炎症性肠病（inflammatory bowel disease，IBD）是一类病因未明、病程迁延反复的慢性肠道炎症性疾病，临床治疗难度较高，而中医药在其防治领域展现出独特优势。苦参为豆科槐属植物苦参Sophora flavescens的干燥根，是临床治疗IBD的常用中药，其化学成分复杂，目前已从中分离出百余种活性成分，其中以氧化苦参碱、苦参碱等为代表的生物碱类，以及苦参酮、降苦参酮、苦参醇F等为代表的黄酮类，是其发挥抗IBD作用的核心药效物质基础。现代药理学研究证实，苦参治疗IBD具有多途径、多靶点的协同作用特点，具有抗炎、抗氧化应激、调节免疫、调节肠道菌群、保护肠道屏障和抑制肠道上皮细胞凋亡、铁死亡及焦亡等程序性死亡过程的多重药理作用。临床应用中，苦参常与地榆、青黛、黄芪等药材配伍形成药对，或组成当归贝母苦参丸、青赤散等复方制剂，实现协同增效，用于IBD的临床治疗。通过系统综述苦参抗IBD的药效物质基础、药动学特征、作用机制及临床应用，梳理当前研究现状，并展望未来研究方向，为苦参在IBD治疗中的进一步开发利用及临床合理应用提供坚实的科学依据。

Inflammatory bowel disease (IBD) is a group of chronic recurrent intestinal inflammatory diseases with unclear etiology and protracted course, which poses great challenges to clinical treatment. Traditional Chinese medicine (TCM) exhibits unique advantages in the prevention and treatment of IBD. Sophora flavescens, belonging to the genus Sophora of the Leguminosae family, has its dried roots used as a commonly prescribed TCM herb for the clinical management of IBD. It possesses complex chemical constituents, and more than one hundred active ingredients have been isolated from it to date. Among these, alkaloids represented by oxymatrine and matrine, as well as flavonoids such as kurarinone, norkurarinone and kushenol F, constitute the core pharmacodynamic material basis for its anti-IBD effect. Modern pharmacological studies have confirmed that S. flavescentis exerts synergistic effects against IBD through multiple pathways and targets. It possesses multiple pharmacological activities, including anti-inflammation, anti-oxidative stress, immune regulation, gut microbiota modulation, intestinal barrier protection, as well as regulation of programmed cell death such as intestinal epithelial cell apoptosis, ferroptosis and pyroptosis. In clinical practice, S. flavescentis is often combined with medicinal herbs such as Sanguisorbae Radix (Diyu), Indigo Naturalis (Qingdai) and Astragali Radix (Huangqi) to form herb pairs, or compound preparations including Danggui Beimu Kushen Pill (当归贝母苦参丸) and Qingchi Powder (青赤散), to achieve synergistic efficacy in the clinical treatment of IBD. This article systematically reviews the pharmacodynamic material basis, pharmacokinetic characteristics, action mechanisms and clinical applications of S. flavescentis against IBD, summarizes the current research progress and prospects future research directions, aiming to provide a solid scientific basis for the further development, utilization and rational clinical application of S. flavescentis in the treatment of IBD.

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国家自然科学基金面上项目（81973625）；河南省科技研发计划联合基金（242301420114，252301420095）；河南省科技攻关项目（232102311221，262102311235）；河南省医学科技攻关项目（LHGJ20250412）；河南省中医药重点学科-中医肛肠病学（CZ-0404-08）