OBJECTIVE: To evaluate the efficacy of herb-partitioned moxibustion(HPM) at Qihai(CV6), Tianshu(ST25) and Shangjuxu(ST37) acupoints in relieving symptoms and the immune regulation of HPM on the toll-like receptors 4(TLR4) signaling pathway in ulcerative colitis(UC) patients.METHODS: A randomized, single-blind study was conducted 63 patients to receive HPM or sham HPM treatment. The efficacy outcomes included scores of the Mayo, Baron, inflammatory bowel disease questionnaire(IBDQ), self-rating depression scale(SDS), self-rating anxiety scale(SAS). HE staining was used to observe the histopathological changes of the colon. The expression of inflammatory cytokines and TLR4 signaling pathway related molecules were determined by enzyme-linked immunosorbent assay and immunohistochemistry.RESULTS: Baron, SDS, SAS scores were significantly decreased in moxibustion group(P < 0.05), IBDQ score was significantly greater in the moxibustion group than in the sham moxibustion group(P < 0.05). Histopathology of mucosal biopsies showed that both two groups improved in mucosa after treatment. The expression levels of tumor necrosis factor-α, interleukin-2, interleukin-12, interferon-γ, and TLR4, lipopolysaccharide, myeloid differentiation factor 88, interleukin receptor associated kinase, tumor necrosis factor receptor associated factor 6 and nuclear factor kappa-B p65 were significantly lower in the moxibustion group than in the sham moxibustion group(P < 0.05).CONCLUSION: This study showed that HPM at Qihai(CV6), Tianshu(ST25) and Shangjuxu(ST37) acupoints is effective to relieve symptoms, anxiety, depression and improving life quality in UC patients,which may be related to the immune regulation of HPM on TLR4 signaling pathway.