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

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.