Ulcerative colitis is one of the difficult to treat clinical diseases, which has the characteristics of recurrence and intractable. Under the guidance of the basic theory of TCM surgery, the use of meridian prescriptions for the identification and treatment of ulcerative colitis has achieved better therapeutic effects in terms of disease control and reduction of recurrence. Ulcerative colitis; Sutra formula; Chinese medicine treatment “Ulcerative colitis” is abbreviated as (UC). The lesions mainly occur in the mucosal layer of the colon, mainly ulcers and erosions, and mostly start from the distal end of the colon, and can also involve the whole colon. The cause of this disease is still unknown. The main clinical manifestations are abdominal pain, diarrhea, and mucus and blood stools. The disease is known as one of the intractable diseases in the medical field because of its mild severity, slow course and recurrent and intractable characteristics. The acute fulminant form of the disease has a high mortality rate and the chronic persistent form is prone to cancer, which not only affects the quality of life of patients, but also poses a serious threat to their survival. With the continuous improvement of people’s living standard, dietary structure and treatment technology, the detection rate and prevalence of this disease are also increasing year by year. Although there are more drugs available for the treatment of the disease, there are factors such as long medication cycles, high costs, more side effects, and difficulty in controlling the dosage and time of increasing or decreasing drugs, which make the patients’ compliance with treatment poor and the doctors’ confidence in the cure of the disease insufficient, resulting in recurrent and persistent attacks of the disease. In the past ten years, we have carefully observed the characteristics and rules of the occurrence and development of the disease, starting from the logic of the thinking of TCM surgical diagnosis and treatment, choosing TCM meridian prescriptions to treat the disease, and through continuous practice, we have gained some experience in rapidly turning the degree of the disease into remission, reducing the recurrence rate and lowering the surgery rate. We believe that this disease belongs to the category of “intestinal carbuncle” in TCM surgery. The name of the disease, the cause of the disease, the mechanism of the lesion, the symptoms and the complications of the disease can be found in many ancient medical texts, such as the Nei Jing, the Treatise on Typhoid, the Jin Kui Yao, the Liu Juan Zi’s Ghost Legacy Formula, and the Zheng Zong of Surgery. We believe that the causes of ulcerative colitis (intestinal carbuncle) are related to uncontrolled diet, heat and cold, unregulated life, and unrestrained emotions. The above-mentioned causes can lead to internal dampness and turbidity, and the lack of separation between clear and turbid, which can lead to congestion of Qi and blood, and the creation of pus and rot, resulting in the development of intestinal canker. The disease is mainly caused by “dampness and turbidity”, and the stagnation of qi and blood in the veins and ligaments, which makes the disease long and recurrent. Therefore, in accordance with the characteristics of TCM surgical staging treatment, we take “ascending and descending dampness, eliminating stasis and clearing ligaments” as the principle of treatment, which can eventually remove dampness and dampness, clear heat and toxicity, unblock blood vessels and ligaments, and restore the function of spleen and stomach. There are two specific applications: internal treatment and external treatment. The internal treatment method is applicable to patients with mild, moderate and active stage. Severe patients should be given the application after supportive therapy and when the condition turns into mild or moderate. When using the internal treatment method, the patient should first be divided into three stages according to the clinical manifestations. That is, initial onset, pus formation, and post-ulceration. Then follow the three principles of “elimination, support and supplementation” in TCM surgery to implement evidence-based treatment. The “elimination method” is used in the initial stage; the “support method” is used in the pus-forming stage; and the “supplementation method” is used in the post-ulcerated stage, which also assumes the role of preventing recurrence. Clinically, the three methods can be applied independently, but they can also be referred to each other, so we need to pay attention to flexible tailoring and treatment by evidence. Initial symptoms: abdominal pain on both sides, urgency and heaviness, frequent stools, or constipation, not much pus and blood, fever and cold, slightly red tongue, thin white tongue coating, late and tight pulse. Colonoscopy can also be seen: disturbance of the vascular texture of the colonic mucosa, congestion and edema, and mucus secretions on the surface. The main pathogenesis of this stage is damp-heat internalization and stagnation of Qi and blood. The treatment method is to clear heat and detoxify the toxins, resolve stasis and open the ligaments. The preferred formula is Dahuang Mudan Tang plus reduction. Rhubarb 9 grams, peony bark 12 grams, peach kernel 9 grams, winter melon seed 20 grams, mannite 9 grams. One dose of decoction is taken twice a day, with 100ml of the decoction taken every 12 hours. Among them, rhubarb, mangosteen and melon seeds diarrhea heat and detoxify dampness; peony bark and peach kernel cool the blood and disperse blood stasis. In this way, the combination of clearing dampness and heat, activating blood circulation and resolving blood stasis, eliminating carbuncles and relieving pain. The duration of this period is short, and diagnosis and treatment need to be timely, otherwise the disease may turn into chronic relapse or chronic persistence, which will make it more difficult to stabilize the disease in remission. Symptoms of the pus-forming stage: ①Shortness of breath and lazy speech, distention and fullness of the abdomen, frequent belching, increased frequency of stools, pus and blood in the stool, slightly red