Original Articles

Therapeutic efficacy of Jichuan decoction (济川煎) in slow-transit constipation: focus on gut microbiota modulation

  • WANG Xiumin ,
  • Lü Lixia ,
  • LI Jianghua ,
  • CHEN Jilan ,
  • TAN Cailin ,
  • DING Weijun
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  • 1 Department of General Surgery, Chengdu Second People's Hospital, Chengdu 610021, China
    2 Department of Anorectal Medicine, Affiliated Hospital of Integrative Chinese Medicine and Western Medicine of Chengdu University of Traditional Chinese Medicine, Chengdu 610042, China
    3 Department of Fundamental Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China
    4 Department of Endocrinology and Metabolism, Chengdu First People’s Hospital, Chengdu 610041, China
    5 Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, China
    6 Department of Gastroenterology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine Deyang Hospital, Deyang 618000, China
Pro. DING Weijun, Department of Fundamental Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China. Dingweijun@cdutcm.edu.cn, Telephone: +86-28-61800219

Received date: 2025-08-10

  Accepted date: 2026-04-05

  Online published: 2026-06-08

Supported by

National Natural Science Foundation of China: Exploring the Mechanism of Qi-tonifying and Phlegm-eliminating Acupuncture Promoting Intestinal Nerve Precursor Cell Regeneration in Obese Mice Based on the Single-cell RNA-sep Platform(82374176);Natural Science Foundation of Sichuan Province: Discovery of "Active Center" Oligosaccharide Fragments in Polysaccharides of Pinellia Ternata and Its Processed Products and Research on Quality Evaluation Techniques and Methods(2022NSFSC0591);Youth Nursery Project of Sichuan Provincial Health Commission: Mechanism Research on miR-491-5p Targeting Akt to Inhibit Intestinal Nerve Apoptosis in the Pathogenesis of Slow Transit Constipation(24QNMP030);General Project of Sichuan Provincial Administration of Traditional Chinese Medicine: Exploring the Mechanism of Jichuan Decoction in Regulating Intestinal nerve Apoptosis in Slow Transit Constipation Rats Based on the Tumor Necrosis Factor Signaling Pathway(2024MS589);Project of Sichuan Medical Association: Exploring the Mechanism of Jichuan Decoction in Regulating Intestinal Nerve Apoptosis in Slow Transit Constipation Rats Based on the Glial Cell line-derived Neurotrophic Factor/Phosphoinositide 3-kinase/Protein Kinase B Signaling Pathway(S23034)

Abstract

OBJECTIVE: To clarify the therapeutic mechanisms of Jichuan decoction (济川煎, JCD) in slow-transit constipation (STC), we focused on its neuromuscular and microbiota-modifying effects.

METHODS: An STC mouse model was induced by administering diphenoxylate for 14 consecutive days. The experimental groups included healthy controls (HC), a saline-treated STC model group, a mosapride-treated positive control group (MSP), and JCD-treated groups at different dosages. Gastrointestinal motility was evaluated first by black stool latency and then by colonic 5-hydroxytryptamine and substance P levels. Neural markers were assessed by real-time quantitative reverse transcription polymerase chain reaction, and glial-derived neurotrophic factor (GDNF) and central nervous system specific protein β (S100β) levels were measured via enzyme-linked immunosorbent assay. Histopathological analysis was performed via hematoxylin-eosin and periodic acid-Schiff staining. Microbial profiling was conducted via 16S rRNA sequencing.

RESULTS: JCD treatment improved intestinal motility in STC mice, increased colonic neurotransmitter levels, increased mucosal thickness and goblet cell density, upregulated protein gene product 9.5 and GDNF, downregulated neuronal nitric oxide synthase and S100β, and reversed dysbiosis through the enrichment of Akkermansia muciniphila.

CONCLUSION: JCD alleviates STC by restoring enteric nervous system function and gut microbiota homeostasis, indicating its potential for STC management.

