肠道菌群是与人体共存的正常微生物环境。胆汁酸（bile acid，BA）是由肝脏产生，在肠道微生物作用下产生的主要代谢物，二者在维持肠道稳态、防止脂肪细胞过度吸收上作用关键，与肥胖、抑郁、糖尿病等疾病相关。肥胖治疗途径中的饮食、药物、代谢手术等方法，可能伴随内分泌失调等不良反应，相比之下，中药在治疗肥胖方面展现出安全有效、整体调节的优势。综述了肠道菌群、胆汁酸代谢通过肠-脑轴机制与宿主之间的相互作用，涉及肠道菌群膳食消化后产生的代谢物短链脂肪酸（short chain fatty acids，SCFAs）以及2种主要的胆汁酸受体：法尼醇X受体（farnesoid X receptor，FXR）、武田G蛋白偶联受体5（takeda G protein-coupled receptor 5，TGR5）。阐明了肥胖病在肠-脑轴机制中的研究现状，论证了利用中药调控肠道菌群结构和胆汁酸代谢，从而预防和治疗肥胖的可靠性。

The intestinal flora is a normal microbial environment that coexists with the human body. Bile acids are the main metabolites produced by the liver under the action of intestinal microorganisms. They play a crucial role in maintaining intestinal homeostasis and preventing excessive absorption by fat cells, and are associated with diseases such as obesity, depression, and diabetes. Among the treatment approaches for obesity, such as diet, medication, and metabolic surgery may be accompanied by side effects like endocrine disorders. In contrast, traditional Chinese medicine and its compound prescriptions have demonstrated advantages in terms of safety, effectiveness, and overall regulation in the treatment of obesity. This article reviews the interaction between the gut microbiota, bile acid metabolism and the host through the gut-brain axis mechanism, involving the metabolites short-chain fatty acids (SCFAs) produced after dietary digestion of the gut microbiota and two major bile acid receptors: farnesoid X receptor (FXR), takeda G protein-coupled receptor 5 (TGR5). The current research status of obesity in the gut-brain axis mechanism was clarified, and the reliability of using traditional Chinese medicine to regulate the structure of intestinal flora and bile acid metabolism for the prevention and treatment of obesity was demonstrated.

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全国中药特色技术传承人才培训项目（国中医药人教函［2023］96号）；山东省重点研发计划（2024CXGC010619，2019GSF108150）；国家中医药管理局高水平重点学科建设项目（ZYYZDXK-2023121）