Research progress on the treatment of inflammatory bowel disease by traditional Chinese medicine

Introduction Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), represents a growing global health challenge. This is particularly evident in China, where incidence rates have risen rapidly. Grounded in holistic principles, traditional Chinese medicine (TCM) approaches IBD through syndrome differentiation, aiming to address its pathogenesis via multi-target mechanisms. This review integrates contemporary research with classical TCM theory to evaluate the potential of TCM in improving clinical outcomes for IBD. By synthesizing mechanistic insights, analyzing currently listed drugs, and outlining future development directions, it aims to provide a scientific foundation for key research priorities in this field. Methods A literature search was conducted for articles published up to March 20, 2025, across multiple databases, including Web of Science, PubMed, and Scopus. Search terms incorporated keywords related to traditional medicine ('traditional Chinese medicine', 'traditional herbal medicine', 'natural products') and the disease ('inflammatory bowel disease', 'ulcerative colitis', 'Crohn's disease', 'UC', 'CD'). The focus was on identifying research detailing the progress in TCM application for the prevention and treatment of IBD within a modern medical context. Results TCM demonstrates positive outcomes in the treatment of IBD. Its key pharmacological actions include anti-inflammatory effects, modulation of the gut microbiota, reinforcement of the intestinal barrier, immune regulation, antioxidant activity, and inhibition of ferroptosis. The analysis also highlights persistent challenges, such as standardizing syndrome differentiation and translating promising preclinical findings into personalized therapies. Discussion TCM has been widely studied and applied for IBD. However, a deeper elucidation of its mechanisms and the clinical relevance of existing animal models require further investigation. The primary task for future research is to address translational gaps. This necessitates conducting large, rigorously designed, patient-centered randomized controlled trials that utilize objective biological markers and clinical endpoints for the most promising candidate components. Furthermore, exploring individualized TCM formulas represents a crucial direction for optimizing IBD management.