Clinical Application and Pharmacological Mechanism of Sishenwan in Treatment of Ulcerative Colitis： A Review
10.13422/j.cnki.syfjx.20251009
- VernacularTitle:四神丸治疗溃疡性结肠炎的临床应用与药理作用研究进展
- Author:
Keqiu YAN
1
;
Xiaoyu ZHANG
2
;
Sifeng JIA
1
;
Yuyu DUAN
1
;
Zixing QIAN
1
;
Yifan CAI
1
;
Junyi SHEN
1
;
Wenjie XIAO
2
;
Xinkun BAO
2
;
Guangjun SUN
2
;
Aizhen LIN
2
Author Information
1. College of Traditional Chinese Medicine（TCM）， Hubei University of Chinese Medicine， Wuhan 430065， China
2. Affiliated Hospital of Hubei University of Chinese Medicine/ Hubei Provincial Hospital of TCM/Hubei Academy of TCM， Wuhan 430061， China
- Publication Type:Review
- Keywords:
ulcerative colitis;
Sishenwan;
material basis;
clinical application;
mechanism;
combination of disease and syndrome
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2025;31(21):261-270
- CountryChina
- Language:Chinese
-
Abstract:
Ulcerative colitis （UC）， a chronic， non-specific inflammatory bowel disease with typical symptoms such as abdominal pain， diarrhea， and bloody stools， demonstrates a high relapse rate and difficulty in curing. Sishenwan， first recorded in Internal Medicine Abstract （Nei Ke Zhai Yao）， are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney， and astringing the intestine and stopping diarrhea. In recent years， Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors， including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term， its side effects， high relapse rate， and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan， used alone or in combination with Western medicine or other Chinese medicine compound prescriptions， significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus， pus， and blood in stools， and persistent abdominal pain， reduce Mayo scores and the relapse rate， and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen， isopsoralen， and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level， Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future， a full-chain system covering syndrome differentiation， targeting， and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics， providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.
