基于先前的研究，采用传统中医理论改进了胃肠急性放射综合征（GI-ARS）的药物组合。本研究的目的是研究梁血骨髓益肾汤（LGYD）对GI-ARS的治疗机制，并为放射损伤的治疗提供新方案。在此，我们调查了LGYD对GI-ARS大鼠模型中的肠道干细胞（ISCs）的影响。分析大鼠的健康状况、存活率以及LGYD对肠道的保护效果。利用液相色谱-质谱联用技术（LC-MS）检测LGYD中的活性成分。利用免疫组化、免疫印迹（WB）和逆转录定量聚合酶链反应（RT-qPCR）探索ISC增殖、肠道上皮紧密连接蛋白（TJ）的表达以及相关调节途径。采用网络药理学分析筛选肠道恢复中WNT和MEK/ERK途径的作用，并通过WB和RT-qPCR进行验证。LGYD的给药显著改善了GI-ARS大鼠的健康状况和存活率。病理分析显示，LGYD改善了放射引起的肠道损伤，显著促进了肠道小窝中LGR5+干细胞的再生，上调了TJ蛋白，并加速了辐射大鼠的小窝重建。LC-MS检测到≥13种成分可能有助于LGYD的保护效应。综上所述，LGYD可促进辐射损伤后小窝细胞的增殖和ISC的增多，这种效应可能与WNT和MEK/ERK途径有关。© 2023作者。由牛津大学出版社代表日本放射研究学会和日本放射肿瘤学会发表。

On the basis of the previous research, the Traditional Chinese Medicine theory was used to improve the drug composition for gastrointestinal acute radiation syndrome (GI-ARS). The purpose of this study was to study the therapeutic mechanism of Liangxue-Guyuan-Yishen decoction (LGYD) on GI-ARS and to provide a new scheme for the treatment of radiation injury. Here, we investigated the effects of LGYD on intestinal stem cells (ISCs) in a GI-ARS rat model. Rat health and survival and the protective efficacy of LGYD on the intestines were analyzed. The active principles in LGYD were detected using liquid chromatography-mass spectrometry (LC-MS). ISC proliferation, intestinal epithelial tight junction (TJ) protein expression and regulatory pathways were explored using immunohistochemistry, western blotting (WB) and reverse transcription quantitative polymerase chain reaction (RT-qPCR), respectively. Involvement of the WNT and MEK/ERK pathways in intestinal recovery was screened using network pharmacology analysis and validated by WB and RT-qPCR. LGYD administration significantly improved health and survival in GI-ARS rats. Pathological analysis showed that LGYD ameliorated radiation-induced intestinal injury and significantly promoted LGR5+ stem cell regeneration in the intestinal crypts, upregulated TJ protein, and accelerated crypt reconstruction in the irradiated rats. LC-MS revealed ≥13 constituents that might contribute to LGYD's protective effects. Collectively, LGYD can promote crypt cell proliferation and ISCs after radiation damage, the above effect may be related to WNT and MEK/ERK pathway.© The Author(s) 2023. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.