{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:08:06Z","timestamp":1784092086023,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ulcerative Colitis (UC) is a chronic autoimmune disease with increasing incidence, particularly in Asia. Traditional Chinese Medicine (TCM) provides effective treatment through pattern differentiation. This study integrated multidimensional data to investigate the clinical differences between two common TCM patterns, dampness-heat in the large intestine (Da-Chang-Shi-Re, DCSR) and spleen deficiency with dampness accumulation (Pi-Xu-Shi-Yun, PXSY), providing a basis for revealing the biological connotation of TCM patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 180 UC patients (90 with DCSR pattern and 90 with PXSY pattern) were enrolled from March 2024 to March 2025. Peripheral inflammatory markers were measured. Endoscopic features were assessed using four scoring systems, along with detailed endoscopic characteristics. Multivariate regression models were constructed, adjusting for confounding variables including sex, medication history, baseline lesion severity, disease duration and smoking status. Intestinal histological injury was quantified using the Robarts Histopathology Index (RHI). Immunohistochemical staining was performed to assess tissue CD4 and myeloperoxidase (MPO) expression. Immunofluorescence staining was further applied to detect the expression of NADPH oxidase 2 (NOX2), CD11b, and citrullinated histone H3-labelled neutrophil extracellular traps (NETs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for multiple covariates, patients with DCSR pattern exhibited significantly higher levels of neutrophil-to-lymphocyte ratio (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f1.602, adjusted-\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.006), platelet-to-lymphocyte ratio (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f75.851, adjusted-\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.006), and neutrophil-to-albumin ratio (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f0.044, adjusted-\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.006) compared to patients with PXSY pattern. Endoscopically, DCSR patients showed more severe inflammation with higher endoscopic scores. After adjusting for confounding factors, Multivariate analysis showed that ulcer formation was an independent differentiating factor between the two (OR\u202f=\u202f2.429, 95% CI: 1.209\u20134.880,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.013). Histologically, the DCSR pattern demonstrated more severe mucosal damage with significantly higher RHI scores and increased MPO\n                      <jats:sup>+<\/jats:sup>\n                      cells (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.01). In addition, patients in the DCSR group showed higher expression levels of NOX2, CD11b, and NETs in the colon.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The DCSR pattern is characterized by more severe systemic and local inflammation, while the PXSY pattern reflects a milder, chronic inflammatory state. Neutrophil activation was also markedly elevated among patients presenting the DCSR pattern. The integration of multidimensional biomarkers provides objective evidence for TCM pattern differentiation and offers valuable insights for personalized treatment strategies in UC management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1830908","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:46:39Z","timestamp":1784090799000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A comparative study on the clinical differences in traditional Chinese medicine pattern in ulcerative colitis utilizing multidimensional data"],"prefix":"10.3389","volume":"13","author":[{"given":"Xingyao","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hangzhou Red Cross Hospital","place":["Hangzhou, China"]},{"name":"Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichuan","family":"Xv","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enjia","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongya","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Hangzhou Red Cross Hospital","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1016\/j.gtc.2020.07.005","article-title":"Epidemiology and pathogenesis of ulcerative colitis","volume":"49","author":"Du","year":"2020","journal-title":"Gastroenterol Clin N Am"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"111580","DOI":"10.1016\/j.biopha.2021.111580","article-title":"Randomised clinical trial: efficacy and safety of Qing-Chang-Hua-Shi granules in a multicenter, randomized, and double-blind clinical trial of patients with moderately active ulcerative colitis","volume":"139","author":"Shen","year":"2021","journal-title":"Biomed Pharmacother"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1557331","DOI":"10.3389\/fcimb.2025.1557331","article-title":"Targeting CD4+ T cells through gut microbiota: therapeutic potential of traditional Chinese medicine in inflammatory bowel disease","volume":"15","author":"Lu","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"117956","DOI":"10.1016\/j.jep.2024.117956","article-title":"Gegen Qinlian decoction ameliorates TNBS-induced ulcerative colitis by regulating Th2\/Th1 and Tregs\/Th17 cells balance, inhibiting NLRP3 inflammasome activation and reshaping gut microbiota","volume":"328","author":"Hu","year":"2024","journal-title":"J Ethnopharmacol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3242","DOI":"10.3748\/wjg.v25.i25.3242","article-title":"Gut microbiota contributes to the distinction between two traditional Chinese medicine syndromes of ulcerative colitis","volume":"25","author":"Zhang","year":"2019","journal-title":"World J Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"830","DOI":"10.14148\/j.issn.1672-0482.2021.0830","article-title":"Metabolic characteristics of spleen-Qi deficiency syndrome in ulcerative colitis","volume":"37","author":"Lian","year":"2021","journal-title":"J Nanjing Univ Tradit Chin Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"170","DOI":"10.13463\/j.cnki.jlzyy.2018.02.015","article-title":"Expression of IL-6 and IL-23 in peripheral blood of patients with ulcerative colitis with express on of IL-6 and IL-23 in peripheral blood of patients with ulcerative colitis with different TCM syndromes","volume":"38","author":"Cao","year":"2018","journal-title":"Jilin J. 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