Cite this article

WANG Xiumin , Lü Lixia , LI Jianghua , CHEN Jilan , TAN Cailin , DING Weijun . Therapeutic efficacy of Jichuan decoction (济川煎) in slow-transit constipation: focus on gut microbiota modulation[J]. Journal of Traditional Chinese Medicine, 2026 , 46(3) : 544 -551 . DOI: 10.19852/j.cnki.jtcm.2026.03.002

References

1. Bharucha AE, Lacy BE. Mechanisms, evaluation, and management of chronic constipation. Gastroenterology 2020; 158: 1232-49.
2. Barberio B, Judge C, Savarino EV, Ford AC. Global prevalence of functional constipation according to the Rome criteria: a systematic review and Meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 638-48.
3. van Mill MJ, Koppen IJN, Benninga MA. Controversies in the management of functional constipation in children. Curr Gastroenterol Rep 2019; 21: 23-9.
4. Shin JE, Park KS, Nam K. Chronic functional constipation. Korean J Gastroenterol 2019; 73: 92-8.
5. Bharucha AE, Pemberton JH, Locke GR. American gastroenterological association technical review on constipation. Gastroenterology 2013; 144: 218-38.
6. Tanner S, Chaudhry A, Goraya N, et al. Prevalence and clinical characteristics of dyssynergic defecation and slow transit constipation in patients with chronic constipation. J Clin Med 2021; 10: 2027-32.
7. Wang HL. Understanding the pathogenesis of slow-transit constipation: one step forward. Dig Dis Sci 2015; 60: 2216-18.
8. Cho YS, Lee YJ, Shin JE, et al. 2022 seoul consensus on clinical practice guidelines for functional constipation. J Neurogastroenterol Motil 2023; 29: 271-305.
9. Xu MM, Guo Y, Chen Y, Zhang W, Wang L, Li Y. Electroacupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice. J Integr Med 2023; 21: 397-406.
10. Zou S, Xie B, An Z, et al. Olive oil solution of volatile oil from citri reticulatae pericarpium viride alleviates slow-transit constipation via regulating SCF/c-kit signaling pathway and intestinal flora. Drug Des, Devel and Ther 2025; 19: 4275-95.
11. Hu L, Liu Q, Ke X, Zhao P, Fang W, Ren Y. Correlation of the intestinal flora and its metabolites with the colonic transport function in functional constipation. Front Microbiol 2025; 16: 1591697.
12. Ali MZ, Mehmood MH, Haneef M, et al. A flavonoid driven phyto-pharmacological effects of capparis decidua edgew. in rodents. Pak J Pharm Sci 2020; 33: 333-42.
13. Dai L, Zhong LL, Ji G. Irritable bowel syndrome and functional constipation management with integrative medicine: a systematic review. World J Clin Cases 2019; 7:3486-504.
14. Vicentini FA, Keenan CM, Wallace LE, et al. Intestinal microbiota shapes gut physiology and regulates enteric neurons and glia. Microbiome 2021; 9: 210-9.
15. Wang XM, Lü LX, Qin YS, et al. Jichuan decoction ameliorates slow transit constipation via regulation of intestinal glial apoptosis. World J Gastroenterol 2022; 28: 5007-22.
16. Huang L, Duan C, Xia X, et al. Commensal microbe-derived propionic acid mediates juvenile social isolation-induced social deficits and anxiety-like behaviors. Brain Res Bull 2021; 166:161-71.
17. Meng X, Ma J, Kang AN, et al. A novel approach based on metabolomics coupled with Intestinal flora analysis and network pharmacology to explain the mechanisms of action of bekhogainsam decoction in the improvement of symptoms of streptozotocin-induced diabetic nephropathy in mice. Front Pharmacol 2020; 11: 633-41.
18. Alavi K, Thorsen AJ, Fang SH, et al. The american society of colon and rectal surgeons clinical practice guidelines for the evaluation and management of chronic constipation. Dis Colon Rectum 2024; 67: 1244-57.
19. Chen KD, Wang KL, Chen C, et al. Hydrogen-rich water alleviates constipation by attenuating oxidative stress through the sirtuin1/nuclear factor-erythroid-2-related factor 2/heme oxygenase-1 signaling pathway. World J Gastroenterol 2024; 30: 2709-25.
20. Liu J, Ji L, Wang Y, et al. Tongbian decoction inhibits cell autophagy via PI3K/Akt/mTOR signaling pathway to treat constipation rats. J Ethnopharmacol 2025; 339: 119-39.
21. Wang Y, Wang X, Qian Y, et al. Naringenin attenuates slow-transit constipation by regulating the AMPK/mTOR/ULK1 signaling pathway: in vivo and in vitro studies. J Nutr Biochem 2025; 24: 11-3.
