Pathogenesis of extraintestinal manifestations of ulcerative colitis based on the theory of"collateral disease"
Ulcerative colitis(UC)belongs to the categories of"dysentery","diarrhea",and"hemafecia"in TCM.As a kind of persistent and refractory digestive system disease,UC can also cause lesions of skin,bone joint,liver,gallbladder,and other extraintestinal systems,tissues,and organs,exerting great impacts on the physical and mental health of patients.However,a consensus on the pathogenesis of UC extraintestinal manifestations(EIMs)has not been formed yet,which brings certain obstacles to its clinical diagnosis and treatment.Considering that the collateral system networks with the whole body,through which qi and blood permeate all parts of the body,it is proposed to explore the pathogenesis of EIMs of UC based on the theory of"collateral disease".It is believed that spleen deficiency,which is the root,and damage of intestinal collaterals are the key to the pathogenesis of UC.Dampness,heat,static blood,and toxin invade the collaterals and spread to other organs,resulting in many EIMs.On this basis,the pathological mechanisms of lesions of skin,joint,liver,and gallbladder in UC patients have been expounded.The pathogenesis of skin lesions is summarized as the lung and spleen disorders causing collateral emptiness,and thus contributing to the retention of the pathogenic factors in the collaterals;the pathogenesis of joint disease is summarized as the spleen and kidney deficiency and the invasion of the collaterals by exogenous pathogenic factors;the pathogenesis of liver and gallbladder diseases is summarized as the obstruction of dampness-heat in the(liver)collaterals and disharmony of qi and blood.This paper aims to provide new ideas with TCM characteristics for the diagnosis and treatment of EIMs of UC.
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