中草药

基于肠-肺轴探讨中医药保护肺肠屏障防治肺系疾病的研究进展

PDF下载

中草药 | 综述 2026,57(11): 4411-4421

收起

中草药 |综述 2026 , 57 (11) : 4411 -4421

基于肠-肺轴探讨中医药保护肺肠屏障防治肺系疾病的研究进展

全屏

任堂君^1,2, 刘怡曼^1,2, 孟鋆钰^1,2, 孙梦珂^1,2, 杨剑^1,2

作者信息

通讯作者:

孙梦珂

作者简介:

任堂君: 任堂君，硕士研究生，研究方向为中药药理学及中药药剂学。E-mail:rentangjun620@163.com

Research progress on protection of gut-lung barrier by traditional Chinese medicine for prevention and treatment of pulmonary diseases based on gut-lung axis

REN Tangjun, LIU Yiman, MENG Junyu, SUN Mengke, YANG Jian

Affiliations

doi: 10.7501/j.issn.0253-2670.2026.11.027

文章导航

摘要

收起

肠-肺轴是连接呼吸系统与消化系统的重要通路，在维持机体免疫稳态、调控炎症反应及保护黏膜屏障中发挥关键作用。中医“肺与大肠相表里”的理论与现代肠-肺轴概念高度契合，为“肺肠同治”提供了科学依据。研究表明，肠道菌群失衡及屏障功能受损可通过炎症介质与代谢物影响肺部炎症免疫反应，加重慢性阻塞性肺疾病、哮喘及肺纤维化等肺系疾病的发生发展。中医药通过调节肠道菌群及代谢产物（如短链脂肪酸、色氨酸代谢物），并修复黏膜屏障，从整体上改善肠-肺轴稳态，减轻肺部炎症反应与组织损伤。因此，以肠-肺轴为基础，着重阐明了中医药通过调控肠道菌群、菌群代谢产物及黏膜免疫，保护肺肠屏障、防治肺系疾病等主要药效缓解的作用环节的研究进展，为深入阐释“以肠调肺”的作用机制及中医药防治呼吸系统疾病提供了新思路。

关键词

肠-肺轴 / 肺肠屏障 / 中医药 / 肺系疾病 / 肠道菌群

Abstract

收起

The gut-lung axis is an important pathway connecting the respiratory system and the digestive system, playing a key role in maintaining immune homeostasis, regulating inflammatory responses, and protecting the mucosal barrier. Traditional Chinese medicine (TCM) theory that “the lung and the large intestine are exterior-interior related” is highly consistent with the modern concept of gut-lung axis, providing a scientific basis for “lung and intestine co-treatment”. Studies have shown that the imbalance of the intestinal flora and the damage of the barrier function can affect the inflammatory immune response in lungs through inflammatory mediators and metabolites, aggravating the occurrence and development of lung diseases such as chronic obstructive pulmonary disease, asthma and pulmonary fibrosis. TCM can improve the stability of gut-lung axis as a whole by regulating the intestinal flora and metabolic products (such as short-chain fatty acids and tryptophan metabolites), and repairing the mucosal barrier, thereby reducing the inflammatory response and tissue damage in lungs. Therefore, based on gut-lung axis, this paper mainly expounds the research progress of the main therapeutic effect relief links of traditional Chinese medicine throug regulating intestinal flora, flora metabolites and mucosal immunity, protecting lung-intestine barrier and preventing and treating lung diseases, providing a new idea for in-depth explanation of mechanism of “regulating the lung through the intestine” and the prevention and treatment of respiratory diseases by TCM.

