Research Progress on the Diagnosis and Treatment of Intestinal Fibrosis in Crohn's Disease with Traditional Chinese and Western Medicine

Context: Intestinal fibrosis, a severe complication of Crohn's disease (CD), arises from multifactorial interactions, including chronic inflammation, genetic predisposition, gut microbiota dysbiosis, and impaired mucosal barrier function. Objectives: Since intestinal fibrosis often leads to irreversible stenosis and obstruction symptoms, this article will focus on a series of reviews on the progress of traditional Chinese and Western medicine in the diagnosis and treatment of intestinal fibrosis in CD. Methods: We conducted a systematic literature search in PubMed, CNKI, and Wanfang databases using the keywords: 'Crohn's disease', 'intestinal fibrosis', and 'Traditional Chinese Medicine (TCM)'. The initial search yielded 216 articles. After removing duplicates (n = 146), 70 articles underwent full-text screening based on predefined criteria. Results: Current diagnostic modalities for CD-related intestinal fibrosis are well-established. However, neither pharmacological agents nor TCM therapies have demonstrated definitive efficacy in reversing fibrosis in clinical settings. Conclusions: Despite the current absence of clinically approved antifibrotic drugs, this review synthesizes critical advances in mechanistic understanding and emerging therapeutic strategies. We highlight the urgent unmet clinical need and propose integrative medicine as a promising paradigm shift for fibrosis management. While no therapies yet fully reverse established fibrosis, this review provides three key contributions: Systematically maps molecular pathways from inflammation to fibrosis, identifies knowledge gaps in TCM translational research, and proposes a “control-prevent-reverse” framework for future drug development. These insights are timely given the rising CD prevalence in China and increasing NIH funding for antifibrotic research.