Ulcerative colitis (UC) is a chronic nonspecific inflammatory bowel disease with a long course, easy recurrence, difficult treatment, and a risk of cancer crisis. So far, its pathogenesis remains unclear. MicroRNA (miRNA), a class of non-coding RNA, has been recognized as important regulators of gene expression. Studies have shown that miRNA exhibits differential expression in UC and targets miRNA to participate in post-transcriptional gene expression regulation in UC, mainly regulating intestinal epithelial barrier function, immune homeostasis and inflammatory balance in UC. Therefore, miRNA-based drugs are expected to be potential innovative drugs for UC. Traditional Chinese Medicine (TCM) boasts a broad spectrum of applications for the prevention and treatment of UC, offering significant efficacy and unique advantages such as multi-targeting and multi-pathway effects. However, there is still a lack of review on regulating miRNA by TCM to prevent UC. This article reviewed the mechanisms of miRNA in UC and the research findings on TCM compounds and active components' intervention in miRNA regulation for UC treatment. It was found that TCM could modulate the differential expression of miRNA thereby participating in the regulation of various pathological and physiological processes such as intestinal epithelial barrier damage, apoptosis, inflammation, and abnormal differentiation of immune cells. This modulation contributed to alleviate UC. This review is expected to provide theoretical reference and research guidance for future studies on regulating miRNA therapy for UC.

溃疡性结肠炎（UC）是一种慢性非特异性炎症性肠病，具有病程长、反复发作、难治愈、易癌变等特点。迄今为止，其发病机制尚不明确。微小RNA（miRNA）是一组非编码RNA，是公认的基因表达的重要调控因子。研究表明miRNA在UC中具有表达差异，靶向miRNA参与的转录后基因表达调控，在UC中主要调控肠上皮屏障功能、免疫稳态和炎症平衡。因此，基于miRNA的药物有望成为治疗UC的潜在创新药物。在防治UC方面，中医药应用广泛、疗效显著，显示出多靶点、多通路的独特优势，但目前尚缺少中医药调控miRNA防治UC的系统总结。本文通过归纳miRNA在UC中的作用机制和调控miRNA差异表达防治UC的中药复方及有效成分，发现中医药通过调节miRNA介导的肠上皮屏障受损、细胞凋亡、炎症、免疫细胞异常分化等多种病理生理过程改善了UC。该综述为未来针对调控miRNA防治UC的研究提供理论参考和研究指引。