Key words

gut-lung axis / gut-lung barrier / traditional Chinese medicine / pulmonary diseases / gut microbiota

引用本文

任堂君, 刘怡曼, 孟鋆钰, 孙梦珂, 杨剑. 基于肠-肺轴探讨中医药保护肺肠屏障防治肺系疾病的研究进展. 中草药, 2026 , 57 (11) : 4411 -4421 . DOI: 10.7501/j.issn.0253-2670.2026.11.027

REN Tangjun, LIU Yiman, MENG Junyu, SUN Mengke, YANG Jian. Research progress on protection of gut-lung barrier by traditional Chinese medicine for prevention and treatment of pulmonary diseases based on gut-lung axis[J]. Chinese Traditional and Herbal Drugs, 2026 , 57 (11) : 4411 -4421 . DOI: 10.7501/j.issn.0253-2670.2026.11.027

基金

收起

现代中药新质生产力科技创新工程专项 (24ZXZKSY00050); 国家自然科学基金资助项目 (62231025)

参考文献

收起

文献

收起

参考文献引证文献

排序方式：

Wang X J, Chen L, Cai M, et al. Air pollution associated with incidence and progression trajectory of chronic lung diseases: A population-based cohort study [J]. Thorax, 2023, 78(7): 698-705.
Maher T M. Interstitial lung disease: A review [J]. JAMA, 2024, 331(19): 1655.
Wang X L, Hou L M, Cui M, et al. The traditional Chinese medicine and non-small cell lung cancer: From a gut microbiome perspective [J]. Front Cell Infect Microbiol, 2023, 13: 1151557.
Narayana J K, Aliberti S, Mac Aogáin M, et al. Microbial dysregulation of the gut-lung axis in bronchiectasis [J]. Am J Respir Crit Care Med, 2023, 207(7): 908-920.
Wang Y H, Yan Z Z, Luo S D, et al. Gut microbiota-derived succinate aggravates acute lung injury after intestinal ischaemia/reperfusion in mice [J]. Eur Respir J, 2023, 61(2): 2200840.
Ma P J, Wang M M, Wang Y. Gut microbiota: A new insight into lung diseases [J]. Biomed Pharmacother, 2022, 155: 113810.
Yuksel N, Gelmez B, Yildiz-Pekoz A. Lung microbiota: Its relationship to respiratory system diseases and approaches for lung-targeted probiotic bacteria delivery [J]. Mol Pharm, 2023, 20(7): 3320-3337.
Alqahtani S A M. Mucosal immunity in COVID-19: A comprehensive review [J]. Front Immunol, 2024, 15: 1433452.
Ye L, Fan S C, Zhao P F, et al. Potential herb-drug interactions between anti-COVID-19 drugs and traditional Chinese medicine [J]. Acta Pharm Sin B, 2023, 13(9): 3598-3637.
Xia K Y, Zhao Z Y, Shah T, et al. Composition, clinical efficiency, and mechanism of NHC-approved “three Chinese medicines and three Chinese recipes” for COVID-19 treatment [J]. Front Pharmacol, 2022, 12: 781090.
Xu H B, Chen X Z, Wang X, et al. Xihuang Pill in the treatment of cancer: TCM theories, pharmacological activities, chemical compounds and clinical applications [J]. J Ethnopharmacol, 2023, 316: 116699.
Yu D L, Lou Z P, Ma F Y, et al. The interactions of paclitaxel with tumour microenvironment [J]. Int Immunopharmacol, 2022, 105: 108555.
Ashrafizadeh M, Zarrabi A, Hashemi F, et al. Curcumin in cancer therapy: A novel adjunct for combination chemotherapy with paclitaxel and alleviation of its adverse effects [J]. Life Sci, 2020, 256: 117984.
Wang H, Wang Y. What makes the gut-lung axis working? From the perspective of microbiota and traditional Chinese medicine [J]. Can J Infect Dis Med Microbiol, 2024, 2024: 8640014.
Luo T T, Che Q Y, Guo Z Y, et al. Modulatory effects of traditional Chinese medicines on gut microbiota and the microbiota-gut-x axis [J]. Front Pharmacol, 2024, 15: 1442854.
Zheng L X, Fu Y, Wu J W, et al. Modulation of gut microbiota by traditional Chinese medicine: A novel therapeutic approach for chronic inflammatory airway diseases [J]. Am J Chin Med, 2025, 53(7): 2043-2070.
