伊立替康是治疗结直肠癌复发和恶化的常见化疗药物，其引起的迟发型腹泻、恶心、呕吐等胃肠道毒副作用严重限制了其临床应用。研究表明伊立替康的胃肠道毒副作用与其在"肠道菌群-肠-肝"轴中的代谢，及其诱导的胆汁酸、色氨酸等内源性物质代谢紊乱密切相关。在综述伊立替康在"肠道菌群-肠-肝"轴中的代谢及其对内源性物质代谢影响的基础上，分析内源性物质代谢异常与伊立替康胃肠道毒副反应间的关系，并介绍常见中药对其调控及防治作用，以期为相关药物的开发及深入研究提供参考。

Irinotecan was a commonly used chemotherapeutic drug for treating colorectal cancer recurrence and deterioration. Despite its good efficacy, gastrointestinal toxicities such as delayed-onset diarrhea, nausea, and vomiting have severely restrained its clinical application. Recent studies have suggested that the gastrointestinal toxicities of irinotecan were closely related to its metabolism in microbiota-gut-liver axis and the associated bile acid and tryptophan metabolic disturbance. Therefore, this review was mainly focused on the relationship between the disturbed metabolism of endogenous and gastrointestinal toxicities of irinotecan. What's more, in order to provide reference for further study and development of related drugs, the effect of Chinese materia medica in intervention and treatment of irinotecan-induced gastrointestinal toxicity have also been discussed.

国家自然科学基金资助项目（81202983）；江苏省自然科学基金资助项目（BK20171491）