Irritable bowel syndrome (IBS) is a gastrointestinal disorder with no structural damage and biochemical abnormality, and its pathogenic mechanism is still unclear. Variety of drugs, psychotherapy, diet regulation and other methods have been used by modern medicine to relieve symptoms, but the effect is not satisfactory. In recent years, TCM treatment of IBS has attracted widespread attention, especially for constipation type and diarrhea type. Among the many experiments, most of the traditional Chinese medicine experiments aimed at the 5-HT signaling pathway have achieved good results. Therefore, this paper summarizes the main mechanisms and results of traditional Chinese medicine based on 5-HT in the treatment of IBS, in order to provide a reference for subsequent research.
Diarrhea irritable bowel syndrome (IBS-D) is a common clinical disease with high prevalence and recurrent episodes. Patients with IBS-D often suffer from anxiety and depression, which bring a huge medical burden to the society. There are many clinical treatment options for IBS-D, especially in the field of traditional Chinese medicine (TCM) . Which one is better among traditional Chinese medicine treatment methods has become a common concern of clinicians, patients and medical decision-makers. By reviewing the comparative effect research (CER) application of clinical effect assessment in the treatment of IBS-D with TCM, combined with the methodological innovations of comparative effect research in the past five years, this article discusses the current status of CER in the treatment of IBS-D with TCM, and then considers how to design, implement and evaluate the comparative effect of TCM in real-world clinical research.
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder frequently encountered clinically. Many IBS patients use complementary and alternative medicine (CAM) therapies for better treatment results when their conditions could not be improved by first-line drug treatment. However, due to limitations of quality and quantity of studies about CAM therapies, most of these therapies for IBS have not been recommended by relevant consensuses and guidelines. We overviewed common CAM therapies for IBS, detailed three types, namely, natural products, psychosomatic therapies, and Chinese medicine, aiming at increasing clinical workers and patients' understanding and application of these therapies.
Clinical treatment often achieves unsatisfactory effect for irritable bowel syndrome (IBS) , a common complex functional gastrointestinal disease. Huangqi Jianzhong Decoction is widely used for diarrhea IBS (IBS-D) , and its efficacy has been recognized, but the mechanism is unclear and relevant studies are rare.
To explore the potential mechanism of Huangqi Jianzhong Decoction in the treatment of IBS-D based on network pharmacology and molecular docking.
TCMSP database was adopted to acquire the active ingredients and corresponding targets of all herbals in Huangqi Jianzhong Decoction. And targets related to IBS-D were identified using GeneCards, OMIM, TTD, Drug Bank and PharmGKB databases. Then the intersection of herbal targets and IBS-D-related targets were selected to obtain the potential therapeutic targets of Huangqi Jianzhong Decoction for IBS-D. Cytoscape, String and Metascape were used to construct an "herbals-active ingredients-target" network map, draw the protein-protein interaction network (PPI) , and conduct genetic ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. AutoDock Vina and PyMOL were used for the visualization of molecular docking results.
Finally, we obtained 123 active ingredients and 247 potential targets of Huangqi Jianzhong Decoction, 3 486 IBS-D related targets, and 180 intersected herbals targets and IBS-D-related targets. A total of 2 376 items of biological process, 194 items of molecular function and 115 items of cellular component were identified through GO enrichment analysis. Enrichment analysis of KEGG signaling pathway revealed MAPK, NF-κB, cAMP, estrogen and other related signal pathways. The molecular docking results showed that the main active ingredients of Huangqi Jianzhong Decoction in the treatment of IBS-D are quercetin, kaempferol, β-sitosterol, isorhamnetin, formononetin, stigmasterol, calycosin, 7-O-methylisomucronulatol, and they showed good binding to core proteins AKT1, TP53, TNF, IL-6, CASP3, IL-1B, EGFR and CTNNB1.
Therefore, we speculated that Huangqi Jianzhong Decoction may plays a role in the treatment of IBS-D by enhancing intestinal barrier function, reducing visceral hypersensitivity, reducing inflammatory response and regulating intestinal flora.
