口服难吸收中药重塑肠道微生态干预代谢相关脂肪性肝病的研究进展

代谢相关脂肪性肝病（MAFLD）是多系统代谢紊乱的肝脏疾病，其发病机制的复杂性和治疗目标的多元化导致临床缺乏效果理想的药物。中药对防治肝脏疾病有很好的疗效，口服给药是最普遍的给药方式，药物不仅可以通过肠道与肠道菌群建立联系，而且经肠道细菌作用后可改善吸收差、生物利用度低的问题。然而，肠道微生态紊乱会导致机体免疫功能障碍并促进MAFLD的发生发展。因此，口服难吸收中药对肠道菌群的调节作用可能是治疗MAFLD的潜在靶点。从口服难吸收中药的药理作用、相关代谢、肠道菌群作用等不同角度总结了中药对MAFLD的治疗作用以及肠道菌群与MAFLD的联系，为研究中药、MAFLD和肠道菌群间的关系提供理论依据，为进一步研究中药治疗MAFLD奠定药效物质基础，为从肠道菌群角度研究中药治疗MAFLD的作用机制与靶点奠定基础。

Research progress on reshaping of gut microecology in metabolic associated fatty liver disease by oral difficult-to-absorb Chinese medicine

Metabolic associated fatty liver disease(MAFLD) is a multi-systemic metabolic disorder of the liver disease. The complexity of its pathogenesis and the diversity of its therapeutic targets have led to a lack of clinically recognised and effective drugs. Traditional Chinese medicine is highly effective in the prevention and treatment of liver disease and oral administration is the most common way of drug delivery, which not only establishes contact with the gut microbiota through the gut, but also improves the poor absorption and low bioavailability through the action of gut microbiota. However, the disturbance of gut microecology can lead to immune dysfunction and promote the development of MAFLD. Therefore, the regulatory effect of orally difficult-to-absorb Chinese medicine on gut microbiota may be a potential target for the treatment of MAFLD. The therapeutic effects of traditional Chinese medicine on MAFLD and the relationship between gut microbiota and MAFLD were summarized from the perspectives of pharmacological effects and metabolism of orally difficult-to-absorb Chinese medicine and the effects of gut microbiota, providing a theoretical basis for the study of the relationship between traditional Chinese medicine, MAFLD and gut microbiota, laying the pharmacodynamic material basis for further research on the treatment of MAFLD with traditional Chinese medicine, and providing a basis for the study of the mechanism of action and targets of traditional Chinese medicine for the treatment of MAFLD from the perspective of gut microbiota.