International Journal of Clinical Research

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.

Pulsatilla decoction; Ulcerative colitis; Large intestine damp-heat; Mechanism of action; Inflammatory response; Intestinal mucosal barrier; Research progress