the liver and stomach,regulating qi and blood are often used.

ObjectiveTo analyse the current implementation status of Chinese herbal medicine （CHM） placebo and systematically evaluate the placebo effect in randomised controlled trials （RCTs） of traditional Chinese medicine （TCM） for the treatment of functional dyspepsia （FD）. MethodsA combination of medical subject terms and free words was used to search six databases， including PubMed， EMBASE， Cochrane Library， Web of Science， China National Knowledge Infrastructure， and Wanfang， for RCTs with CHM placebo group for FD published from January 31st， 1994 to September 30th， 2023. The dosage forms， composition， and methodological quality were collected and evaluated. The quality of the included articles was evaluated by Cochrane risk of bias assessment tool， and meta-analysis was performed on the CHM placebo response rate of patients with FD， and subgroup analysis and meta-regression was performed according to diagnostic criteria， efficacy criteria， duration of treatment， type of placebo， whether it contained active ingredient， and whether it evaluated placebo effects. ResultsA total of 34 publications were included involving 5046 participants， of which 2221 FD patients received CHM placebo treatment. Granules were the predominant placebo preparation， accounting for 71% （24/34）； 32.35% （11/34） of the studies added real CHM to the placebo， and only 12 （35%） of the studies described appearance， odour， and taste. The placebo response rate in FD patients in the placebo group was 41% （95% CI： 0.35 to 0.47； P＜0.01， I² = 87%）； there was significant difference between groups with different diagnostic criteria and different treatment durations （P＜0.05 or P＜0.01）， but there was no significant difference between the different efficacy evaluation criteria， the different placebo preparation， the presence of a low-dose active ingredient， and the presence or absence of placebo assessment （P＞0.05）. ConclusionThere was a significant CHM placebo effect in patients with FD， with granules as the main preparation of placebop. Different diagnostic criteria and different treatment times may affect the response rate of patients， and the addition of low-dose real medicine to the CHM placebos has not been seen to have an effect on the response rate. Clinical investigators have not paid enough attention to placebos， and there is a lack of uniform standards and norms for the preparation and evaluation of CHM placebos.

The construction of standard system is an important part of standardization work， and also the top-level design of standardization work.Taking the group standards of the China Association of Chinese Medicine as a reference， and following the steps of establishing an expert group， literature research， Delphi method expert consultation and expert meeting， it was clarified that the content of the standard system for clinical diagnosis and treatment techniques of gastroenterology in traditional Chinese medicine， including terms （symptoms and signs， syndromes and syndrome components， and therapeutic principles and methods）， guidelines and standards （traditional Chinese medicine disease name， western medicine disease name， and classical syndromes）， effectiveness evaluation （modern medicine evaluation， traditional Chinese medicine characteristics of diseases， symptoms and signs grading， traditional Chinese medicine syndrome evaluation）， and practical techniques. Meanwhile， the structure chart of the standard system， the table of standard details and the table of statistical standards were compiled to lay the foundation for the standardisation of clinical diagnosis and treatment techniques of gastroenterology， and to provide reference for the construction of the standard system of various disciplines.

Spleen deficiency is an important part of the theoretical system of Traditional Chinese Medicine,which has experienced the process of origin,standardization,maturity,perfection and development in different historical periods.The physiological function of the spleen in Traditional Chinese Medicine involves"the spleen governs transportation and transformation,promotes blood circulation";The study of"spleen governing transportation and transformation"divided into"spleen governing transportation"and"spleen governing transformation"from the function of spleen,which is more conducive to explaining the scientific connotation of spleen governing transportation and transformation.Spleen governing transport and transformation is the basis of spleen governing clearing,and spleen governing clearing is the purpose of spleen governing transport and transformation.Spleen governing blood circulation is the outcome of spleen governing clearing,and there is a progressive logical hierarchy relationship between them.With the rise of proteomics,metabonomics and intestinal flora research,it provides technical support for the study of spleen deficiency syndrome;In addition,based on the correlation between spleen of Traditional Chinese Medicine and the functions of endoplasmic reticulum,the material basis of essence of spleen deficiency is discussed from the perspective of endoplasmic reticulum stress,which provides a new direction for the study of spleen deficiency.

