Application of traditional Chinese medicine integrated therapy based on Tuina and herbal medicine in pediatric diarrhea

Table 1 Key techniques and herbal formulations in integrated traditional Chinese medicine therapy

Therapy modality	Specific technique/herbal formula type	Key components/target	Standard application	Primary proposed therapeutic mechanisms
Tuina	Rou Fa (kneading)	ST25, ST36, GV1	Gentle rhythmic pressure applied to specific points during sessions	Local stimulation modulating neural reflexes influencing gut motility/secretion; promoting local Qi/blood flow
Tuina	Mo Fu (abdominal rubbing)	Abdomen centered on CV8	Broad clockwise circular motions over abdomen	Regulating peristalsis, alleviating spasm/distension; warming the middle jiao; resolving abdominal Qi stagnation
Tuina	Nie Ji (spine pinching)	Skin along Du meridian (GV14-GV4 region)	Gentle sequential pinching and lifting	Regulating autonomic nervous system; strengthening overall Zheng Qi (spleen/Lung); influencing gut-brain axis
Tuina	Tui Shang Qijiegu	Qijiegu region (GV2-GV1)	Upward unidirectional pushing	Warming spleen/kidney Yang; lifting sinking Qi to consolidate intestines and stop diarrhea
Tuina	Bu Pi Jing (supp spleen meridian)	Radial side of thumb (spleen meridian)	Pushing towards thumb tip	Tonifying spleen Qi; resolving dampness; enhancing digestive and absorptive functions
Topical herbal (umbilical)	Spleen-fortifying and damp-resolving	Atractylodes macrocephala (Baizhu), Poria cocos (Fuling)	Paste applied to CV8 region daily	Transdermal absorption of compounds modulating intestinal fluid transport/ion channels; reducing inflammation; strengthening spleen function
Topical herbal (umbilical)	Spleen-transporting and stagnation-resolving	Pseudostellaria heterophylla (Taizishen), Atractylodes lancea (Cangzhu), Crataegus pinnatifida (Shanzha)	Paste applied to CV8 region daily	Enhancing digestive enzyme activity; promoting gastrointestinal motility; resolving food accumulation; regulating gut microbiota
Topical herbal (umbilical)	Warm compress (Re Yan Bao) for cold	Evodia rutaecarpa (Wuzhuyu), Raphanus sativus (Laifuzi)	Warmed paste applied to CV8 region daily	Dispelling cold pathogen; warming middle jiao; alleviating smooth muscle spasm/pain; promoting downward Qi movement

Table 2 Evidence of barrier function restoration with herbal medicine interventions[107-110]

Barrier component	Assessment marker	Intervention modality	Observed effect	Proposed mechanism	Ref.
Physical barrier	Intestinal permeability/tight junction proteins	TCM monomer (baicalein)	Reduced intestinal permeability/restored colonic tight junction integrity/attenuated gut inflammation	Activation of AhR in ILC3s-promotes IL-22 production-upregulates TJ proteins	Li et al[107]
	Serum DAO/gastrointestinal dysfunction score/first exhaust and defecation time	Modified Huanglian Jiedu decoction + electroacupuncture	Reduced serum DAO levels, gastrointestinal dysfunction scores and mechanical ventilation time/accelerated first exhaust/defecation time	Purgation and detoxification reduced intestinal permeability and restored barrier integrity/DAO reduction indicates attenuated epithelial damage	Wang et al[108]
Chemical barrier	Goblet cell density/MUC2 mRNA expression/mucin production	Gegen Qinlian decoction	Goblet cell differentiation/MUC2 synthesis/restored mucus layer/promoted mucosal healing	Bidirectional regulation of Notch signaling	Zhao et al[109]
Immune barrier	SIgA expression/plasma DAO/D-lactate/gut microbiota diversity	Hetiao Jianpi decoction	SIgA in colon tissue (increase)/beneficial bacteria (increase)/plasma DAO/D-lactate (decrease)/pathogenic bacteria (decrease)	Enhanced mucosal immunity via SIgA secretion-reduced intestinal permeability-modulated gut microbiota to restore immune homeostasis	Li et al[110]

TCM: Traditional Chinese medicine; DAO: Diamine oxidase; mRNA: Messenger RNA; D-lactate: D-lactic acid; SIgA: Secretory immunoglobulin A; AhR: Aryl hydrocarbon receptor; ILC3s: Group 3 innate lymphoid cells; IL-22: Interleukin-22; TJ: Tight Junction.