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OBJECTIVE:To observe the effects of the Bupi Hewei (BPHW) decoction on diarrhea and intestinal flora disorder induced by 5-fluorouracil (5-FU) and investigate the possible mechanism underlying these actions.METHODS:Thirty-five male Sprague-Dawley rats were randomly divided into four groups:normal control,5-FU,5-FU + BPHW decoction (10.5 g/kg for 5 consecutive days),and 5-FU + Bacillus licheniformis capsule groups (0.2 g/kg for 5 consecutive days).Animal models were established via the intraperitoneal injection of 5-FU (30 mg/kg for 5 consecutive days).At the end of the treatment period,diarrhea was assessed,and the change of the intestinal flora was examined using 16S rDNA highthroughput sequencing.Interleukin (IL)-17,IL-21,IL-6,IL-10,RAR-related orphan receptor gamma (RORyt),and forkhead box P3 (Foxp3) expression in the jejunum was detected using immunohistochemistry,quantitative real-time polymerase chain reaction (PCR),West blotting,and enzymelinked immuno sorbent assay.RESULTS:In this study,the BPHW decoction effectively lowered the diarrhea score,increased the proportions of Bacteroidetes and Prevotellaceae-Alloprevotella species,and reduced the proportions of Proteobacteria,Escherichia-Shigella,Ruminococcaceae NK4A214,and Ruminococcaceae UCG-005 species in the rat intestine after 5-FU chemotherapy.In addition,the BPHW decoction significantly suppressed the expression of IL-17,IL-21,IL-6,IL-10,RORYt,and Foxp3 in the jejunum.CONCLUSION:Our findings suggest that the BPHW decoction can improve the intestinal immune balance and reduce intestinal inflammation by targeting T helper cell/T regulatory cell-associated factors.