bubble_chart Concept

Traditional Chinese medicine believes that this disease mostly falls under the categories of "diarrhea," "dysentery," and "abdominal pain." It is often caused by exposure to summer heat and cold-dampness, or internal damage from consuming raw and cold foods, depression due to the seven emotions, and weakness of the zang-fu organs. If the spleen and stomach are injured, leading to abnormal transportation and transformation, dampness turbidity descends to the large intestine, or dampness turbidity accumulates, causing dysfunction of the gastrointestinal organs, stagnation of qi and blood, and mutual binding of dampness-heat, which injures the intestinal collaterals and leads to bleeding or the formation of pus, resulting in persistent stickiness and the discharge of red and white substances, this is considered a substantial disease. Alternatively, if the disease arises from internal damage due to the seven emotions, such as depression and anger damaging the liver, leading to deficient dispersion, the liver overacting on the spleen, resulting in liver excess and spleen deficiency, dysfunction of the spleen in transportation, internal generation of dampness turbidity, which directly affects the large intestine, or deficiency of kidney yang, leading to the spleen losing its warmth and becoming unable to transform and transport, resulting in diarrhea, this is considered a deficient disease.

bubble_chart Modern Research

Ulcerative colitis, also known as chronic nonspecific ulcerative colitis, is a chronic inflammatory bowel disease of the rectum and colon associated with autoimmune reactions. Clinically, it is characterized by chronic abdominal pain, diarrhea, mucus and bloody stools, and tenesmus, with a prolonged course, varying severity, and a tendency to relapse. Based on clinical manifestations, it can be divided into the stage of attack and the stage of remission.

Modern medicine believes that this disease is related to factors such as immunity and genetics. It is often complicated by extraintestinal manifestations of autoimmune diseases such as erythema nodosum and arthritis, and is effectively treated with adrenal corticosteroids. Anti-colonic epithelial cell antibodies can be detected in the serum of some patients, suggesting that the disease is related to autoimmune reactions. Lymphocyte infiltration is present in the affected colon tissue, which has cytotoxic effects on fetal colonic epithelial cells, indicating that the disease is related to abnormal cellular immunity. The pathological changes mainly occur in the rectum and sigmoid colon, and can extend upward to the descending colon and transverse colon. In severe cases, the entire colon may be involved, showing a so-called "upside-down" progression.

[Diagnosis]

1. Medical history: Some patients may have a family history of the disease. Most cases have a slow onset, while a few may present acutely. The course can last for several years, or even more than a decade, often alternating between the stage of attack and the stage of remission, or progressively worsening. Occasionally, acute exacerbations may occur. The disease can be aggravated or triggered by factors such as emotional stress, overwork, dietary irregularities, and gastrointestinal infections.
2. Symptoms: Alternating diarrhea and constipation, mucus and bloody stools; abdominal pain follows a pattern of pain—urge to defecate—relief after defecation, often accompanied by abdominal distension and fullness, loss of appetite, nausea, vomiting, fever, weight loss, anemia, and symptoms such as erythema nodosum and arthritis.
3. Laboratory and other examinations:
   1. Blood tests may reveal anemia, increased white blood cell count, and accelerated erythrocyte sedimentation rate. In the stage of remission, an increase in serum α₂ globulin often indicates an impending relapse; in the stage of attack, a decrease in serum γ globulin suggests a poor prognosis.
   2. Stool examination: Red blood cells, white blood cells, and macrophages are present, but no specific pathogens are found.
   3. Rectosigmoidoscopy, fiberoptic colonoscopy, and X-ray barium enema examinations are all helpful in diagnosing the disease.

