韩卓君 吴小平 严明煜 史胜楠 邓艳萍 张露 王培利

摘要 肠道菌群（IF）被称为体内最大的“内分泌器官”，能够产生具有生物活性的大量代谢产物，影响宿主生理病理过程。研究表明，某些中药不仅可以调节益生菌或益生元，而且本身具有益生菌、益生元作用，可通过肠道菌群发挥多种生物学效应，通过调控肠道菌群结构和功能来治疗相关疾病;同时肠道菌群可能具有增加中药药效或降低中药毒性的作用。其相互作用机制涉及逆转氧化三甲胺（TMAO）、减少内毒素、抑制病原菌定植、增加肠黏膜sIgA分泌、抑制α-糖苷酶活性等。现就中药与肠道菌群相互作用机制及利用肠道菌群干预相关疾病进行理论探讨，为未来研究提供方向。

关键词 肠道菌群;中药;作用机制;干预治疗;益生菌;肠道环境;功能;结构

Abstract Intestinal Flora（IF），which is called the largest endocrine organ in the body，produces a large number of bioactive metabolites which affect the physiological and pathological processes of the host.Studies have shown that some Traditional Chinese Medicine（TCM）can not only regulate probiotics or prebiotics，but also have the effect of probiotics and prebiotics.They can play a variety of biological effects through IF and treat related diseases by regulating the structure and function of IF.At the same time，intestinal flora may increase the efficacy or reduce the toxicity of TCM.The interaction mechanism involves reversal of TMAO，reduction of endotoxin，inhibition of colonization of pathogenic bacteria，increase of intestinal mucosa sIgA secretion，inhibition of-glycosidase activity，etc.In this paper，the mechanism of interactions between TCM and IF，and the use of IF to intervene in related diseases were discussed，so as to provide directions for future research.

Keywords Intestinal flora; Traditional Chinese medicine; Mechanism; Intervention treatment; Probiotic; Intestinal environment; Function; Structure

中图分类号：R285文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.24.004

肠道菌群是寄居在人体肠道内的庞大微生物群落，主要功能是维护机体内环境稳态（Homeostasis）和身体健康[1]。当肠道菌群组成、结构或分布发生变化，则会改变宿主体内平衡，扰乱宿主代谢，进而导致疾病。近年来大量研究表明中医药与肠道菌群组成关联密切，口服中药后经胃肠道消化吸收，药效最先作用于胃肠，经过肠道菌群的代谢和运输，达到治疗效果，揭示了中草药与肠道菌群的相互作用[2]。现以肠道菌群为切入点，探讨中医药与肠道菌群相互作用以及治疗相关疾病的机制，为临床提供新的思路。

1 肠道菌群概述

1.1 肠道菌群分布