Chen Z J, Liu Y Q, Huang W Z. Alveolar macrophage modulation via the gut–lung axis in lung diseases [J]. Front Immunol, 2023, 14: 1279677.
Enaud R, Prevel R, Ciarlo E, et al. The gut-lung axis in health and respiratory diseases: A place for inter-organ and inter-Kingdom crosstalks [J]. Front Cell Infect Microbiol, 2020, 10: 9.
Liu S Y, Sun D W, Butler R, et al. RTK signalling promotes epithelial columnar cell shape and apical junction maintenance in human lung progenitor cells [J]. Development, 2023, 150(11): dev201284.
Saint-Criq V, Lugo-Villarino G, Thomas M. Dysbiosis, malnutrition and enhanced gut-lung axis contribute to age-related respiratory diseases [J]. Ageing Res Rev, 2021, 66: 101235.
Zhang F, Lau R I, Liu Q, et al. Gut microbiota in COVID-19: Key microbial changes, potential mechanisms and clinical applications [J]. Nat Rev Gastroenterol Hepatol, 2023, 20(5): 323-337.
Espírito Santo C, Caseiro C, Martins M J, et al. Gut microbiota, in the halfway between nutrition and lung function [J]. Nutrients, 2021, 13(5): 1716.
Burrows K, Ngai L, Chiaranunt P, et al. A gut commensal protozoan determines respiratory disease outcomes by shaping pulmonary immunity [J]. Cell, 2025, 188(2): 316-330.
Hufnagl K, Pali-Schöll I, Roth-Walter F, et al. Dysbiosis of the gut and lung microbiome has a role in asthma [J]. Semin Immunopathol, 2020, 42(1): 75-93.
Xue S C, Abdullahi R, Wu N S, et al. Gut microecological regulation on bronchiolitis and asthma in children: A review [J]. Clin Respir J, 2023, 17(10): 975-985.
Martín R, Rios-Covian D, Huillet E, et al. Faecalibacterium: A bacterial genus with promising human health applications [J]. FEMS Microbiol Rev, 2023, 47(4): fuad039.
Chen C, Wang J L, Cheng M Q, et al. Muribaculum intestinale-derived 3-hydroxybutyric acid from heterophyllin B attenuated pulmonary fibrosis through IDO1-mediated ferroptosis [J]. Pharmacol Res, 2025, 212: 107587.
Wang W F, Li Y F, Han G J, et al. Lactobacillus fermentum CECT5716 alleviates the inflammatory response in asthma by regulating TLR2/TLR4 expression [J]. Front Nutr, 2022, 9: 931427.
Jia M J, Liu Y M, Liu J, et al. Xuanfei Baidu Decoction ameliorates bleomycin-elicited idiopathic pulmonary fibrosis in mice by regulating the lung-gut crosstalk via IFNγ/STAT1/STAT3 axis [J]. Phytomedicine, 2024, 135: 155997.
Tang J, Xu L Q, Zeng Y W, et al. Effect of gut microbiota on LPS-induced acute lung injury by regulating the TLR4/NF-kB signaling pathway [J]. Int Immunopharmacol, 2021, 91: 107272.
Xia F, Wen L P, Ge B C, et al. Gut microbiota as a target for prevention and treatment of type 2 diabetes: Mechanisms and dietary natural products [J]. World J Diabetes, 2021, 12(8): 1146-1163.
Zhang D, Jian Y P, Zhang Y N, et al. Short-chain fatty acids in diseases [J]. Cell Commun Signal, 2023, 21(1): 212.
Hildebrand C B, Lichatz R, Pich A, et al. Short-chain fatty acids improve inflamm-aging and acute lung injury in old mice [J]. Am J Physiol Lung Cell Mol Physiol, 2023, 324(4): L480-L492.
Antunes K H, Stein R T, Franceschina C, et al. Short-chain fatty acid acetate triggers antiviral response mediated by RIG-I in cells from infants with respiratory syncytial virus bronchiolitis [J]. eBioMedicine, 2022, 77: 103891.
Li X P, Shang S J, Wu M, et al. Gut microbial metabolites in lung cancer development and immunotherapy: Novel insights into gut-lung axis [J]. Cancer Lett, 2024, 598: 217096.