bubble_chart Pattern Analysis

1. Dampness-heat︰Fever, abdominal pain, diarrhea with red and white mucus stools, or tenesmus, burning sensation in the anus, scanty dark urine. Tongue texture red with yellow greasy coating, slippery and rapid pulse. Clear heat and remove toxins, resolve dampness to stop dysentery. Modified Pulsatilla Decoction combined with Peony Root Decoction. Chinese pulsatilla root 15g, ash bark 12g, Phellodendron bark 12g, Coptis rhizome 10g, skullcap root 10g, red peony root 10g, peony root 15g, Lonicera 10g, Aucklandia root 10g, betel nut 10g. For severe heat with stagnation, add raw rhubarb rhizome 15g, Pueraria root 15g; for severe dampness, add magnolia bark 12g, Atractylodes rhizome 10g; for prominent exterior pattern, add Schizonepeta 12g, Forsythia 12g; for abdominal distension, fullness, and pain, add immature orange fruit 15g, green tangerine peel 10g.
2. Liver and Spleen Disharmony︰Abdominal pain often occurs after emotional stress or fatigue, with diarrhea containing pus and blood, pain preceding bowel movements that relieves after defecation, accompanied by chest and hypochondriac distension, headache, irritability, epigastric stuffiness, anorexia, and belching. The tongue is red with thin white coating, and the pulse is wiry or wiry and rapid. Treatment involves soothing the liver and regulating the spleen, moving qi to stop dysentery. Modified Cold-Limbs Powder combined with Pain and Diarrhea Vital Formula is used. Ingredients include Submature Bitter Orange 15g, Peony Root 15g, Bupleurum 10g, Liquorice Root 6g, White Atractylodes Rhizome 10g, Dried Tangerine Peel 10g, Saposhnikovia Root 12g, Chinese Yam 20g, and Cyperus 12g. For frequent diarrhea with tenesmus, add Smoked Plum 6g and Schisandra Fruit 6g. For food stagnation, add Hawthorn Fruit 15g, Medicated Leaven 12g, and Radish Seed 10g. For mental fatigue and anorexia, add Tangshen 10g and Villous Amomum Fruit 6g.
3. Intestinal Collateral Stasis︰The abdominal pain is severe or persistent distending pain, accompanied by nausea, vomiting, persistent high fever, abdominal distension and fullness like a drum, tenderness, constipation, and foul belching. The tongue is red with a gray-white or yellow-white greasy coating, and the pulse is slippery-rapid or wiry-tight. The treatment principle is to invigorate blood and resolve stasis, as well as promote bowel movement. Modified Peach Kernel Chengqi Decoction is used, including: Raw Rhubarb Rhizome 20–30g (infused separately and taken later), Peach Kernel 10g, Red Peony Root 12g, Leech 10g, Gadfly 10g, Submature Bitter Orange 12g, Magnolia Bark 15g, Aucklandia Root 10g, Radish Seed 12g. For persistent high fever, add Coptis Rhizome 10g, Gardenia 10g, Tokyo Violet Herb 12g, Lonicera 10g, Dandelion 10g. For joint pain, add Gentian 12g, Notopterygium 10g, Pubescent Angelica 10g. For erythema nodosum, add Moutan Bark 10g, Salvia 12g.
4. Spleen-stomach Weakness︰Borborygmus diarrhea, loose stools, or undigested food in stool, poor appetite, mental fatigue and lack of strength, pale or sallow complexion. The tongue texture is pale with a white or white greasy coating, and the pulse is soggy and slow or deep, thin, and weak. The treatment involves invigorating the spleen and harmonizing the stomach to promote digestion and stop diarrhea. Modified Ginseng, Poria, and White Atractylodes Powder is used. The prescription includes: Tangshen 15g, White Atractylodes Rhizome 12g, Chinese Yam 20g, Poria 15g, Coix Seed 20g, Dried Tangerine Peel 10g, Hyacinth Bean 12g, Stir-fried Millet Sprout 10g, Stir-fried Germinated Barley 10g, Hawthorn Fruit 15g, Lotus Seed 15g, Platycodon Root 6g, Villous Amomum Fruit 6g (to be decocted later). For chronic diarrhea with qi deficiency and rectal prolapse, add Pueraria Root 20g, Cimicifuga Rhizome 15g, Bupleurum 10g, and Submature Bitter Orange 30g. If accompanied by middle yang deficiency, add Blast-Fried Ginger 10g and Prepared Common Monkshood Daughter Root 10g.
5. Spleen-kidney Yang Deficiency︰Chronic diarrhea, undigested food in stool, gastric stuffiness, anorexia, fatigue, dull complexion, fear of cold with preference for warmth, or cold pain in the epigastric region, diarrhea before dawn. Pale and swollen tongue with teeth marks, deep and weak pulse. Warm and tonify the spleen and kidney, astringe the intestines and stop diarrhea. Modified Four Miracle Pill combined with Peach Blossom Decoction: Psoralea 15g, Evodia 10g, Nutmeg 15g, Red Halloysite 20g, Limonite 20g, Chinese Yam 20g, Poria 15g, White Atractylodes Rhizome 10g, Cassia Bark 10g, Blast-Fried Ginger 10g, Chebula Fruit 10g, Pomegranate Rind 10g. For undigested food in stool, add Hawthorn Fruit 15g, Medicated Leaven 12g; for poor appetite, add Cardamon Fruit 10g, Villous Amomum Fruit 10g (to be decocted later); for elderly or weak constitution, add Tangshen 15g, Astragalus Root 20g, Stir-fried Hyacinth Bean 10g.