Preventive Effects of a Chinese Herbal Formula, Shengjiang Xiexin Decoction, on Irinotecan‐Induced Delayed‐Onset Diarrhea in Rats

Irinotecan is a well‐known chemotherapy drug for the treatment of various cancers. However, delayed‐onset diarrhea is a common adverse reaction, limiting the application of the drug. The study presented was designed to evaluate the preventive effects of Shengjiang Xiexin decoction (SXD) on irinotecan‐induced diarrhea and to explore the possible mechanisms of this action. We established a diarrhea rat model. The condition of the rats was observed. The proliferation and apoptosis of intestinal cells were measured using immunohistochemical assays and a caspase‐3 activity assay, respectively. The expression of Lgr5 and CD44 staining were used to observe intestinal stem cells (ISCs). In addition, the activity of β ‐glucuronidase in the rats’ feces was measured. Our results showed that the number of proliferating intestinal cells in the SXD groups was obviously higher, while the activity of caspase‐3 was lower. The expression of Lgr5 and the integrated option density (IOD) of CD44 stain were increased significantly by SXD. Additionally, SXD decreased the activity of β ‐glucuronidase after irinotecan administration. In conclusion, SXD exhibited preventive effects on irinotecan‐induced diarrhea, and this action was associated with an inhibitory effect on intestinal apoptosis and β ‐glucuronidase and a promotive effect on intestinal cell proliferation due to increased maintenance of ISCs.