Zhu Y, Dong HC, Zhang Y, Wang XA, Chen JY, Wang JJ. Application of traditional Chinese medicine integrated therapy based on Tuina and herbal medicine in pediatric diarrhea. World J Gastroenterol 2025; 31(44): 113017 [DOI: 10.3748/wjg.v31.i44.113017]
Corresponding Author of This Article
Yu Zhu, MD, Doctor, Department of Traditional Chinese Medicine, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, No. 57 Zhugan Lane, Wulin Street, Gongshu District, Hangzhou 310003, Zhejiang Province, China. 6504036@zju.edu.cn
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Gastroenterology & Hepatology
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Review
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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/
Nov 28, 2025 (publication date) through Dec 1, 2025
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Publication Name
World Journal of Gastroenterology
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1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhu Y, Dong HC, Zhang Y, Wang XA, Chen JY, Wang JJ. Application of traditional Chinese medicine integrated therapy based on Tuina and herbal medicine in pediatric diarrhea. World J Gastroenterol 2025; 31(44): 113017 [DOI: 10.3748/wjg.v31.i44.113017]
World J Gastroenterol. Nov 28, 2025; 31(44): 113017 Published online Nov 28, 2025. doi: 10.3748/wjg.v31.i44.113017
Application of traditional Chinese medicine integrated therapy based on Tuina and herbal medicine in pediatric diarrhea
Yu Zhu, Hai-Cheng Dong, Yao Zhang, Xiao-Ai Wang, Jun-Yi Chen, Jing-Jing Wang
Yu Zhu, Hai-Cheng Dong, Yao Zhang, Xiao-Ai Wang, Department of Traditional Chinese Medicine, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, Zhejiang Province, China
Jun-Yi Chen, Jing-Jing Wang, Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, Zhejiang Province, China
Author contributions: Zhu Y, Dong HC, Zhang Y and Wang XA designed the experiments and conducted clinical data collection; Chen JY and Wang JJ performed postoperative follow-up and recorded the data, conducted the collation and statistical analysis; Zhu Y make critical revisions to important knowledge content; all authors read and approved the final manuscript.
Supported by the Key Research and Development Program of Zhejiang Province, No. 2024C03211; and the Traditional Chinese Medicine Science and Technology Plan Project of Zhejiang Province, No. 2023ZL498.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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 Zhu, MD, Doctor, Department of Traditional Chinese Medicine, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, No. 57 Zhugan Lane, Wulin Street, Gongshu District, Hangzhou 310003, Zhejiang Province, China. 6504036@zju.edu.cn
Received: August 19, 2025 Revised: September 18, 2025 Accepted: October 21, 2025 Published online: November 28, 2025 Processing time: 100 Days and 19.4 Hours
Abstract
This review examines the distinct mechanisms of Tuina massage and topical herbal medicine in pediatric diarrhea management, focusing on their independent regulation of gastrointestinal metabolism and barrier function. Tuina therapy primarily enhances gastrointestinal motility through the stimulation of targeted acupoints such as Tianshu (ST25) and Shenque (CV8), activating vagal efferent pathways to normalize motility hormones including motilin while suppressing pro-inflammatory cytokines such interleukin-6 and tumor necrosis factor-alpha. It further reinforces mucosal defense by inhibiting mast cell degranulation and augmenting microcirculation via nitric oxide-mediated vasodilation. Herbal medicine containing bioactive compounds from Atractylodes macrocephala and Poria cocos directly restores intestinal barrier integrity by upregulating tight junction proteins occludin and zonula occludens-1, inhibiting epithelial apoptosis, and stimulating MUC2 production. These formulations additionally reprogram enterocyte metabolism by reactivating mitochondrial tricarboxylic acid cycle flux and modulating short-chain fatty acid profiles, with the independent prebiotic effects enhancing commensal butyrate production. Tuina primarily modulates neuroimmune pathways and motility, and herbal medicine directly targets epithelial repair and metabolism. These therapeutic pathways may address core diarrhea pathophysiology, providing holistic complementary therapies. Standardized protocols and interdisciplinary research are urgently needed for clinical translation.
Core Tip: This review elucidates the distinct mechanisms by which integrated traditional Chinese medicine therapies Tuina massage and topical herbal medicine ameliorate pediatric diarrhea. We highlight that Tuina primarily modulates neuro-immune pathways to regulate motility and inflammation, while herbal applications directly restore intestinal barrier integrity and reprogram enterocyte metabolism. Crucially, this work synthesizes evidence for their synergistic action in repairing the gut barrier, a core pathophysiological defect, providing a mechanistic foundation for non-pharmacological, holistic complementary strategies in children.
