基于短链脂肪酸稳态探讨中医药治疗溃疡性结肠炎的微生态机制

Exploring Microecological Mechanisms of Traditional Chinese Medicine in Treating Ulcerative Colitis via Short-Chain Fatty Acid Homeostasis

中文关键词:短链脂肪酸  溃疡性结肠炎  中医药  肠道微生态

keywords:Short-chain fatty acids  ulcerative colitis  traditional chinese medicine  intestinal microecology

中文摘要:溃疡性结肠炎（UC）的发生发展与肠道菌群失调及其代谢产物短链脂肪酸（SCFAs）的稳态失衡密切相关，后者是推动肠屏障损伤、免疫紊乱及能量代谢障碍的核心环节。虽然中医药在防治UC时体现出多靶点调节的优势，但其基于肠道微生态代谢的作用机制仍有待系统阐明。为此，本文围绕“菌群-SCFAs-宿主”轴，系统梳理SCFAs在UC病理中的作用，并重点综述中医药通过调控该轴治疗UC的微生态机制。综合多组学与药理学研究显示，中医药能够通过活性成分、单味药及复方等多层次途径，重塑肠道菌群结构、促进有益菌增殖、优化SCFAs组成，进而激活GPCRs信号、抑制HDAC活性，协同增强肠屏障功能、调节Treg/Th17免疫平衡、并改善结肠能量代谢，从而多环节干预UC的疾病进程。本研究以期从代谢稳态视角为诠释中医药“整体观”与“辨证论治”提供现代科学依据，并为发展基于肠道微生态调控的UC治疗新策略奠定理论基础。

Abstract:Ulcerative colitis (UC) pathogenesis is closely linked to gut microbiota dysbiosis and the subsequent disruption of short-chain fatty acid (SCFA) homeostasis. This SCFA imbalance is a central driver of intestinal barrier impairment, immune dysregulation, and metabolic disturbance in UC. Although traditional Chinese medicine (TCM) shows multi-targeting potential in managing UC, its mechanisms related to microbial metabolism require further clarification. This review focuses on the "microbiota-SCFA-host" axis to systematically outline the role of SCFAs in UC and the mechanisms by which TCM modulates this axis. Evidence from multi-omics and pharmacology reveals that TCM through its active components, single herbs, and formulations can reshape gut microbiota, promote beneficial bacteria, and optimize SCFA profiles. These effects further activate GPCRs, inhibit HDAC, and collectively enhance barrier function, restore Treg/Th17 balance, and improve colonic energy metabolism, thereby multi-dimensionally alleviating UC progression. This work provides a scientific rationale for TCM's holistic and syndrome-differentiation principles from a metabolic perspective and supports novel microecology-based strategies for UC treatment.