Objective: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, and a symptom-based diagnosis. Because of the unclear mechanisms, the treatment available have not acquired the satisfied effect. We performed a meta-analysis to assess the effectiveness and safety of herbal enema in treating IBS compared to the calcium channel blocker administration. Methods: We searched for randomized controlled trials (RCTs) testing herbal enema in patients with IBS which compared to the calcium channel blocker administration in PubMed, EMMBASE, the Chinese National Knowledge Infrastructure (CNKI), the Wan-fang Database and the VIP Database up to May 2016 with no language restrictions. Primary outcome was the global symptom improvement and secondary outcome was the symptom severity scale score. Safety was also assessed. We used Revman 5.3 to estimate the pooled mean difference (MD) for continuous outcomes and relative risk (RR) for binary outcome measures, with a 95% confidence interval (CI). Results: Five studies (230 patients in experimental group and 209 patients in control group) were included in the meta-analysis. The results showed that herbal enema as the sole intervention or combined with other treating methods could significantly promote the global symptom improvement and mucous stool scale and has potential to improve abdominal distention compared to the calcium channel blocker administration. But there was no difference between the two groups in abdominal pain. The recurrence rate was lower than the control group. Conclusions: The study indicated that herbal enema may be an effective assistant means for IBS.

Background: Ma-Zi-Ren-Wan (MZRW) is a classic Chinese formula for treating human constipation. It is comprised of six herbs. Our previous studies have shown its great therapeutic effect. The absorbed compounds had been studied in rat, while there was no study about its components in human body. Objectives: To observe the components of MZRW absorbed in health subjects and study the pharmacokinetics of major compounds. At the same time, to observe the renal excretion of MZRW in health subjects based on the quantification of major compounds. Methods: Health adults were randomly assigned to three dose groups (5g, 7.5g and 10g q.d.) of MZRW. Blood samples were collected from the medial cubital vein just before and at 0.25, 0.5, 1, 2, 4, 8 and 12 h after administration. Urine samples were collected at 0 to 3 h, 3 to 6 h, 6 to 9 h and 9 to 12 h after MZRW administration, with the urine volume recorded for each time segment. Plasma and urine samples were analyzed by optimized LC-MSMS (Liquid chromatography-tandem mass spectrometry) method for pharmacokinetics and renal excretion study of MZRW. Results: Ten compounds of MZRW were observed in 23 health subjects. Due to the low concentration in plasma at the current dose, only four compounds (Albiflorin, paeoniflorin, magnolol and rhein) were quantified in the plasma sample. Honokiol, aloe emodin and emodin could only meet the LLOQ at some time points of the high dose group. Hesperidin, naringin and amygdalin could not be detected in plasma sample. While seven compounds (Amygdalin, albiflorin, paeoniflorin, magnolol, honokiol, rhein and aloe emodin) could be quantified in urine, the renal excretion was well studied. Conclusion: MZRW was safe and well tolerated in this clinical study. Albiflorin, paeoniflorin, magnolol and rhein was well quantified in plasma. The renal excretion of paeoniflorin, albiflorin and rhein were dose dependent for doses ranging between 5 and 10g.

Introductioo: This manuscript aims to provide a protocol of systematic review to assess the safety and effectiveness of Chinese herbal medicine (CHM) for the treatment of ulcerative colitis (UC). Although CHM has been widely used for UC, its effectiveness and safety has not yet been well defined and analyzed. Methods and analysis: Seven electronic databases were searched, including China National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBL), VIP database, Cochrane Library, MEDLINE, PubMed and China Journals Full-text Database. Related Chinese literature will be searched in other Chinese databases. All relevant randomized controlled literature of publication type will be included. Assessment of risk of bias, data synthesis and subgroup analysis will be carried out using Review Manager 5.2. Ethics and dissemination: The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. Trail registartion number: PROSPERO CRD42015019350.

Although irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are clinically common diseases with unclear pathogenesis, both of them are related to the immune system. With progress in studies on their pathogenesis, the two diseases are currently believed to be associated with the presence of intestinal inflammation and intestinal mucosal immune disorder. In recent years, a new approach for the prevention and treatment of chronic intestinal disease is to protect the complete structure and normal immunity of the intestinal mucosal barrier during the treatment of intestinal diseases. However, traditional Chinese medicine (TCM) may have more advantages in regulating the imbalance of the intestinal immune microenvironment, as various single herbs and compounds of TCM have been investigated from the perspective of immune regulation. The use of TCM is prevalent in China. The effectiveness of these therapies appears to be supported by preliminary evidence and clinical experience, although the mechanisms that underlie these effects will require further research. In this paper, with common chronic bowel diseases including IBS, ulcerative colitis and Crohn’s disease as the research objects, the relationship between TCM and immunity was explored from the perspectives of the pathogenesis of intestinal mucosal immune injury, the correlation between TCM syndromes and immune disorders, and TCM immune regulation. Moreover, the problems and limitations of the present study were pointed out, and several suggestions were proposed. The purpose of this article is to explore the potential mechanism of TCM on intestinal mucosal immunity in chronic intestinal diseases.

Objective: To determine how safe and effective Chinese Herbal Medicine (CHM) is in alleviating the nausea, vomiting, oral ulceration, diarrhea and constipation for cancer patients with chemotherapy. Methods: Data sources: A systematic review of Chinese and English articles using Ovid SP, CNKI, VIP Database and Traditional Chinese Medicine Database System. Study selection: Only randomized controlled trials (RCTs) for the prevention or treatment of any one of gastrointestinal side effects, namely nausea, vomiting, oral ulceration, diarrhea and constipation, of CHM with or without western medicine (WM) vs WM, placebo or no treatment were included. Data Extraction: Independent extraction of articles was first performed by four medical students using predefined data fields. Then, all data, including study quality indicators, was checked by two authors. Results: Eighty-six RCTs involving 7076 cancer patients were found and analyzed in this review. Because of the heterogeneity of study design and low overall methodological quality, only descriptive summaries were performed. Beneficial effects were found in some CHM interventions, regardless of being taken alone or taken with WM. Moreover, none of serious adverse effect was reported. However, same intervention had not been repeatedly investigated by different research teams. Conclusions: Implications of the analysis support the efficacy and safety of CHM for the management of gastrointestinal side effects. However, definite clinical recommendation for particular CHM intervention still cannot be made due to low methodological quality of included studies and lack of duplicated verification. Further large scale and high quality RCTs on the same CHM interventions are suggested.