Targeting inflammasome in digestive diseases: A dual approach of Western and Chinese medicine

Table 1 Traditional Chinese medicine syndrome-based classification, indications, and contraindications of herbal interventions for NOD-like receptor family pyrin domain-containing 3-mediated digestive diseases

TCM intervention	TCM syndrome type	Core therapeutic principle	Typical digestive indications	Clinical contraindications/cautions
Saikosaponin-d (from Bupleurum Chinense)	Liver depression and spleen deficiency	Soothing liver, harmonizing stomach, tonifying spleen	Chronic hepatitis, MASLD with qi stagnation	Avoid in yin deficiency with fire
Ursolic acid (from Crataegus/Ligustrum)	Damp-heat in the intestines	Clearing heat, resolving dampness, relieving toxicity	UC (active phase)	Caution in spleen deficiency with cold
Emodin (from Rheum palmatum)	Heat toxin and blood stasis	Purging heat, removing stasis, unblocking fu organs	AP, severe constipation	Contraindicated in pregnancy and spleen-stomach deficiency
Curcumin (from Curcuma longa)	Damp-heat jaundice	Clearing damp-heat, promoting gallbladder function, protecting liver	Viral hepatitis, cholestasis	Use with caution in blood deficiency
Buzhong Yiqi decoction	Spleen qi sinking	Tonifying middle-qi, lifting yang, replenishing qi	IBD in remission, chronic diarrhea with fatigue	Contraindicated in Damp-Heat syndrome (e.g., active UC with bloody diarrhea, fever, greasy tongue coating) – may “block the pathogen” and worsen inflammation
Shaoyao decoction	Damp-heat dysentery	Clearing heat, drying dampness, regulating qi and blood	Active UC, bacterial dysentery	Avoid in spleen deficiency with cold diarrhea
Qingyi decoction	Excessive heat in fu organs	Clearing heat, detoxifying, purging fu organs, reducing turbidity	AP (early stage)	Contraindicated in chronic deficiency patterns

AP: Acute pancreatitis; TCM: Traditional Chinese medicine; MASLD: Metabolic dysfunction-associated steatotic liver disease; IBD: Inflammatory bowel disease; UC: Ulcerative colitis.