脓毒症相关急性肺损伤（sepsis-associated acute lung injury，SA-ALI）是临床常见的危重并发症，当前治疗手段有限，严重威胁患者生命健康。中药具有多靶点、多途径干预和不良反应少等优势，在SA-ALI防治中展现出一定潜力。铁死亡是一种铁依赖性的新型程序性细胞死亡，其机制与铁代谢失衡、脂质过氧化失控及抗氧化防御能力受损密切相关，在SA-ALI的病理进程中发挥重要作用。现有研究表明，姜黄素、银杏叶提取物及血必净注射液等可通过激活抗氧化信号通路、促进谷胱甘肽合成、调节铁离子代谢稳态等途径抑制铁死亡，进而减轻肺组织损伤。通过阐述铁死亡与SA-ALI的关联，系统总结近年来中药靶向调控铁死亡干预SA-ALI的研究成果，为临床诊疗策略优化及创新药物开发提供理论支撑。

Sepsis-associated acute lung injury (SA-ALI) is a common and life-threatening complication in critically ill patients, for which current therapeutic options remain limited. Traditional Chinese medicine (TCM) exhibits multi-target and multi-pathway regulatory effects with relatively few adverse reactions, showing promising potential in the prevention and treatment of SA-ALI. Ferroptosis is an iron-dependent form of regulated cell death, driven by iron metabolism dysregulation, uncontrolled lipid peroxidation chain reaction, and impaired antioxidant defense systems, and it plays a pivotal role in the pathogenesis of SA-ALI. Emerging evidence indicates that TCM agents—such as curcumin, Ginkgo leaves extract, and Xuebijing Injection—can suppress ferroptosis by activating antioxidant signaling pathways, promoting glutathione synthesis, and restoring iron homeostasis, thereby alleviating pulmonary tissue damage. This article systematically reviews recent advances in TCM-mediated targeting of ferroptosis for SA-ALI, aiming to provide a theoretical foundation for optimizing clinical strategies and developing novel therapeutics.

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国家自然科学基金面上项目(82374018); 河南省“三个100”计划临床医学科学家培养专项(HNCMS202432,HNCMS202411); 河南省中青年卫生健康科技创新人才培养“杰青项目”(JQRC2024013)