Recent Advances in the Treatment of Ulcerative Colitis with Shenling Baizhu San

Abstract

Ulcerative colitis (UC) is an intestinal disorder of unknown aetiology, characterised primarily by chronic, non-specific inflammation of the mucosa of the colon and rectum. The lesions mainly affect the mucosa and submucosa, Clinically, it presents as persistent or recurrent abdominal pain, diarrhoea, and mucoid, purulent or bloody stools. Characterised by a protracted course, recurrent episodes and a high risk of malignancy, it is widely recognised as one of the intractable diseases of the digestive system. Shenling Baizhu San, derived from the "Taiping Huimin Heji Jufang", is a classic formula representing the Traditional Chinese Medicine (TCM) principle of ‘strengthening the spleen and draining dampness’. It is widely used in the clinical treatment of UC and has demonstrated proven efficacy. Mechanistic studies have further demonstrated that Shenling Baizhu San treats ulcerative colitis through multiple mechanisms, including promoting the release of anti-inflammatory factors, inhibiting the secretion of pro-inflammatory factors, regulating immune function, repairing the intestinal mucosal barrier, and maintaining the homeostasis of the gut microbiota. In recent years, with the advancement of network pharmacology, multi-omics technologies and molecular biology research, the modern scientific underpinnings of Shenling Baizhu San in the treatment of UC have been progressively elucidated. This paper systematically reviews the theoretical foundations of Traditional Chinese Medicine underlying the use of Shenling Baizhu San for the treatment of UC. It summarises its mechanisms of action from multiple dimensions, including the regulation of inflammatory factors and related pathways, modulation of immune function, repair of the intestinal mucosal barrier, regulation of the gut microbiota, and antioxidant stress. Furthermore, by integrating the latest clinical research advances, the paper explores the value of its use as a monotherapy and in combination therapy, with the aim of providing a reference for the in-depth study and clinical optimisation of this formula.