Some Chinese scholars used CM to treat chronic constipation and achieved certain achievements. In the study on the mechanism of drug action, CM showed an effect on gut microbiota. Due to the current unsatisfactory effect of long-term use of laxatives, increasing scholars studied the efficacy and mechanism of CM to relieve constipation from the perspective of gut microbiota. There are many similarities between gut microbiota and CM theory, especially CM holistic concept, CM Yin-Yang balance theory, and CM constitutional theory.
CM studies focus on the normal physiological activities and disease states of the human body from a holistic perspective. The holistic concept involves two parts. Firstly, natural and social environments can affect the structures and functions of human body. Secondly, the gut interacts with other organs.
According to CM theory, the changes in natural and social environments can affect the structures and functions of human body, including the gut microbiota. For instance, western diets containing less fibers are prone to lead to constipation. In northwestern China with the dry climate, the incidence of constipation symptoms is growing. Besides, the gut microbiota is involved in the formation of gut immunity, but the structure of the gut microbiota may also change and affect the gut immunity when the environment and climate change.
According to the holistic concept of CM, organs, tissues, and cells constitute human body as the whole organic structure, and they are interconnected and interact with each other. Therefore, local changes may lead to the functional changes of the whole body. Gut is the largest digestive organ of the human body and is closely related to the life activities of human beings. In many studies on the gut-liver axis and the gut-brain axis, the gut microbiota was treated as an important bridge between the gut and other organs.
There is a symbiotic, interdependent, and interacting relationship between the gut microbiota and the host/environment. Therefore, the study on the gut microbiota should focus on its connection with the host and environment.
Certain herbs or herbal formulas have been widely used to treat chronic constipation in East Asia. Especially in China, more and more patients with chronic constipation are more willing to seek help from Chinese medicine. Furthermore, many studies proved that Chinese medicine was an effective treatment way for chronic constipation.
The patients with STC (45 cases) were treated for 3 weeks with Huangxin Runchang Pian, a Chinese patent drug made by Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, and 45 cases in the control group were treated with Danggui Longhui Wan, a Chinese patent drug that had been applied in clinical practices. The total clinical effective rates after the treatment and in 1 month after stopping medication were, respectively, 95.6% and 82.2% in the treatment group and 93.3% and 80.0% in the control group. However, there was no significant difference between the two groups.
In China, some Chinese medicine formulas are also particularly concerned due to their multiple-target and multipath mechanism. Liu D et al. Used Zengye Decoction (ZYD), a CM formula consisting of Radix scrophulariae, Ophiopogon japonicus, and Radix rehmannia, to treat elderly constipation rats. The results indicated that ZYD exerted a therapeutic effect by restoring the gut microbiota of constipation rats and regulating host metabolites. In addition, Yangyin Runchang Decoction (YRD) consists of Zengye Decoction and Zhizhu pills are important Chinese medicine for the treatment of constipation. YRD had been proven to be effective for the treatment of STC mouse model by restoring the stem cell factor (SCF)/c-kit pathway, increasing interstitial cells of Cajal (ICC) counts and enhancing ICC function. Moreover, lubricating gut pill (LGP), a Chinese medicine formula, had been used to treat constipation rats and LGP enhanced fluid and Cl− secretion through prostaglandin receptor signaling as well as the CAMP and protein kinase A pathway.