Research advances on pulsatilla decoction in treating ulcerative colitis
白头翁汤治疗溃疡性结肠炎研究进展

摘要

溃疡性结肠炎是病因复杂、病程迁延的慢性肠道炎症性疾病，现代医学治疗有局限。中医学将其归为“痢疾”“肠澼”范畴，大肠湿热证为活动期常见证型。白头翁汤源自《伤寒论》，是该证型经典方剂，具清热解毒、凉血止痢功效。本文综述其药效及机制进展。研究显示，白头翁汤可改善临床症状，通过多靶点多通路调节：抗炎上抑制NF-κB、MAPK通路，调控促炎与抗炎因子；保护肠黏膜屏障，修复机械屏障并增强化学、免疫屏障；还可调控肠道菌群、代谢及激活 BMP 通路。本文为其临床应用及研究提供依据。

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with complex etiology and prolonged course, for which conventional therapies have limitations. In Traditional Chinese Medicine (TCM), it is classified as "dysentery" or "intestinal flux," with large intestine damp-heat syndrome being the predominant pattern during active phases. Pulsatilla Decoction, originating from Treatise on Cold Damage Disorders, serves as a classic prescription for this syndrome, exhibiting heat-clearing, detoxifying, blood-cooling and dysentery-relieving properties. This review synthesizes current advances in its pharmacological effects and mechanisms. Research demonstrates that Pulsatilla Decoction alleviates clinical symptoms through multi-target and multi-pathway regulation: exhibiting anti-inflammatory effects by inhibiting NF-κB and MAPK pathways while modulating pro- and anti-inflammatory cytokines; protecting intestinal mucosal barriers through mechanical barrier restoration and chemical/immune barrier enhancement; and additionally regulating gut microbiota, metabolism and BMP pathway activation. This work provides a foundation for clinical application and further investigation.