Journal of Clinical Medicine Research

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by immune dysregulation, mucosal barrier damage, and gut microbiota imbalance. Despite advances with biologics and immunosuppressants, long-term efficacy remains limited. In traditional Chinese medicine (TCM), UC is classified under "dysentery" or "diarrhea," with spleen deficiency and damp-heat excess as key mechanisms, reflecting the theory of "the spleen as the defender." This paper integrates this theory with modern immunology to explore how TCM interventions — such as strengthening the spleen and qi, clearing heat and dampness, and protecting intestinal collaterals — regulate immune responses. Clinical and experimental evidence indicates that TCM can modulate cytokine networks, restore mucosal barrier integrity, and reshape gut microbiota. These findings highlight the unique value of TCM in UC treatment and suggest new directions for integrative approaches to immune-related diseases.