To explore the therapeutic effect of Huangqi Jianzhong decoction combined with mesalazine enteric-coated tablets and bifidobacterium triplex live bacteria enteric-coated capsules on patients with ulcerative colitis (UC) and its impact on intestinal mucosal barrier function.

From June 2022 to March 2025, 120 patients with UC who visited Shangluo Hospital of Traditional Chinese Medicine were randomly assigned into a control group and a monitored group, with 60 cases in each group. The control group used oral bifidobacterium triplex live bacteria enteric-coated capsules and mesalazine enteric coated tablets, while the monitored group used Huangqi Jianzhong decoction in addition to the control group. The therapeutic effect, pre-and post-treatment TCM symptom scores, Baron score, intestinal mucosal barrier function indicators, inflammatory factors, immune function indicators, and adverse reactions of the two groups were compared.

The monitored group showed better total effective rate (91.67% vs. 76.67%, P<0.05). After treatment, the TCM syndrome score, Baron score, endotoxin, diamine oxidase, D-lactate, interleukin-6, C-reactive protein, and tumor necrosis factor-α reduced prominently in both groups, while CD₃⁺, CD₄⁺, and CD₄⁺/CD₈⁺ increased prominently, and the monitored group was better (P<0.05). The adverse reactions showed no prominent difference between the two groups (13.33% vs. 8.33%, P>0.05).

Huangqi Jianzhong decoction combined with mesalazine enteric-coated tablets and bifidobacterium triplex live bacteria enteric-coated capsules has obvious curative effect in the treatment of UC patients, which can improve the intestinal mucosal barrier function and immune function of patients, reduce inflammatory reactions, and have good safety.