tongue, thin white tongue coating, teeth marks on the edge of the tongue, and slippery pulse. The preferred formula for treatment is Han Xia Di Xuan Xin Tang plus reduction. Panaxia 9g, Huang Lian 4g, Scutellaria 6g, Dry Ginger 12g, Radix Codonopsis 12g, Roasted Licorice 6g, Jujube 4. Decoction as before. ② Cold form and cold limbs, distention and fullness of the abdomen, hidden pain in the lesser abdomen, increased stool, mucus and pus, red tongue with white fur, petechiae on the edge of the tongue, and sunken pulse. Treatment preferred is Wu Mei Wan with addition and subtraction. Wu Mei 9, Hsiang Xin 6g, Gan Jiang 12g, Huang Lian 4g, Angelica Sinensis 12g, Radix et Rhizoma Polygonati 9g, Shu Jiao 9g, Cinnamon 9g, Dang Shen 12g, Huang Bai 6g. Decoction is taken as before. At this stage, scattered, elevated, grayish pustules, or scattered, or continuous ulcers can be seen on colonoscopy. The pathogenesis is mainly Yang Qi deficiency, cold and dampness, stagnation of Qi and blood, and damp-heat decay. The treatment mainly adopts the “tonic-tropical method” of the “Tonic Method”, in which the treatment is based on Qi deficiency and subcardiac puffiness with the addition and reduction of Han Xia Di Xin Tang; and the treatment is based on Yang deficiency and spleen and stomach coldness with the addition and reduction of Wu Mei Wan. The two formulas complement qi and yang, while also playing the role of “pungent opening and bitter lowering”. In this way, the deficiencies will be compensated, and the veins will be cleared and the internal ulcers will be restored. This period of medication adjustment time is about 1 to 2 years. Patients belonging to this period have poor compliance, so doctors should encourage them in time to calm the patients and establish the confidence of doctors and patients to cure the disease, otherwise the treatment will be repeated in this period. Symptoms in the late stage of ulceration: pale face, little breath and lazy speech, weakness and dullness, infrequent stools, reduced pus and blood, or even no blood at all, pale tongue with white coating and weak pulse. The formula of choice for treatment is “roasted licorice soup plus reduction”. Roasted licorice 12g, ginger 9g, Radix Codonopsis pilosulae 6g, Radix Rehmanniae 30g, Rhizoma Atractylodes Macrocephalae 12g, Colla Corii Asini 6g, Radix Angelicae Sinensis 12g, Radix Paeoniae Alba 12g, Jujube 6pcs, Rhizoma Chuanxiong 12g, Poria 12g. Decoction is taken as before. During this period, the mucosa under colonoscopy is mildly congested and edematous, with indistinct vascular texture, ulcer repair, or with bridge-type healing. Within this period, emphasis is placed on benefiting Qi and nourishing Blood, activating Blood circulation, promoting healing, and strictly preventing recurrence. The addition and subtraction of drugs in the internal treatment formula include: abdominal fullness and distension plus Su Stem and Buddha’s Hand; intestinal rumbling plus Scrophularia; abdominal pain and vague plus Yuan Hu, Neem, and Centipede; less abdominal distension and fullness plus Wu Juhua and Wicker; pus and blood stool with mucus as the main cause plus Severus, Amaranthus, Dong Gua Pi, Atractylodes, and Calamus; pus and blood stool with blood as the main cause plus Xian He Cao, Sheng Di Yu; pus and blood are equal plus Severus, Amaranthus, Xian He Cao, Sheng Di Yu, Xie Cao or Xie Cao Char; and palm char. The formula must also add Chuanxiong, leech, Liu Fan Nu, etc., in order to resolve blood stasis and open the ligaments, remove decay and create muscle. The external treatment method is more often used is the enema method. It is suitable for patients with mild or moderate active stage, persistent type, rectum and sigmoid colon. The main method is to clear heat and detoxify, cool the blood and stop bleeding, and produce muscle and astringent sores. The commonly used drugs are 10 grams of Qing Dai, 10 grams of Hou Pu, 20 grams of Slippery Rock, 15 grams of Horsetail, 15 grams of Wu Bei Zi, 15 grams of Xian He Cao, 15 grams of Palm Charcoal, and 6 grams of Bai He powder (added to the medicine solution during enema). Decoct 2 times per dose, taking 100ml each time, and decide to give 1 to 2 enemas according to the degree of the disease. The enema is administered to the patient in the lateral position, and the enema or syringe is filled and sucked at a temperature of 38℃～40℃, and the solution is injected into the rectum through the anal canal or slowly, and then the patient is turned over, knee-chested position, etc., so that the solution is spread all over the trauma. Each course of treatment for one month, and decide to reduce or stop the dosage according to the effect. Patients with ulcers located in the right hemicocele also have better therapeutic effect after absorption of the infused drug. In addition when cold, overworked, emotionally unstable, diet, this disease has the characteristics of aggravation, so in the seasonal changes, dietary intake to pay special attention to; life should pay attention to what objects, food contact after aggravation should be avoided as far as possible; during the disease to pay attention to the combination of work and rest, emotional stability, otherwise it will prolong the treatment time or aggravate the disease; women in remission can be pregnant, due to the influence of endocrine The performance is stable during pregnancy, but it is necessary to communicate and contact with the doctor in time after delivery, otherwise it is easy to have a rebound that cannot be easily controlled. Although the course of ulcerative colitis is protracted, the effect of combined Chinese and Western medicine treatment is certain, especially the internal treatment of Chinese medicine will make the disease stable in remission for a longer period of time, if coupled with the continuous addition of acupuncture, moxibustion, patching, massage, foot bath, buried thread and other Chinese medicine external treatment and treatment techniques, will enrich the treatment means of the disease. We hope that in the near future, we will find better solutions to shorten the treatment period and reduce the recurrence rate, so that patients can recover soon.