嗜黏蛋白阿克曼菌（Akkermansia muciniphila，AKK）是定植于肠道黏液层的重要共生菌，在维持肠道屏障完整性、调节免疫稳态及参与代谢调控等方面发挥关键作用。近年来研究表明，炎症性肠病（inflammatory bowel disease，IBD）患者肠道内AKK丰度显著降低，其动态变化与疾病活动度密切相关。动物实验显示，补充该菌或其功能蛋白可通过调控“肠屏障-免疫炎症-代谢”三重通路缓解肠道炎症。然而，在特定病理状态下，AKK亦可能通过过度降解黏液层而加重屏障损伤，提示其具有显著的情境依赖性双向调控特征。中药及其活性成分可通过直接提供营养底物、促进黏液分泌、重塑菌群结构及调节代谢互作等多途径，双向调控AKK丰度与功能，从而维持肠道微生态稳态并发挥抗IBD作用。系统综述AKK在IBD中的双重作用机制及其在肠屏障修复、免疫调控和代谢重塑中的作用，并重点总结中药通过靶向AKK介导“菌群-屏障-免疫”轴改善IBD的研究进展，以期为基于关键菌调控的中药微生态干预策略提供理论依据与研究方向。

Akkermansia muciniphila (AKK) is a key commensal bacterium colonizing the intestinal mucus layer, playing a crucial role in maintaining intestinal barrier integrity, regulating immune homeostasis and participating in metabolic control. Recent studies indicate that the abundance of AKK is significantly reduced in the intestines of patients with inflammatory bowel disease (IBD), with its dynamic changes closely correlated with disease activity. Animal experiments demonstrate that supplementing this bacterium or its functional proteins can alleviate intestinal inflammation by regulating the “intestinal barrier-immune inflammation-metabolism” triple pathway. However, under specific pathological conditions, AKK may also exacerbate barrier damage by excessively degrading the mucus layer, suggesting that they exhibit significant context-dependent bidirectional regulatory characteristics. Traditional Chinese medicine (TCM) and its active components can bidirectionally regulate the abundance and function of AKK through multiple pathways, including the direct supply of nutritional substrates, promotion of mucus secretion, remodeling of the microbial community structure and regulation of metabolic interactions, thereby maintaining the homeostasis of the gut microbiome and exerting an anti-IBD effect. This article systematically reviews the dual mechanisms of action of AKK in IBD and their roles in intestinal barrier repair, immune regulation and metabolic remodeling. It focuses on summarizing research progress of TCM in improving IBD by targeting the AKK-mediated “microbiota-barrier-immunity” axis, with the aim of providing a theoretical basis and research directions for TCM microbiota intervention strategies based on the regulation of key bacteria.

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黑龙江省自然科学基金项目（PL2024H207）；湖南省自然科学基金项目（2026JJ60391）