ABSTRACT
Shaoyaotang is composed of Cptidis Rhizoma, Scutellariae Radix, Rhei Radix et Rhizoma, Paeoniae Radix Alba, Angelicae Sinensis Radix, Aucklandiae Radix, Arecae Semen, Cinnamomi Cortex and Glycyrrhizae Radix et Rhizoma, with the functions of clearing away heat, eliminating dampness, regulating Qi and activating blood. Thus, it is proposed as the main formula for the treatment of dampness-heat dysentery by later generations of doctors. In modern clinical application, in addition to original Shaoyaotang, its modified formulas are also used for the treatment of ulcerative colitis, and can be used in combination with other prescriptions (such as Tongxie Yaofang, Pulsatilla Soup, Shenling Baizhu San), western medicine (such as mesalazine, sulfasalazine, Infliximab), traditional Chinese medicine (TCM) acupuncture or moxibustion and other characteristic therapies. Clinical efficacy results indicate that Shaoyaotang and its modified formulas can significantly lower Mayo Endoscopic Score (MES), Baron score, TCM syndrome score and other disease scores, and improve patients’ intestinal symptoms, with few side effects. Experimental pharmacological studies reveal that Shaoyaotang can inhibit tumor necrosis factor-α (TNF-α), nuclear transcription factor-κB (NF-κB), interleukin-1β (IL-1β) and other pro-inflammatory factors to up regulate the expression of anti-inflammatory factors such as interleukin-10 (IL-10), thereby reducing the inflammatory response. The formula could also reduce apoptosis by regulating inflammatory signaling pathway and blocking the chain reaction, and repair abnormal immune barrier by balancing immune axis and regulating immune proteins. Additionally, it could adjust the balance of intestinal flora, promote intestinal epithelial cell regeneration and improve mucosal permeability, so as to restore the balance of intestinal environment and thus treat ulcerative colitis. Its monomers baicalin, paeoniflorin, and berberine have anti-inflammatory, antibacterial, metabolism-regulating and other effects. This paper systematically reviewed the clinical and basic research progress of Shaoyaotang in the treatment of ulcerative colitis.
ABSTRACT
ObjectiveTo investigate the effect of Shaoyaotang on fecal metabolites in rats with ulcerative colitis (UC) induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS) based on liquid chromatography-mass spectrometry (LC-MS). MethodMale SPF SD rats were randomly divided into normal group, model group and Shaoyaotang group (11.1 g·kg-1). Except for normal group, UC rat model was induced by TNBS, and each group was given normal saline except Shaoyaotang group. All groups were treated for 7 days, and the general condition and disease activity index (DAI) were observed. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of colon, and the protein expressions of interleukin-8 (IL-8) and interleukin-22 (IL-22) in colon tissue were detected by immunohistochemistry (IHC). Rat fecal samples were detected by LC-MS, and the data were analyzed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). Human Metabolome Database (HMDB) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were searched to screen differential metabolites in combination with literature reference. Then, pathway enrichment analysis was conducted using Metabo Analyst 5.0. ResultShaoyaotang (ig) decreased the DAI of UC rats. Compared with the normal group, the model group had damaged colonic mucosa structure, submucosal inflammatory cell infiltration, increased protein expressions of IL-8 (P<0.01) and IL-22 (P<0.05) in colon tissue. Compared with the conditions in the model group, the colonic damage was alleviated in the Shaoyaotang group, and the protein expressions of IL-8 and IL-22 in colon tissue were decreased (P<0.01). After screening, 15 differential metabolites were identified from the Shaoyaotang group, and the involved pathways mainly included biosynthesis of unsaturated fatty acids, linoleic acid metabolism, terpenoid backbone biosynthesis, porphyrin and chlorophyll metabolism, amino sugar and nucleotide sugar metabolism, pyrimidine metabolism and steroid hormone biosynthesis. ConclusionShaoyaotang has a therapeutic effect on UC, and its anti-inflammatory effect may be related to improving lipid metabolism and regulating the metabolism of cofactors and vitamins as well as the abnormal carbohydrate metabolism.