近年来，肠道菌群在缺血性卒中和脑缺血再灌注损伤中所起的作用越来越受到关注。国内外对中医药基于肠道菌群防治脑缺血再灌注损伤开展了大量研究。通过对微生物-肠-脑轴及其功能，脑缺血再灌注损伤后肠道屏障与菌群的变化及其关联，肠道菌群及其部分重要代谢产物包括短链脂肪酸、三甲胺-N-氧化物、脂多糖、次级胆汁酸等对脑缺血再灌注损伤的影响，以及中医药基于肠道菌群对脑缺血再灌注损伤的干预作用和相关机制进行总结，以期为临床基于肠道微生态调控和中医药干预防治脑缺血再灌注损伤提供新思路。

In recent years, the role of gut microbiota in ischemic stroke and cerebral ischemia-reperfusion injury has received increasing attention. At the same time, extensive research both domestically and internationally has been conducted on the prevention and treatment of cerebral ischemia-reperfusion injury by traditional Chinese medicine (TCM) based on gut microbiota. This article reviews the microbiome-gut-brain axis and its functions, the changes in the gut barrier and microbiota after cerebral ischemia-reperfusion injury and their associations, the effects of gut microbiota and some of its important metabolites, including short-chain fatty acids, trimethylamine-N-oxide, lipopolysaccharides, and secondary bile acids, on cerebral ischemia-reperfusion injury, as well as the intervention effects and related mechanisms of TCM based on gut microbiota in addressing cerebral ischemia-reperfusion injury. It is intended to provide new ideas for clinical interventions in the prevention and treatment of cerebral ischemia-reperfusion injury through gut microbiota regulation and TCM interventions.

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国家级大学生创新创业计划项目（S202410541044）；国家自然科学基金青年项目（82405157）；湖南省卫生健康委科研项目（D202303077508）；湖南省中医药科研计划项目（B2023025）