Rowland S N, Green C G, Halliwill J R, et al. Gut feelings on short-chain fatty acids to regulate respiratory health [J]. Trends Endocrinol Metab, 2025, 36(10): 889-898.
Niu J L, Cui M M, Yang X, et al. Microbiota-derived acetate enhances host antiviral response via NLRP3[J]. Nat Commun, 2023, 14: 642.
Wypych T P, Pattaroni C, Perdijk O, et al. Microbial metabolism of L-tyrosine protects against allergic airway inflammation [J]. Nat Immunol, 2021, 22(3): 279-286.
Sun Y L, Yu G, Wang X Y, et al. Elimination of gut microbiota hinders the therapeutic effect of amentoflavone on respiratory syncytial virus-induced lung inflammation injury by regulating innate immunity [J]. Phytomedicine, 2025, 145: 157033.
Stutz M R, Dylla N P, Pearson S D, et al. Immunomodulatory fecal metabolites are associated with mortality in COVID-19 patients with respiratory failure [J]. Nat Commun, 2022, 13: 6615.
Zhang T Y, Zhao X Y, Zhang X N, et al. Research on the metabolic regulation mechanism of Yangyin Qingfei Decoction plus in severe pneumonia caused by Mycoplasma pneumoniae in mice [J]. Front Pharmacol, 2024, 15: 1376812.
Di M M, Niu F B, Yang P, et al. Integrated metabolomics and gut microbiota analysis to explore potential mechanism of Qi-Huo-Yi-Fei Formula against chronic obstructive pulmonary disease [J]. J Pharm Biomed Anal, 2025, 252: 116511.
Zhang Y J, Wan Y D, Xin X, et al. Signals from intestinal microbiota mediate the crosstalk between the lung-gut axis in an influenza infection mouse model [J]. Front Immunol, 2024, 15: 1435180.
Xue C, Li G L, Zheng Q X, et al. Tryptophan metabolism in health and disease [J]. Cell Metab, 2023, 35(8): 1304-1326.
Wang P T, Tao W, Li Q J, et al. Indole-3-aldehyde alleviates lung inflammation in COPD through activating aryl hydrocarbon receptor to inhibit HDACs/NF-κB/ NLRP3 signaling pathways [J]. J Mol Med, 2025, 103(2): 157-174.
Yan Z Z, Chen B X, Yang Y Q, et al. Multi-omics analyses of airway host-microbe interactions in chronic obstructive pulmonary disease identify potential therapeutic interventions [J]. Nat Microbiol, 2022, 7(9): 1361-1375.
Shaheen N, Miao J X, Li D, et al. Indole-3-acetic acid protects against lipopolysaccharide-induced endothelial cell dysfunction and lung injury through the activation of USP40[J]. Am J Respir Cell Mol Biol, 2024, 71(3): 307-317.
Wang H C, He Y, Dang D T, et al. Gut microbiota-derived tryptophan metabolites alleviate allergic asthma inflammation in ovalbumin-induced mice [J]. Foods, 2024, 13(9): 1336.
Ni S L, Yuan X L, Cao Q H, et al. Gut microbiota regulate migration of lymphocytes from gut to lung [J]. Microb Pathog, 2023, 183: 106311.
Albarracin L, Dentice Maidana S, Fukuyama K, et al. Orally administered Lactobacilli strains modulate alveolar macrophages and improve protection against respiratory superinfection [J]. Biomolecules, 2024, 14(12): 1600.
Yin Z Y, Zhou Y W, Turnquist H R, et al. Neuro-epithelial-ILC2 crosstalk in barrier tissues [J]. Trends Immunol, 2022, 43(11): 901-916.
Du B X, Fu Y, Han Y X, et al. The lung-gut crosstalk in respiratory and inflammatory bowel disease [J]. Front Cell Infect Microbiol, 2023, 13: 1218565.
Lei L H, Zhang X L, Yang R, et al. Host immune response to clinical hypervirulent Klebsiella pneumoniae pulmonary infections via transcriptome analysis [J]. J Immunol Res, 2022, 2022(1): 5336931.
