Mechanisms and therapeutic potential of traditional Chinese medicine for inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of the intestine with a rising global incidence that significantly impairs patients' quality of life. Although modern medical therapies can provide short-term symptom relief, they are often limited by dependence on medication and considerable adverse effects. Traditional Chinese medicine (TCM) has demonstrated longstanding clinical efficacy and preclinical advantages in IBD management, yet systematic summaries and in-depth mechanistic insights remain insufficient. This minireview explores recent advances in the mechanistic research of TCM for IBD to inform alternative therapeutic strategies. A systematic literature search was conducted using databases including PubMed, Science Citation Index Expanded, and China National Knowledge Infrastructure to synthesize current evidence, focusing on literature published between 2023 and 2025. Findings reveal that TCM exerts therapeutic effects through holistic, multicomponent, multi-target, and multi-pathway regulation. Key mechanisms involve modulation of inflammatory signaling pathways, immune homeostasis, gut microbiota composition, intestinal barrier integrity, autophagy, metabolic functions, gene expression, and synergistic multi-target therapy. Despite existing research limitations, the evolution from empirical herbal use toward modern scientific understanding promises to accelerate the modernization and global integration of TCM. This minireview provides foundational insights for future research and clinical practice, with the potential to benefit IBD patients worldwide.