Traditional Chinese medicine prescription Shenling BaiZhu powder to treat ulcerative colitis: Clinical evidence and potential mechanisms

Abstract

Ulcerative colitis (UC), characterized by syndromes including abdominal pain, bloody stool, diarrhea, weight loss, and repeated relapse, is a non-specific inflammatory intestinal disease. In recent years, with the changing dietary habits in China, the incidence of UC has shown an upward trend. UC belongs to the category of recorded as “diarrhea,” “chronic dysentery,” and “hematochezia” in traditional Chinese medicine (TCM), and Shenling BaiZhu powder (SLBZP) is one of the most effective and commonly used prescriptions. In this review, we aim to systematically summarize the clinical application and pharmacological mechanism of SLBZP in the treatment of UC to provide a theoretical basis for its clinical use and experimental evaluation of SLBZP. Our results showed that both SLBZP and SLBZP in combination with chemical drugs, have a significant therapeutic effect against UC with few adverse reactions. Furthermore, combined therapy was better than western medicine. Further, pathophysiological studies indicated that SLBZP has anti-inflammatory, immunomodulatory, antioxidant effects, regulation relative cell signal transduction and regulation of gut microbiota. Although evidence suggests superior therapeutic efficacy of SLBZP for treating UC and the relative mechanism has been studied extensively, various shortcomings limit the existing research on the topic. There is a lack of UC animal models, especially UC with TCM syndromes, with no uniform standard and certain differences between the animal model and clinical syndrome. The dosage, dosage form, and therapeutic time of SLBZP are inconsistent and lack pharmacological verification, and clinical trial data are not detailed or sufficiently rigorous. In addition, SLSZP is composed of multiple Chinese drugs that contain massive numbers of ingredients and which or several components contribute to therapeutic effects. How they work synergistically together remains unknown. Therefore, on the one hand, large sample prospective cohort studies to clarify the clinical efficacy and safety of SLBZP in the treatment of UC are needed. In contrast, researchers should strengthen the study of the molecular biological mechanism of active ingredients and its synergistic actions, clarifying the mechanism of SLBZP in treating UC by multi-component, multi-target, and multi-pathway.

Alleviating effect of Nexrutine on mucosal inflammation in mice with ulcerative colitis: Involvement of the RELA suppression

“…DC., Dioscorea opposita Thunb., Nelumbo nucifera Gaertn., and Dolichos lablab L., has been recently suggested as a promising regimen in the prevention and treatment of UC. 38 As previously mentioned, Nexrutine is reported to play a relieving role in inflammation, abdominal pain, gastroenteritis, and diarrhea. For safety concerns, a prior test showed that the administration of Nexrutine at moderate doses in rats (250, 500, 750 mg/kg) for continuous 28 days did not result in any sign of toxicity.…”

“…Mey., Glycyrrhiza uralensis Fisch., Amomum villosum Lour., Poria cocos Wolf., Platycodon grandiflorum A. DC., Dioscorea opposita Thunb., Nelumbo nucifera Gaertn., and Dolichos lablab L., has been recently suggested as a promising regimen in the prevention and treatment of UC 38 . As previously mentioned, Nexrutine is reported to play a relieving role in inflammation, abdominal pain, gastroenteritis, and diarrhea.…”

Proposing anti‐counterfeiting pharmacopoeia quality markers for Shenlingbaizhu granule based on UHPLC‐Q‐orbitrap‐MS identification

“…2,3 These functions and curative effects have facilitated its wide applications. [4][5][6][7] Correspondingly, two traditional dosage forms, that is, Shenlingbaizhu pulvis and Shenlingbaizhu pills, have been collected in the Chinese Pharmacopoeia (ChP), which defines certain quality markers (Q-markers) to prevent possible counterfeiting. 1 With the modernisation of pharmaceutical technology, a new dosage form (i.e.…”

“…According to the theory of Traditional Chinese Medicine (TCM), Shenlingbaizhu formula has the traditional function of “nourishing spleen and stomach as well as benefiting lung and qi .” Thereby, it can be used for various diseases related to spleen, lung, and stomach 2,3 . These functions and curative effects have facilitated its wide applications 4–7 . Correspondingly, two traditional dosage forms, that is, Shenlingbaizhu pulvis and Shenlingbaizhu pills, have been collected in the Chinese Pharmacopoeia (ChP), which defines certain quality markers (Q‐markers) to prevent possible counterfeiting 1…”

Library-based UHPLC-Q-Exactive-Orbitrap-MS Putative Identification of Isomeric and Non-isomeric Compounds from Shenling Baizhu Granule and its Pharmacopoeia Quality-marker Chemistry

“…Thereby, it can be used for various diseases about spleen, lung, and stomach [2,3] . These function and curative effects have facilitated its wide applications [4][5][6][7]. For this reason, some traditional dosage forms of Shenling Baizhu formula have been collected in Chinese Pharmacopoeia (ChP), including Shenling Baizhu Pulvis andShenling Baizhu Pills [1] .…”