Observation on the Efficacy of Shouhui Tongbian Capsule in the Treatment of Functional Constipation and Study on Its Regulatory Effect on Intestinal Flora

Abstract

Functional constipation is relatively common in both adults and children, exhibiting similar symptoms. However, there are significant differences in the epidemiology, symptomatology, pathophysiology, diagnostic tests, and treatment management of functional constipation by age. The treatment of functional constipation is generally based on lifestyle interventions, pelvic floor interventions, and pharmacotherapy. Pharmacological treatment is popular as the most direct and effective modality, especially the herbal preparations (e.g., Shouhui Tongbian capsule), which are popular for their lower toxic side effects and less physiological reactions. In our clinical study, patients with functional constipation who took Shouhui Tongbian capsules for a longer period of time showed significantly better improvement than those who took them for a shorter period of time ( P < 0.001 ). Relative to the duration of the disease, the improvement effect was higher in patients with short duration of the disease than in patients with long duration of the disease ( P < 0.001 ). What’s more, Shouhui Tongbian capsule had a regulating effect on intestinal flora, and the regulating effect was stronger in patients with a shorter disease duration.

Shouhui Tongbian Capsule in treatment of constipation: Treatment and mechanism development

“…It was found that effectiveness and quality of life of patients were significantly improved after prolonging the duration of SHTB. Furthermore, SHTB could regulate intestinal flora, and the regulating effect was more obvious in patients with shorter disease duration ( Zhang, Han, Zhang, Tian, & Yu, 2021 ). Zhou et al selected 98 elderly patients with functional constipation, which were divided into a control group (taking lactulose oral solution) and an study group (adding SHTB on the basis of the control group) and continuous treated for 4 weeks, judged the efficacy of the two groups, and counted the recurrence after stopping the drug ( Zhou & Zhou, 2019 ).…”

“…SHTB could improve constipation not only by promoting intestinal motility and intestinal fluid secretion, but also by regulating intestinal flora and enhancing the energy metabolism and promoting the proliferation of ICCs ( Bai et al, 2022 , Lin et al, 2022 , Zhang et al, 2021 ). In the regulation of intestinal flora, SHTB could increase the relative abundances of Lactobacillus and the ratio of Firmicutes to Bacteroides (F/B).…”

“…Another study of SHTB in the treatment of constipation after chemotherapy for malignant biliary and pancreatic tumors showed that the bowel scores (interval between bowel movements and time per bowel movement) were significantly lower than the lactulose control group and that the total effective rate in the SHTB group was significantly higher than the control. The results indicated that SHTB could significantly improve constipation after chemotherapy for hepatobiliary and pancreatic malignancies and effectively relieve bowel pain and reduce defecation time ( Zhang, Liu, Zhang, Lv, & Liu, 2020 ). An another study showed that SHTB had a significant effect on constipation in patients with gastric and colorectal cancer after chemotherapy, which could significantly improve defecation difficulty, defecation frequency score and defecation time ( Li, Zhao, Hu, & Ma, 2021 ).…”

“…), Atractylodis Macrocephalae Rhizoma ( Atractylodes macrocephala Koidz. ), Aurantii Fructus Immaturus ( Citrus aurantium L.) and Asini Corii Colla ( Equus asinm L.), which could nourish yin and boost qi , simultaneous reinforcement and reduction, address both symptoms and root causes ( Gong et al, 2022 , Guan et al, 2021 , Wang et al, 2021 , Xu, Liu, Li, Yu, & Li, 2021 , Zhang et al, 2021 ). We use the accepted format for writing of plant names and the full plant names has been checked via The Plant List ( https://www.theplantlist.org ) on October 30, 2022.…”

Progress of research on the mechanism of action of Chinese medicine for functional constipation based on intestinal flora

“…Nowadays, the prevalence of constipation is on the rise, and its development is related to a variety of factors, such as social factors, dietary structure, medication or psychological factors. Constipation not only causes discomfort in defecation, but also contributes to some common anorectal diseases such as anal fissure and hemorrhoids, and for patients with underlying diseases such as hypertension and heart disease, it can also aggravate these diseases, posing a great threat to the physical and mental health of patients [1] .Currently, Western medicine mainly uses laxatives to treat constipation, but laxatives cannot be applied for a long time, and they not only produce dependence on constipated patients, but also may cause adverse effects such as blackening of the large intestine [2] .It has been reported that constipation persists in 20-40% of patients after appropriate application of modern medications for laxatives [3] .With the continuous research of many scholars on the diagnosis and treatment of functional constipation, it has been found that compared with Western medicine, the treatment of constipation with Chinese herbal medicine has shown the unique advantages of low cost, safety and cost-effectiveness [4] ,Long-term application is possible. It has been shown that dysbiosis of the intestinal flora is an important part of the pathogenesis of functional constipation [5] .Therefore, the author explores several possible mechanisms of action of TCM in the treatment of constipation from the perspective of the development mechanism of intestinal flora affecting functional constipation, in order to provide a new perspective and reference basis for TCM treatment of constipation.…”