尿液核磁共振（NMR）代谢组学凭借高重复性、高分辨率、高通量的技术特性，成为中医药现代化研究的重要分析工具，可通过检测生物体内小分子代谢物动态变化客观反映机体整体代谢水平，与中医药整体观和辨证论治的核心特点高度契合。系统综述尿液NMR代谢组学在中医药领域的应用进展，发现其可从代谢层面精准揭示中药活性成分、单味中药及复方的药效机制，明确此类药物多通过调控能量、氨基酸、肠道菌群等核心代谢网络发挥作用，且中药复方呈现出“核心代谢网络共性调控、病理环节通路特异调节”的作用特征；同时该技术能客观评价中药安全性，证实中药毒性存在三羧酸循环与丙氨酸-天冬氨酸-谷氨酸代谢紊乱的共性基础，肝、肾等靶器官毒性则具有特异性代谢特征。尽管该领域目前仍面临代谢数据库不完善、代谢通路解析能力有限、临床样本采集与处理标准化不足等挑战，但随着人工智能（AI）技术在代谢物智能识别与模式挖掘中的深度融合，以及代谢组学与基因组学、蛋白组学等多组学整合分析策略的广泛采用，NMR代谢组学的技术瓶颈正被逐步突破。尿液NMR代谢组学已成为连接传统中医与现代生命科学的重要桥梁，随着跨学科方法的深度融合与应用场景的持续开拓，持续推动中医药的传承、创新与国际发展。

Urine nuclear magnetic resonance (NMR) metabolomics, with its high repeatability, high resolution, and high-throughput technical characteristics, has become an important analytical tool in the modernization research of traditional Chinese medicine (TCM). It can objectively reflect the overall metabolic level of the body by detecting the dynamic changes of small molecule metabolites in the body, which is highly consistent with the core characteristics of TCM's holistic view and syndrome differentiation and treatment. This systematic review summarizes the application progress of urine NMR metabolomics in the field of TCM and finds that it can precisely reveal the pharmacological mechanisms of active components of Chinese herbs, single herbs, and compound prescriptions at the metabolic level, and clearly shows that these drugs mainly function by regulating core metabolic networks such as energy, amino acids, and intestinal flora. Moreover, compound prescriptions of TCM exhibit the characteristics of “common regulation of core metabolic networks and specific regulation of pathological pathways”. At the same time, this technology can objectively evaluate the safety of TCM, confirming that the toxicity of TCM has a common basis of tricarboxylic acid cycle and alanine-aspartate-glutamate metabolism disorders, and the toxicity to target organs such as the liver and kidneys has specific metabolic features. Although this field still faces challenges such as incomplete metabolic databases, limited ability to analyze metabolic pathways, and insufficient standardization of clinical sample collection and processing, with the deep integration of artificial intelligence (AI) technology in the intelligent recognition and pattern mining of metabolites, as well as the wide adoption of multi-omics integration analysis strategies such as metabolomics and genomics, proteomics, the technical bottlenecks of NMR metabolomics are being gradually overcome. Urine NMR metabolomics has become an important bridge connecting traditional TCM and modern life sciences. With the deep integration of interdisciplinary methods and the continuous expansion of application scenarios, it will continue to promote the inheritance, innovation, and international development of TCM.

R285.5

国家自然科学基金面上项目（82274362）