Zeng XL, Zhu LJ, Zhang Y, Yang XD, Zhu YJ. Unveiling Xuanshen decoction: A novel approach to combat slow transit constipation. World J Gastroenterol 2025; 31(30): 109187 [DOI: 10.3748/wjg.v31.i30.109187]
Corresponding Author of This Article
Yu-Jun Zhu, MD, Associate Chief Physician, Department of General Surgery, Jiangbei Campus of The First Affiliated Hospital of Army Medical University, No. 29 Jianxin East Road, Jiangbei District, Chongqing 400020, China. merezyj@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xing-Lin Zeng, Lian-Jun Zhu, Clinical Medicine College, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China
Xing-Lin Zeng, Yu-Jun Zhu, Department of General Surgery, Jiangbei Campus of The First Affiliated Hospital of Army Medical University, Chongqing 400020, China
Lian-Jun Zhu, Yu Zhang, Xiang-Dong Yang, Department of Colorectal and Anal Surgery, Chengdu Anorectal Hospital, Chengdu 610015, Sichuan Province, China
Co-corresponding authors: Xiang-Dong Yang and Yu-Jun Zhu.
Author contributions: Zeng XL, Zhu LJ, and Zhang Y performed the experiments; Zeng XL, Yang XD, and Zhu YJ designed the research study contributed to the materials/reagents/analysis tools, analyzed the data, and wrote the manuscript; Zhu YJ and Yang XD contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors have read and approved the final manuscript.
Supported by the 2024 Hospital Innovation Talent Cultivation Fund Project, No. 2024YGKT12.
Institutional animal care and use committee statement: All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee of Guizhou University of Traditional Chinese Medicine, approval No. 20220065.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: Study data can be obtained by contacting the corresponding author with appropriate justification.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Jun Zhu, MD, Associate Chief Physician, Department of General Surgery, Jiangbei Campus of The First Affiliated Hospital of Army Medical University, No. 29 Jianxin East Road, Jiangbei District, Chongqing 400020, China. merezyj@163.com
Received: May 6, 2025 Revised: June 9, 2025 Accepted: July 21, 2025 Published online: August 14, 2025 Processing time: 97 Days and 18.7 Hours
Abstract
BACKGROUND
Xuanshen decoction (XSD) is a traditional Chinese medicine formulation that is often applied in treating slow transit constipation (STC). However, its specific therapeutic mechanism remains to be characterized.
AIM
To investigate the mechanism of XSD for STC, we combined network pharmacology prediction, molecular docking analysis, and in vivo studies.
METHODS
The therapeutic effects of XSD on loperamide-induced STC in rats were assessed through 24-hour fecal number, fecal moisture content, and intestinal propelling rate. Hematoxylin–eosin and Alcian blue/periodic acid-Schiff staining were applied to analyze colonic mucosa for histopathological presentation and mucin production. Next, the mechanism of action of XSD for STC was elucidated through network pharmacology and molecular docking analyses, and the findings were validated by the animal experiments.
RESULTS
XSD significantly alleviated the symptoms of STC in rats. Relative to the STC rats, in the medium-dose XSD and high-dose XSD rats, stem cell factor, C-kit, phospho-phosphoinositide 3-kinase/phosphoinositide 3-kinase, phospho-protein kinase B/protein kinase B, catalase, and superoxide dismutase were substantially upregulated (P < 0.01); nuclear factor erythroid 2-related factor 2 (nuclear/cytoplasmic) and B-cell lymphoma 2 (Bcl-2) were increased (P < 0.05), while cleaved caspase-3, Bcl-2-associated X protein (Bax)/Bcl-2, and malondialdehyde were significantly reduced (P < 0.01). Heme oxygenase-1 and glutathione peroxidase in the high-dose XSD group were significantly increased (P < 0.01), and Bax was statistically lowered (P < 0.01); glutathione peroxidase in the medium-dose XSD group was increased (P < 0.05), while Bax was reduced (P < 0.05).
CONCLUSION
XSD may inhibit oxidative-stress-induced apoptosis in interstitial cells of Cajal by stimulating the phosphoinositide 3-kinase/protein kinase B/nuclear factor erythroid 2-related factor 2 pathway, thereby effectively treating STC.
Core Tip: There are limited drugs available to treat slow transit constipation (STC). Xuanshen decoction is a traditional Chinese medicine formulation that can effectively treat STC. In this study, Xuanshen decoction significantly alleviated the symptoms of STC in rats. Xuanshen decoction promoted the expression of key proteins in the phosphoinositide 3-kinase/protein kinase B/nuclear factor erythroid 2-related factor 2 signaling pathway, improved oxidative stress-related parameters, and suppressed the apoptosis of interstitial cells of Cajal.
