Intestinal macrophages play crucial roles in both intestinal inflammation and immune homeostasis. They can adopt two distinct phenotypes

primarily determined by environmental cues. These phenotypes encompass the classically activated pro-inflammatory M1 phenotype

as well as the alternatively activated anti-inflammatory M2 phenotype. In regular conditions

intestinal macrophages serve to shield the gut from inflammatory harm. However

when a combination of genetic and environmental elements influences the polarization of these macrophages

it can result in an M1/M2 macrophage activation imbalance

subsequently leading to a loss of control over intestinal inflammation. This shift transforms normal inflammatory responses into pathological damage within the intestines. In patients with ulcerative colitis-associated colorectal cancer (UC-CRC)

disorders related to intestinal inflammation are closely correlated with an imbalance in the polarization of intestinal M1/M2 macrophages. Therefore

reinstating the equilibrium in M1/M2 macrophage polarization could potentially serve as an effective approach to the prevention and treatment of UC-CRC. This paper aims to scrutinize the clinical evidence regarding Chinese medicine (CM) in the treatment of UC-CRC

the pivotal role of macrophage polarization in UC-CRC pathogenesis

and the potential mechanisms through which CM regulates macrophage polarization to address UC-CRC. Our objective is to offer fresh perspectives for clinical application

fundamental research

and pharmaceutical advancement in UC-CRC.