急性肺损伤（acute lung injury，ALI）作为呼吸系统疾病，严重时会发展为急性呼吸窘迫综合征。目前，现代医学针对ALI的治疗主要以机械辅助通气、抗炎及激素治疗为主，但药物治疗效果有限，主要集中于改善肺部病理状态，缓解疾病症状，存在一定局限性。因此，寻找一种安全有效的方法预防ALI的发生，是临床亟待解决的重要医学问题。肠道和肺之间的双向通讯枢纽能够影响肠、肺的免疫状态，肠道菌群经“肠-肺轴”途径交互串扰在ALI的发病过程中扮演着重要角色。中医认为肺与大肠相表里，二者在气机升降、津液代谢、阴阳及经络等方面联系紧密。因此，中医药通过发挥整体调节，多靶点交互的独特优势，能调控“肠-肺轴”促进肠道微生物群和代谢物平衡，抑制肺组织氧化应激和炎症反应，治疗ALI。基于此，从“肠-肺轴”治疗ALI的作用机制及药物干预等对其归纳总结，探究肠道菌群失衡与呼吸道疾病的关联，为临床ALI患者预后和探索肠道菌群经“肠-肺轴”干预ALI的防治提供新见解。

Acute lung injury (ALI), as a respiratory disease, can develop into acute respiratory distress syndrome in severe cases. Currently, the treatment of ALI in modern medicine is mainly based on mechanically assisted ventilation, anti-inflammation and hormonal therapy, but the effect of drug therapy is limited and mainly focuses on improving the pathological state of the lungs and relieving the symptoms of the disease, which has certain limitations. Therefore, finding a safe and effective method to prevent ALI is an important medical problem that needs to be solved urgently in clinical practice. The two-way communication hub between the intestine and the lungs can influence the immune status of the intestine and the lungs, and the interaction of intestinal flora through the “intestinal-lung axis” pathway plays an important role in the pathogenesis of ALI. Traditional Chinese medicine (TCM) also believes that the lungs and the large intestine are mutually exclusive, and that they are closely linked in terms of qi elevation, fluid metabolism, yin and yang, and meridians and so on. Therefore, TCM can regulate the intestinal-lung axis to promote the balance of intestinal microbiota and metabolites, inhibit oxidative stress and inflammation in lung tissues, and treat ALI by exerting the unique advantages of holistic regulation and multi-target interaction. Based on this, this article summarizes the mechanism of action and drug intervention of “gut-lung axis” in the treatment of ALI, and explores the association between intestinal flora imbalance and respiratory diseases, with a view to providing new insights for the prognosis of clinical ALI patients and exploring the prevention and treatment of ALI by the intervention of intestinal flora via the “gut-lung axis”.

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国家自然科学基金资助项目（82460925）；联合科研基金重大项目（23JRRA1530）；甘肃省科技重大专项计划（2021年度）（21ZDKA0014）