Classical traditional Chinese medicine formulas for inflammatory bowel disease: therapeutic evidence and mechanistic...

Inflammatory bowel disease (IBD) is a digestive system disorder characterized by chronic recurrent inflammation, primarily including ulcerative colitis (UC) and Crohn's disease (CD). Although modern precision medicine therapies, represented by biologics and small-molecule drugs, have reshaped the IBD treatment landscape, clinical practice still faces challenges such as primary non-response, secondary loss of response, risks of severe opportunistic infections, and an increasingly heavy health-economic burden. Traditional Chinese Medicine (TCM), as a unique medical system with millennia of clinical experience and guided by its distinct theoretical framework of "holistic concept" and "treatment based on syndrome differentiation," shows great potential in IBD management. In recent years, advances in evidence-based medicine and modern biotechnology have propelled TCM research in IBD from empirical treatment toward precision medicine. TCM exerts its effects through multi-target and multi-pathway mechanisms, demonstrating unique advantages particularly in immunomodulation, intestinal barrier repair, and gut microbiota regulation. Furthermore, modern research, from holistic perspectives such as the "gut-lung axis" and "gut-brain axis," scientifically interprets the modern biological connotations of traditional TCM theories, providing new understanding for TCM's application in IBD. Concurrently, this article discusses the revolutionary progress of nanodrug delivery systems and multi-omics technologies in enhancing the bioavailability of TCM components, reducing toxicity, and elucidating complex mechanisms. It aims to construct a modern scientific framework for TCM in treating IBD through the dual macroscopic and microscopic perspectives of systems biology and translational medicine, offering insights for achieving precision therapy, whole-life-cycle management of IBD, and complementary integration of Chinese and Western medicine.