代谢综合征（metabolic syndrome，MetS）是一种以中心性肥胖、高血糖、血脂异常及高血压为特征的复杂代谢紊乱。该疾病的本质涉及多器官代谢网络的功能失调，而现行单靶点药物治疗策略难以应对其复杂性。基于“肠道菌群作为代谢调节枢纽”的当前认识，系统梳理了MetS中由肠-肝轴、肠-脑轴、肠-脂肪轴及肠-心血管轴介导的器官间通讯紊乱机制。而中药来源的植物化学成分可通过重塑肠道菌群结构、调节微生物代谢产物、修复肠道屏障及调节宿主信号通路这4大相互关联的机制，多靶点干预胰岛素抵抗与慢性炎症等核心病理环节。通过归纳代表性中药的作用证据，进一步提炼出共性的“多成分-微生物组-多靶点”作用框架，为构建MetS系统性管理的新理论框架提供了科学依据，并提示了潜在的未来实践方向。未来，结合多组学与计算建模方法，有望推动基于该框架的精准营养干预与药物研发探索。

Metabolic syndrome (MetS) is a complex metabolic disorder characterized by central obesity, hyperglycemia, dyslipidemia, and hypertension. At its core, MetS involves dysfunction of multi-organ metabolic networks, whereas current single-target pharmacological strategies are insufficient to address its complexity. Based on the emerging recognition of the gut microbiota as a central hub of metabolic regulation, this study systematically reviews the mechanisms of disrupted inter-organ communication in MetS mediated through the gut-liver axis, gut-brain axis, gut-adipose axis, and gut-cardiovascular axis. Phytochemicals derived from traditional Chinese medicine can exert multi-target interventions on key pathological processes, including insulin resistance and chronic inflammation, through four interconnected mechanisms: remodeling gut microbial composition, regulating microbial metabolites, restoring intestinal barrier integrity, and modulating host signaling pathways. By synthesizing evidence on representative traditional Chinese medicines, this study further distills a shared “multi-component-microbiome-multi-target” framework of action. This framework provides a scientific basis for the development of a novel theoretical paradigm for the systemic management of MetS and highlights potential directions for future practice. Looking ahead, the integration of multi-omics approaches and computational modeling is expected to facilitate the exploration of precision nutrition interventions and drug development based on this framework.

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四川省中医药管理局资助项目(2024zd002);四川省中医药管理局资助项目(2024MS548); 成都市卫?健康委员会成都中医药?学(WXLH202403014)