Liu C, Xiao K, Xie L X. Advances in the use of exosomes for the treatment of ALI/ARDS [J]. Front Immunol, 2022, 13: 971189.
Xu P, Yang Z, Du S Q, et al. Intestinal microbiota analysis and network pharmacology reveal the mechanism by which Lianhua Qingwen Capsule improves the immune function of mice infected with influenza A virus [J]. Front Microbiol, 2022, 13: 1035941.
Lian B, He S S, Jiang H, et al. Qin-Qiao-Xiao-Du Formula alleviate influenza virus infectious pneumonia through regulation gut microbiota and metabolomics [J]. Front Med, 2022, 9: 1032127.
Hao Y Z, Cen L F, Wang T, et al. The protective effect of 999 Xiaoerganmao Granules on the lungs and intestines of influenza A virus-infected mice [J]. Pharm Biol, 2023, 61(1): 630-638.
Ding Z H, Zhong R X, Yang Y N, et al. Systems pharmacology reveals the mechanism of activity of Ge-Gen-Qin-Lian Decoction against LPS-induced acute lung injury: A novel strategy for exploring active components and effective mechanism of TCM formulae [J]. Pharmacol Res, 2020, 156: 104759.
Liu X W, Yuan L, Tang Y S, et al. Da-Cheng-Qi Decoction improves severe acute pancreatitis-associated acute lung injury by interfering with intestinal lymphatic pathway and reducing HMGB1-induced inflammatory response in rats [J]. Pharm Biol, 2023, 61(1): 144-154.
Wang Z J, Liu J, Li F, et al. Mechanisms of Qingyi Decoction in severe acute pancreatitis-associated acute lung injury via gut microbiota: Targeting the short-chain fatty acids-mediated AMPK/NF-κB/NLRP3 pathway [J]. Microbiol Spectr, 2023, 11(4): e03664-e03622.
Guo L F, Bao W L, Yang S Y, et al. Rhei Radix et Rhizoma in Xuanbai-Chengqi Decoction strengthens the intestinal barrier function and promotes lung barrier repair in preventing severe viral pneumonia induced by influenza A virus [J]. J Ethnopharmacol, 2024, 319: 117231.
Hu T T, Zhu Y, Zhu J, et al. Wine-processed Radix Scutellariae alleviates ARDS by regulating tryptophan metabolism through gut microbiota [J]. Front Pharmacol, 2023, 13: 1104280.
Wang J, Xue X Y, Zhao X T, et al. Forsythiaside A alleviates acute lung injury by inhibiting inflammation and epithelial barrier damages in lung and colon through PPAR-γ/RXR-α complex [J]. J Adv Res, 2024, 60: 183-200.
Song W, Yang X T, Wang W Q, et al. Sinomenine ameliorates septic acute lung injury in mice by modulating gut homeostasis via aryl hydrocarbon receptor/Nrf2 pathway [J]. Eur J Pharmacol, 2021, 912: 174581.
Ren T Y, Chen Q H, Xu J Z, et al. Xuebijing alleviates sepsis-induced acute lung injury by inhibiting alveolar epithelial cell apoptosis via cAMP/PKA signaling pathway [J]. J Ethnopharmacol, 2025, 353: 120370.
Mei Q R, Liu Z, Zuo H, et al. Idiopathic pulmonary fibrosis: An update on pathogenesis [J]. Front Pharmacol, 2022, 12: 797292.
Sheng G H, Chen P, Wei Y Q, et al. Viral infection increases the risk of idiopathic pulmonary fibrosis a Meta-analysis [J]. Chest, 2020, 157(5): 1175-1187.
Zhang Q, Luo T, Yuan D Z, et al. Qi-Long-Tian Capsule alleviates pulmonary fibrosis development by modulating inflammatory response and gut microbiota [J]. Funct Integr Genom, 2023, 23(1): 64.
Wei Y, Qi M, Liu C, et al. Astragalus polysaccharide attenuates bleomycin-induced pulmonary fibrosis by inhibiting TLR4/NF-κB signaling pathway and regulating gut microbiota [J]. Eur J Pharmacol, 2023, 944: 175594.