Objective To understand the current status and hot spots of research on spleen deficiency syndrome of functional dyspepsia in China,and to provide reference for clinical treatment and mechanism research of this disease.Methods Research literature on spleen deficiency syndrome of functional dyspepsia included in the three major Chinese databases CNKI,Wanfang database and VIP from January 1,2000 to June 16,2023 were searched and manually screened.NoteExpress 3.6.0.9220 was used to screen duplicate research literature and manage them,and CiteSpace 5.7.R5 software was applied to draw cooperative network graphs and tables of authors and their research institutions,construct co-occurrence network graphs and tables of keywords,emergent graphs,clustering network graphs and tables,and clustering timeline graphs,and analyze them one by one.Results A total of 407 research papers on spleen deficiency in functional dyspepsia were included,with an overall fluctuating upward trend in the number of annual publications;the high-producing authors were Tang Xudong,Lv Lin,Wang Fengyun,Zhang Shengsheng,Huang Suiping,Yin Xiaolan,and Ma Xiangxue in order;the research institutions with more publications were Beijing University of Traditional Chinese Medicine,Hunan University of Traditional Chinese Medicine,Xiyuan Hospital of the Chinese Academy of Traditional Medicine,Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University,and the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,in order;The high-frequency keywords were"functional dyspepsia","liver depression and spleen deficiency","spleen deficiency and qi stagnation","Chinese medicine therapy","clinical research","spleen deficiency syndrome",etc.Accordingly,a list of high-centered keywords(centrality≥0.1),the top 20 emergent words,14 clustering labels and a timeline diagram of research literature were generated.Conclusion The research direction of functional dyspepsia spleen deficiency in China is mainly focused on three aspects:TCM syndrome type,clinical research and mechanism research.

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12^th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.

Objective:To investigate the medication law of TCM and signaling pathway as well as molecular targets in the treatment of chronic atrophic gastritis (CAG).Methods:The literature on TCM treatment of CAG rats in the databases of CNKI, CBM, CQVIP, Wanfang Database, PubMed and Web of Science from January 1, 2010 to May 31, 2022 were retrieved. The literature was screened and evaluated based on inclusion and exclusion criteria. The information on the medicine composition, signaling pathways and molecular targets of formulas was collated and analyzed.Results:A total of 304 articles were included in this study, involving 118 prescriptions and 174 kinds of Chinese materia medica. The high-frequency drugs were Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Curcumae Rhizoma. The most common drug pair were Paeoniae Radix alba-Glycyrrhizae Radix et Rhizoma, Scleromitrion diffusum (Willd.) R. J. Wang-Curcumae Rhizoma、Atractylodis Macrocephalae Rhizoma-Poria. The association rule with high confidence were Coptidis Rhizoma-Codonopsis Radix-Pinelliae Rhizoma, Coptidis Rhizoma-Glycyrrhizae Radix et Rhizoma-Pinelliae Rhizoma, Codonopsis Radix-Hedyotidis Herba-Curcumae Rhizoma. A total of 16 signaling pathways were involved, including PI3K/Akt, hedgehog, Wnt and TLR4 signal pathways with high frequency. There were 198 molecular targets, mainly including inflammation immunity targets (IL-6, NF-κB, TNF-α), proliferation and apoptosis related targets (Bcl-2, PCNA, Bax), Oxidative damage molecules (SOD, MDA), gastric mucosal secretion markers (GAS, PG), and hypoxia or angiogenesis markers (HIF-1 ɑ, VEGF).Conclusion:This study summarizes the drug distribution law and action mechanism of prevention and treatment of CAG with TCM in the field of basic research, which provides the reference for understand the overview of basic research on CAG with TCM.

Deciphering the metabolites of multiple components in herbal medicine has far-reaching significance for revealing pharmacodynamic ingredients.However,most chemical components of herbal medicine are secondary metabolites with low content whose in vivo metabolites are close to trace amounts,making it difficult to achieve comprehensive detection and identification.In this paper,an efficient strategy was proposed:herb-derived metabolites were predicted according to the structural characteristics and metabolic reactions of chemical constituents in Corydalis Rhizoma and chemical structure screening tables for metabolites were conducted.The fragmentation patterns were summarized from represen-tative standards combining with specific cleavage behaviors to deduce structures of metabolites.Ion abundance plays an important role in compound identification,and high ion abundance can improve identification accuracy.The types of metabolites in different biological samples were very similar,but their ion abundance might be different.Therefore,for trace metabolites in biological samples,we used the following two methods to process:metabolites of high dose herbal extract were analyzed to char-acterize those of clinical dose herbal extracts in the same biological samples;cross-mapping of different biological samples was applied to identify trace metabolites based on the fact that a metabolite has different ion abundance in different biological samples.Compared with not using this strategy,44 more metabolites of clinical dose herbal extract were detected.This study improved the depth,breadth,and accuracy of current methods for herb-derived metabolites characterization.