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Supplemental Digital Content is available in the text, Introduction: The Chinese herb da huang (DH) (Rhubarb) is commonly used for GIF intensive care unit (ICU)/pediatric intensive care unit (PICU) gastrointestinal failure (GIF) patients in China. However, the potential preventive and therapeutic effect of DH in these patients has not yet been studied systematically. Objectives: The aim of this study was to evaluate the preventive and therapeutic effects of DH in treating ICU/PICU GIF patients with the most recent evidence. Methods: We systematically searched 7 databases from inception to March 30, 2018. RevMan 5.3 software was used to perform a meta-analysis. GRADE methodology was applied to evaluate the quality of evidence for each outcome. The review protocol was registered on PROSPERO (CRD42018092710) in advance. Results: Seven studies comprising 788 pediatric or adult participants were included in this analysis. Three indicators, including GIF occurrence rates (gastrointestinal mucosal hemorrhage, enteroplegia), multiple organ dysfunction syndrome (MODS)-related items (occurrence rates of MODS, mortality rates of MODS) and duration in the ICU was analyzed. The GIF occurrence rate meta-analysis result was (RR 0.47, CI 95% 0.37-0.60; P = .95); MODS related items indicator result was (RR 0.44, CI 95% 0.33–0.59; P = .41); ICU duration ICU result was (RR -2.87, CI 95% -3.53--2.21; P = .40). The safety of Chinese herb DH (Rhubarb) remains unclear. Conclusion: Current evidence suggests that the Chinese herb rhubarb (DH) powder combined with Western medicine was inferior to Western medicine alone in terms of preventive and therapeutic effects in ICU/PICU patients in terms of decreasing GIF occurrence rates (gastrointestinal mucosal hemorrhage and enteroplegia), occurrence rates of MODS, mortality from MODS, and shortened duration time in the ICU/PICU. However, larger sample sizes and rigorously-designed studies are necessary to conclusively determine the association between DH powder and outcomes in ICU/PICU GIF patients.

Background : The rate of gastrointestinal adenomatous polyps, often regarded as precancerous lesions, developing into cancer is 40 – 70 %. Endoscopic resection has been the preferred method for treating gastric polyps since the late 1960s. Surgical removal of polyps continues to play an important role in the treatment of polyps; however, the efficacy of such treatment cannot be guaranteed, and polyps may recur. Case presentation: Here, we report a 44-year-old man suffering from gastrointestinal polyps who refused surgical treatment and instead was treated with traditional Chinese herbal medicine (TCHM) for approximately 1 year. The patient was diagnosed with “qi deficiency and dampness syndrome” based on traditional Chinese medicine theory and was treated with the TCHM “strengthen qi and remove dampness formula”, referred to as the shen-ling-bai-zhu powder/decoction. Conclusion: This case suggests that TCHM may play an important role in the treatment of gastrointestinal polyps. Relevant data are, however, limited and a randomized controlled trial is needed to confirm TCHM efficacy in a larger population. Keywords : Case study, Gastrointestinal polyps, Traditional Chinese herbal medicine, Shen-ling-bai-zhu powder

Aim. To assess the current clinical evidence of the effectiveness of Da-Cheng-Qi Decoction (DCQD) for the treatment of Postoperative gastrointestinal dysfunction (PGD).Methods. Randomized controlled trails (RCTs) of Da-Cheng-Qi Decoction (DCQD) to PGD were searched from available major electronic databases to September 2016. The intervention must be a modified DCQD or DCQD integrated to Western Medicine (WM) compared with WM or placebo or blank. The main outcome index was clinical effectiveness and improvement of major symptoms. Data extraction, data analysis, and methodological quality assessment are conducted according to the Cochrane Handbook for Systematic Review of Interventions, version 5.0.2. RevMan 5.3 software was applied to our data analyses.Results. Seven RCTs involving 494 participants were recruited and identified. The methodological quality of all trials were assessed and generally of low-level. Those studies were published between 2004 and 2013. All 7 studies which used herbals (modified DCQD) integrate WM in test group compared with WM as the intervention and only one study (Sunyouxu 2013) integrates placebo to Western Medicine as the control group intervention. The treatment course was 1 week to 2 weeks. Evaluation of intervention effectiveness consists of the clinical effective rate indicator and the PGD symptoms indicator including time of borborygmus, time of gastrointestinal exhaust, and time of defecate. The clinical effectiveness results are beneficial to the test group.Conclusion. DCQD could improve PGD symptoms and promotion clinical effectiveness.