Li Z H, Shen Y H, Xin J Y, et al. Cryptotanshinone alleviates radiation-induced lung fibrosis via modulation of gut microbiota and bile acid metabolism [J]. Phytother Res, 2023, 37(10): 4557-4571.
Biswas D, Mandal S, Chatterjee Saha S, et al. Ethnobotany, phytochemistry, pharmacology, and toxicity of Centella asiatica (L.) Urban: A comprehensive review [J]. Phytother Res, 2021, 35(12): 6624-6654.
Liu X Q, Liang Q Z, Wang Y F, et al. Advances in the pharmacological mechanisms of berberine in the treatment of fibrosis [J]. Front Pharmacol, 2024, 15: 1455058.
Barcik W, Boutin R C T, Sokolowska M, et al. The role of lung and gut microbiota in the pathology of asthma [J]. Immunity, 2020, 52(2): 241-255.
He R, Wang S H, Yang S X, et al. Shaoyao-Gancao-Tang regulates the T-helper-type 1/T-helper-type 2 ratio in the lung and gut and alters gut microbiota in rats with ovalbumin-induced asthma [J]. J Ethnopharmacol, 2023, 309: 116300.
Liao W Z, Liu W, Yan Y, et al. Hylocereus undatus flower extract suppresses OVA-induced allergic asthma in BALB/c mice by reducing airway inflammation and modulating gut microbiota [J]. Biomed Pharmacother, 2022, 153: 113476.
Cui F, Shi C L, Zhou X J, et al. Lycium barbarum polysaccharide extracted from Lycium barbarum leaves ameliorates asthma in mice by reducing inflammation and modulating gut microbiota [J]. J Med Food, 2020, 23(7): 699-710.
Li J Q, Hu J Q, Zhuo D L, et al. Ginger-processed Magnoliae Officinalis Cortex ameliorates ovalbumin-induced asthma by alleviating inflammation via the gut-lung axis [J]. Phytomedicine, 2025, 145: 156971.
Hong Y F, Cui J Q, Xu G C, et al. Intestinal IL-17 family orchestrates microbiota-driven histone deacetylation and promotes Treg differentiation to mediate the alleviation of asthma by Ma-Xing-Shi-Gan Decoction [J]. Phytomedicine, 2025, 142: 156656.
Todoroff C M, Berry M J. Body composition, physical function and exercise capacity in chronic obstructive pulmonary disease [J]. COPD J Chronic Obstr Pulm Dis, 2023, 20(1): 256-261.
Yang I A, Jenkins C R, Salvi S S. Chronic obstructive pulmonary disease in never-smokers: Risk factors, pathogenesis, and implications for prevention and treatment [J]. Lancet Respir Med, 2022, 10(5): 497-511.
Zhang G, Li Q, Zhang J. Clinical effects of traditional Chinese medicine + azithromycin in the treatment of Mycoplasma Pneumonia [J]. Int J Gen Med, 2025, 18: 825-833.
Wang J M, Ren C X, Jin L L, et al. Seabuckthorn Wuwei Pulvis attenuates chronic obstructive pulmonary disease in rat through gut microbiota-short chain fatty acids axis [J]. J Ethnopharmacol, 2023, 314: 116591.
Mao J, Li Y, Bian Q Q, et al. The Bufei Jianpi Formula improves mucosal immune function by remodeling gut microbiota through the SCFAs/GPR43/NLRP3 pathway in chronic obstructive pulmonary disease rats [J]. Int J Chronic Obstr Pulm Dis, 2022, 17: 1285-1298.
Jia Y, He T T, Wu D, et al. The treatment of Qibai Pingfei Capsule on chronic obstructive pulmonary disease may be mediated by Th17/Treg balance and gut-lung axis microbiota [J]. J Transl Med, 2022, 20(1): 281.

2026年第57卷第11期

PDF下载

引用本文

BibTeX

文章信息

doi: 10.7501/j.issn.0253-2670.2026.11.027

接收时间：2025-11-04
首发时间：2026-09-09

补充材料

相关文章

文章信息

作者

出版历史

收稿日期：2025-11-04

基金

作者信息

参考文献

分享链接

https://castjournals.cast.org.cn/joweb/zcy/CN/10.7501/j.issn.0253-2670.2026.11.027

分享至

全文二维码

扫描看全文

引用本文

BibTeX

本文的引用情况

2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

关闭全屏

BibTeX
EndNote
RefWorks
TxT