This paper summarized the clinical experience of Professor WANG Shouchuan，a renowned traditional Chinese medicine(TCM) practitioner，in the integrated internal and external treatment and pentad therapy of pediatric ulcerative colitis(UC).Although the UC in children primarily affects the large intestine，its root cause lies in the spleen.The pathogenesis is based on spleen deficiency leading to impaired transportation，with the large intestine experiencing dampness-heat as a secondary manifestation.The obstruction of the flow of qi is the central issue，while blood stasis caused by collateral damage progresses as a gradual complication，and the accumulation of toxic heat intensifies the condition.In clinical practice，internal treatment using the pentad therapy focuses on strengthening the spleen，benefiting qi，and stabilizing the root; clearing heat，drying dampness，and addressing the secondary symptoms; regulating qi to resolve stagnation and adjust the central mechanisms; activating blood to dissolve stasis and prevent progression; cooling the blood to remove toxin and address the severe condition.External treatment involves the use of TCM enema therapy，which directly reaches the affected area，enhancing the therapeutic effects synergistically.