发酵中药是我国传统制药工艺与现代生物技术相结合的产物，其发展历程可追溯至先秦时期的“曲蘖”工艺。发酵中药技术通过微生物转化作用，能够提升药效成分的生物利用度，产生新的活性物质，并降低药物毒性。根据发酵工艺特点，可分为曲类、豆类、复方及现代创新发酵中药4大类。发酵中药通过微生物酶解、生物转化及菌株-基质协同作用等机制，在免疫调节、抗肿瘤、肠道微生态调控等方面展现出独特优势。现代发酵中药技术包括固态发酵、液态深层发酵和双向发酵（双向固体发酵与双向液体发酵）3大类型，并逐步向智能化控制方向发展。未来研究应着力于工艺标准化、作用机制解析及临床验证，以推动发酵中药在精准医疗领域的应用。

Fermented traditional Chinese medicine (FTCM) is a product integrating traditional Chinese pharmaceutical techniques with modern biotechnology, with its developmental history traceable to the “Qu Nie” process of the pre-Qin period. Through microbial transformation, FTCM technology enhances the bioavailability of active ingredients, generates novel bioactive compounds, and reduces drug toxicity. Based on process characteristics, it can be categorized into four major types: fermented herbal preparations, bean-based preparations, compound formulations, and modern innovative FTCM. Employing mechanisms such as microbial enzymatic hydrolysis, biotransformation, and strain-substrate synergistic interactions, FTCM demonstrates unique advantages in immunomodulation, antitumor activity, and regulation of intestinal microecology. Modern FTCM technologies include solid-state fermentation, liquid submerged fermentation, and dual-directional fermentation (dual-directional solid fermentation and dual-directional liquid fermentation), with a gradual shift towards intelligent control. Future research should focus on process standardization, elucidation of mechanisms of action, and clinical validation to promote the application of FTCM in the field of precision medicine.

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四川省中医药创新团队专项:四川省中医药管理局中药(民族药)前沿研究与开发创新团队(2022C010);四川中医药管理局科研专项(2024zd033);四川省中医药管理局科研专项(2024zd021)