基于“肠道微生物群-短链脂肪酸”轴的中医药防治溃疡性结肠炎作用机制研究进展

doi:10.3969/j.issn.1006-5725.2026.15.011

Abstract

Abstract:

The dysfunction of the gut microbiota-short-chain fatty acids （SCFAs） axis serves as a crucial microecological mechanism underlying the onset and progression of ulcerative colitis （UC）. As key metabolites of the gut microbiota， SCFAs are involved in the pathological process of UC by maintaining the integrity of the intestinal mucosal barrier， regulating immune and inflammatory responses， restoring microecological homeostasis， and inhibiting inflammatory signaling pathways. Traditional Chinese medicine （TCM） is distinguished by its multi-component， multi-target， and holistic regulatory effects. It can modulate the composition of the gut microbiota， enrich SCFA-producing strains， and increase SCFA levels， thus exerting protective effects on the intestinal mucosa， anti-inflammatory effects， and immunomodulatory effects. The article summarizes the research progress of TCM in intervening in UC through regulating the gut microbiota-SCFA axis， discusses existing problems and future research directions， and offers theoretical evidence for the prevention and treatment of UC with TCM targeting intestinal microecology.

Key words: gut microbiota-short-chain fatty acids, ulcerative colitis, traditional Chinese medicine, mechanism of action

CLC Number:

R259

Xuelian KANG,Bo ZHANG,Pengfei YANG. Research progress on mechanism of traditional Chinese medicine in preventing and treating ulcerative colitis based on the gut microbiota-short-chain fatty acid axis[J]. The Journal of Practical Medicine, 2026, 42(15): 2752-2760.

Figures/Tables 3

Fig.1

Fig.2

Tab.1

Summary on the treatment mechanism of ulcerative colitis by Chinese herbal formulas via regulating the gut microbiota-SCFAs axis"

代表复方	中医证型	核心治法	主要调控菌群（丰度变化）	SCFAs变化	核心作用特点	参考文献
参苓白术散	脾虚湿盛证	健脾益气、渗湿止泻	↑普雷沃菌、颤杆菌属；↓脱硫弧菌属、嗜胆菌属	整体升高 SCFAs水平	改善氧化应激，修复肠黏膜，适用于UC缓解期	［35］
理肠汤	脾虚湿盛证	健脾和肠、利湿止泻	↑双歧杆菌、乳杆菌、酵母菌、消化球菌	SCFAs总量升高	抑制NLRP3炎症小体，修复肠紧密连接	［36］
白头翁汤	大肠湿热证	清热利湿、解毒止痢	↑拟杆菌门、毛螺菌属	↑乙酸、丙酸	激活GPR43，抑制HDACs，调控肠屏障与免疫	［37］
加味葛根芩连汤		清热解表、燥湿止利	↑阿克曼菌属、罗斯菌属、毛螺菌科、梭菌属	↑乙酸、丁酸	依赖肠道菌群发挥作用，抗炎、抗氧化、修复肠屏障	［38］
芍药汤		清热燥湿、调气和血	↑厚壁菌门、拟杆菌门、乳杆菌、双歧杆菌	↑乙酸、丙酸、丁酸	调控Th17/Treg平衡，稳定肠道微生态	［39］
榆苋方		清肠化湿、解毒敛疡	↑双歧杆菌、乳酸杆菌；↓肠杆菌、肠球菌	↑乙酸、丙酸	调节胃肠激素，平衡炎症因子，促进黏膜修复	［40］
清肠化湿方		清热化湿、理肠解毒	↑厚壁菌门	↑丁酸	抑制NLRP3通路，保护杯状细胞与肠道干细胞	［41］
复方芩柏颗粒		清热燥湿、凉血解毒	富集多种产SCFAs有益菌	SCFAs总量显著升高	上调SCFAs相关受体GPR41/GPR43/GPR109A，强效抗炎	［42］
青赤散	湿热瘀毒证	清热解毒、凉血止血、收敛生肌	↑乳杆菌、双歧杆菌、丁酸梭菌	↑丁酸、丙酸	调控Treg/Th17平衡，抑制HDAC，重建肠道免疫稳态	［43］
痛泻要方	肝郁脾虚证	疏肝健脾、抑肝扶脾	↑厚壁菌门/拟杆菌门比值	↑丁酸、戊酸	降低促炎因子，修复肠屏障，改善肠道炎症	［44］
四神丸合痛泻要方	脾肾阳虚兼肝郁证	温肾健脾、疏肝止泻	纠正整体菌群紊乱	↑乙酸、丙酸、丁酸	调节免疫平衡，抑制STAT3通路，针对慢性反复发作UC	［45］
半夏泻心汤	寒热错杂证	辛开苦降、寒热平调	↑乳酸杆菌、双歧杆菌、普雷沃菌；↓脱硫弧菌、拟杆菌	促进SCFAs合成	改善菌群失调，减轻黏膜损伤	［46］
乌梅丸	寒热错杂证	寒热并用、涩肠固脱	↑厚壁菌门、拟杆菌门；↓变形菌门	↑丁酸、丙酸	抑制TLR4/MyD88/NF-κB通路，多靶点抗炎、修复肠屏障	［47］

Tab.1

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Research progress on mechanism of traditional Chinese medicine in preventing and treating ulcerative colitis based on the gut microbiota-short-chain fatty acid axis

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