大黄Rhei Radix et Rhizoma作为传统中药兼具“泻下通便”与“涩肠止泻”的双向调节特性，在胃肠动力障碍性疾病的治疗中具有独特优势。传统医学典籍记载大黄既能“荡涤肠胃”治疗热结便秘，又能“收敛固脱”缓解湿热泄痢，这种矛盾功效的现代科学内涵已成为研究热点。现代研究表明，大黄的化学成分复杂多样，其蒽醌类及蒽酮类成分通过调节肠道菌群及其代谢产物、促进肠液分泌等途径发挥导泻作用，而鞣质类成分则通过抑制肠道蠕动、减少肠液分泌实现止泻功效。在分子机制层面，大黄可通过多靶点调控实现双向调节，同时通过调节肠道菌群结构、抑制核因子-κB炎症通路、调控环磷酸腺苷/蛋白激酶A信号转导等途径维持肠黏膜屏障功能。通过系统梳理大黄“一药双效”的活性成分及其协同作用网络，阐明其在不同病理状态下“损有余而补不足”的动态调节规律，为建立基于辨证施治的精准给药方案提供理论支撑，对推动中药现代化具有重要意义。

Dahuang (Rhei Radix et Rhizoma), as a traditional Chinese medicine (TCM), possesses the dual regulatory characteristics of “purging intestines and promoting defecation” and “astringing intestines and checking diarrhea”, which gives it a unique advantage in the treatment of gastrointestinal motility disorders. Traditional medical classics record that Rhei Radix et Rhizoma can both “purging the intestines and stomach” to treat constipation caused by heat accumulation and “astringing and consolidating to prevent prolapse” to relieve diarrhea caused by damp-heat. The modern scientific connotation of this contradictory efficacy has become a research hotspot. Modern studies have shown that the chemical composition of Rhei Radix et Rhizoma is complex and diverse. Its anthraquinone and anthrone components exert laxative effects by regulating the intestinal flora and its metabolites and promoting intestinal fluid secretion, while tannin components achieve anti-diarrheal effects by inhibiting intestinal peristalsis and reducing intestinal fluid secretion. At the molecular mechanism level, Rhei Radix et Rhizoma can achieve bidirectional regulation through multi-target regulation. At the same time, it maintains intestinal mucosal barrier function through multiple pathways such as regulating the structure of intestinal flora, inhibiting the nuclear factor-κB inflammatory pathway, and regulating cyclic adenosine monophosphate/protein kinase A signal transduction. By systematically sorting out the active components and their synergistic action network of Rhei Radix et Rhizoma’s “dual effects of a single herb”, clarifies its dynamic regulatory rules of “removing excess and supplementing deficiency” under different pathological conditions, provides theoretical support for establishing a precise drug administration plan based on syndrome differentiation and treatment, and is of great significance for promoting the modernization of TCM.

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河南省科技研发计划联合基金（242301420114）；河南省中医药科学研究专项（2022JDZX010）；河南省卫生健康委、国家中医药传承创新中心科研专项（2023ZXZX1088）