溃疡性结肠炎（ulcerative colitis，UC）是一种慢性非特异性肠道炎症性疾病，肠道菌群紊乱与肠道屏障功能障碍形成的恶性循环是其迁延难愈的核心病理机制之一，菌群多样性降低、有益菌减少、致病菌增多，导致短链脂肪酸、色氨酸等代谢紊乱，进而破坏黏液层、紧密连接蛋白及免疫屏障功能，加重炎症。中医药基于“浊毒理论”等核心病机，通过重塑菌群结构，促进有益代谢产物生成，上调紧密连接蛋白表达等途径发挥治疗作用，有效阻断恶性循环。系统综述了UC中肠道菌群与肠道屏障的相互作用，以及中医药的干预理论与现代生物学机制，为UC的中医药治疗提供理论参考，凸显其临床应用潜力。

Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease. A vicious cycle driven by gut microbiota dysbiosis and disruption of the intestinal barrier is considered a key mechanism underlying its recurrent and refractory nature. Reduced microbial diversity, decreased beneficial bacteria, and increased pathogenic taxa lead to disturbances in metabolites such as short-chain fatty acids and tryptophan, which subsequently impair the mucus layer, tight junction proteins, and immune barrier function, further aggravating mucosal inflammation. According to traditional Chinese medicine (TCM), core pathogenic factors such as “turbidity‑toxin theory” play central roles in UC. Guided by these principles, TCM therapies intervene through multiple approaches, including reshaping gut microbial composition, enhancing the production of beneficial metabolites, and upregulating tight junction proteins. These actions contribute to breaking the aforementioned vicious cycle. This review systematically summarizes the interactions between gut microbiota and the intestinal barrier in UC, as well as the theoretical basis and modern biological mechanisms by which TCM exerts therapeutic effects. The findings provide a theoretical reference for the application of TCM in UC management and highlight its potential clinical value.

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国家自然科学基金青年基金项目（82302112）；兰州市科技计划项目（2023-4-4）