肠-肺轴是连接呼吸系统与消化系统的重要通路，在维持机体免疫稳态、调控炎症反应及保护黏膜屏障中发挥关键作用。中医“肺与大肠相表里”的理论与现代肠-肺轴概念高度契合，为“肺肠同治”提供了科学依据。研究表明，肠道菌群失衡及屏障功能受损可通过炎症介质与代谢物影响肺部炎症免疫反应，加重慢性阻塞性肺疾病、哮喘及肺纤维化等肺系疾病的发生发展。中医药通过调节肠道菌群及代谢产物（如短链脂肪酸、色氨酸代谢物），并修复黏膜屏障，从整体上改善肠-肺轴稳态，减轻肺部炎症反应与组织损伤。因此，以肠-肺轴为基础，着重阐明了中医药通过调控肠道菌群、菌群代谢产物及黏膜免疫，保护肺肠屏障、防治肺系疾病等主要药效缓解的作用环节的研究进展，为深入阐释“以肠调肺”的作用机制及中医药防治呼吸系统疾病提供了新思路。

The gut-lung axis is an important pathway connecting the respiratory system and the digestive system, playing a key role in maintaining immune homeostasis, regulating inflammatory responses, and protecting the mucosal barrier. Traditional Chinese medicine (TCM) theory that “the lung and the large intestine are exterior-interior related” is highly consistent with the modern concept of gut-lung axis, providing a scientific basis for “lung and intestine co-treatment”. Studies have shown that the imbalance of the intestinal flora and the damage of the barrier function can affect the inflammatory immune response in lungs through inflammatory mediators and metabolites, aggravating the occurrence and development of lung diseases such as chronic obstructive pulmonary disease, asthma and pulmonary fibrosis. TCM can improve the stability of gut-lung axis as a whole by regulating the intestinal flora and metabolic products (such as short-chain fatty acids and tryptophan metabolites), and repairing the mucosal barrier, thereby reducing the inflammatory response and tissue damage in lungs. Therefore, based on gut-lung axis, this paper mainly expounds the research progress of the main therapeutic effect relief links of traditional Chinese medicine throug regulating intestinal flora, flora metabolites and mucosal immunity, protecting lung-intestine barrier and preventing and treating lung diseases, providing a new idea for in-depth explanation of mechanism of “regulating the lung through the intestine” and the prevention and treatment of respiratory diseases by TCM.

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现代中药新质生产力科技创新工程专项（24ZXZKSY00050）；国家自然科学基金资助项目（62231025）