叉头框蛋白P3（forkhead box P3，FoxP3）/调节性T细胞（regulatory T cell，Treg）轴是维持外周免疫耐受与免疫稳态的关键调控网络，其功能失衡与自身免疫性疾病、肿瘤及过敏性疾病等免疫相关疾病密切相关。中药凭借多成分、多靶点、多通路的整体作用特征，在调控FoxP3/Treg轴方面展现出独特优势。系统综述了中药及其活性成分调控FoxP3表达与Treg细胞分化、稳定性及免疫抑制功能的多维机制，包括直接调控关键信号通路与细胞因子网络、间接影响肠道菌群-免疫轴及介导FoxP3表观遗传修饰等，总结了其在免疫调控中呈现的双向调节、异病同治及同病异治特征。为中药在免疫相关疾病治疗中的精准化与现代化应用提供重要参考。

The forkhead box protein 3 (FoxP3)/regulatory T cell (Treg) axis is a key regulatory network that maintains peripheral immune tolerance and immune homeostasis, and its functional imbalance is closely associated with immune-related diseases, including autoimmune diseases, cancer, and allergic diseases. Traditional Chinese medicine (TCM), with its characteristics of multi-components, multi-targets, and multi-pathways, shows unique advantages in regulating the FoxP3/Treg axis. This article systematically reviews the multidimensional mechanisms by which TCM and its active components regulate FoxP3 expression and Treg cell differentiation, stability, and immunosuppressive functions. These mechanisms include direct regulation of key signaling pathways and cytokine networks, indirect influence on the gut microbiota-immune axis, and mediation of FoxP3 epigenetic modifications. It also summarizes the characteristics of bidirectional regulation, treating different diseases with the same method and treating the same disease with different methods observed in immune regulation. This provides important reference for the precise and modern application of TCM in treatment of immune-related diseases.

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“十四五”国家重点研发计划“中医药现代化”重点专项（2025YFC3509004）；北京市自然基金面上项目（7242240）；国家中医药管理局项目（GZY-KJS-2024-014）；北京中医药大学揭榜挂帅项目（2024-JYB-JBZD-050）