22. Kim JE, Choi YJ, Lee SJ, et al. Molecular characterization of constipation disease as novel phenotypes in CRISPR-Cas9-generated leptin knockout mice with obesity. Int J Mol Sci 2020; 21: 94-104.
23. Kim JE, Park JW, Kang MJ, et al. Anti-inflammatory response and muscarinic cholinergic regulation during the laxative effect of Asparagus cochinchinensis in loperamide-induced constipation of SD rats. Int J Mol Sci 2019; 20: 946-55.
24. Eor JY, Tan PL, Lim SM, et al. Laxative effect of probiotic chocolate on loperamide-induced constipation in rats. Food Res Int 2019; 116: 1173-82.
25. Li T, Hu M, Jiang C, et al. Laxative effect and mechanism of Tiantian Capsule on loperamide-induced constipation in rats. J Ethnopharmacol 2021; 266: 113411.
26. Wang L, Gharibani P, Yang Y, et al. Regulation of enteric nervous system via sacral nerve stimulation in opioid-induced constipated rats. Front Neurosci 2023; 17: 1146883.
27. Guo Y, Song L, Huang Y, et al. Latilactobacillus sakei Furu2019 and stachyose as probiotics, prebiotics, and synbiotics alleviate constipation in mice. Front Nutr 2022; 9: 1039403.
28. Robinson AM, Stojanovska V, Rahman AA, McQuade RM, Senior PV, Nurgali K. Effects of oxaliplatin treatment on the enteric glial cells and neurons in the mouse ileum. J Histochem Cytochem 2016; 64: 530-45.
29. Niu H, Zhou M, Zogona D, et al. Akkermansia muciniphila: a potential candidate for ameliorating metabolic diseases. Front immunol 2024; 15: 1370658.
30. Feng J, Hu X, Liu J, et al. Akkermansia muciniphila in neurological disorders: mechanisms and therapeutic potential via the gut-brain axis. Front Neurosci 2025; 19: 1650807.
31. Yuan H, Shi J, Gu C, et al. Akkermansia muciniphila: a next-generation gut probiotic supporting neurorepair and functional recovery. Neural Regen Res 2025; 29: 00701.
32. Becken B, Davey L, Middleton DR. et al. Genotypic and phenotypic diversity among human isolates of Akkermansia muciniphila. mBio 2021; 12: e00478-21.
33. Kangm EJ, Kim JH, Kim YE, et al. The secreted protein Amuc_1409 from Akkermansia muciniphila improves gut health through intestinal stem cell regulation. Nat Commun 2024; 15: 2983-93.
34. Xu Y, Duan J, Wang D, et al. Akkermansia muciniphila alleviates persistent inflammation, immunosuppression, and catabolism syndrome in mice. Metabolites 2023; 13: 194-206.
35. Yang L, Huang Y, Chen M, et al. Pasteurized Akkermansia muciniphila AKK PROBIO attenuates obesity through gut microbiota-SCFA-GLP-1 axis and potential involvement of AMPK/PPAR-α pathway. Probiotics Antimicrob proteins 2025; 22: 12602.
36. Zhao Y, Yang H, Wu P, et al. Akkermansia muciniphila: a promising probiotic against inflammation and metabolic disorders. Virulence 2024; 15: 2375555.
37. Wang Y, Li C, Li J, et al. Abelmoschus manihot polysaccharide fortifies intestinal mucus barrier to alleviate intestinal inflammation by modulating Akkermansia muciniphila abundance. Acta pharm Sin. B 2024; 14: 3901-15.
38. Mo C, Lou X, Xue J, et al. The influence of Akkermansia muciniphila on intestinal barrier function. Gut pathog 2024; 16: 41-9.
39. Peng Q, Jiang P, Yi L, et al. In vivo systematic analysis of microbiota-prebiotic crosstalk reveals a synbiotic that effectively ameliorates DSS-induced colitis in mice. Gut Microbes 2025; 17: 2541028.
40. Liu J, Guan Y, Yang L, et al. Ferulic acid as an anti-inflammatory agent: insights into molecular mechanisms, pharmacokinetics and applications. Pharmaceuticals 2025; 18: 912-21.
41. Hu X, Han X, Liu G, Guan G, Xia C. Ferulic acid and N-Feruloylserotonin ameliorate LPS-induced intestinal inflammation via modulation of gut microbiota, metabolome, and transcriptome. Front Microbiol 2025; 16: 1597774.
42. Yang CY, Luo J, Peng WJ, Dai WB. Huaiyu pill alleviates inflammatory bowel disease in mice via blocking toll like receptor 4-myeloid differentiation primary response gene 88-nuclear factor kappa B subunit 1 pathway. J Tradit Chin Med 2024; 44: 916-25.
43. Xiong B, Wang H, Song YX, Lan WY, Li J, Wang F. Natural saponins and macrophage polarization: Mechanistic insights and therapeutic perspectives in disease management. Front Pharmacol 2025; 16: 1584035.
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