急性肺損傷（acute lung injury，ALI）作為呼吸系統(tǒng)疾病，嚴(yán)重時(shí)會(huì)發(fā)展為急性呼吸窘迫綜合征。目前，現(xiàn)代醫(yī)學(xué)針對(duì)ALI的治療主要以機(jī)械輔助通氣、抗炎及激素治療為主，但藥物治療效果有限，主要集中于改善肺部病理狀態(tài)，緩解疾病癥狀，存在一定局限性。因此，尋找一種安全有效的方法預(yù)防ALI的發(fā)生，是臨床亟待解決的重要醫(yī)學(xué)問(wèn)題。腸道和肺之間的雙向通訊樞紐能夠影響腸、肺的免疫狀態(tài)，腸道菌群經(jīng)“腸-肺軸”途徑交互串?dāng)_在ALI的發(fā)病過(guò)程中扮演著重要角色。中醫(yī)認(rèn)為肺與大腸相表里，二者在氣機(jī)升降、津液代謝、陰陽(yáng)及經(jīng)絡(luò)等方面聯(lián)系緊密。因此，中醫(yī)藥通過(guò)發(fā)揮整體調(diào)節(jié)，多靶點(diǎn)交互的獨(dú)特優(yōu)勢(shì)，能調(diào)控“腸-肺軸”促進(jìn)腸道微生物群和代謝物平衡，抑制肺組織氧化應(yīng)激和炎癥反應(yīng)，治療ALI。基于此，從“腸-肺軸”治療ALI的作用機(jī)制及藥物干預(yù)等對(duì)其歸納總結(jié)，探究腸道菌群失衡與呼吸道疾病的關(guān)聯(lián)，為臨床ALI患者預(yù)后和探索腸道菌群經(jīng)“腸-肺軸”干預(yù)ALI的防治提供新見(jiàn)解。

Acute lung injury (ALI), as a respiratory disease, can develop into acute respiratory distress syndrome in severe cases. Currently, the treatment of ALI in modern medicine is mainly based on mechanically assisted ventilation, anti-inflammation and hormonal therapy, but the effect of drug therapy is limited and mainly focuses on improving the pathological state of the lungs and relieving the symptoms of the disease, which has certain limitations. Therefore, finding a safe and effective method to prevent ALI is an important medical problem that needs to be solved urgently in clinical practice. The two-way communication hub between the intestine and the lungs can influence the immune status of the intestine and the lungs, and the interaction of intestinal flora through the “intestinal-lung axis” pathway plays an important role in the pathogenesis of ALI. Traditional Chinese medicine (TCM) also believes that the lungs and the large intestine are mutually exclusive, and that they are closely linked in terms of qi elevation, fluid metabolism, yin and yang, and meridians and so on. Therefore, TCM can regulate the intestinal-lung axis to promote the balance of intestinal microbiota and metabolites, inhibit oxidative stress and inflammation in lung tissues, and treat ALI by exerting the unique advantages of holistic regulation and multi-target interaction. Based on this, this article summarizes the mechanism of action and drug intervention of “gut-lung axis” in the treatment of ALI, and explores the association between intestinal flora imbalance and respiratory diseases, with a view to providing new insights for the prognosis of clinical ALI patients and exploring the prevention and treatment of ALI by the intervention of intestinal flora via the “gut-lung axis”.

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國(guó)家自然科學(xué)基金資助項(xiàng)目（82460925）；聯(lián)合科研基金重大項(xiàng)目（23JRRA1530）；甘肅省科技重大專項(xiàng)計(jì)劃（2021年度）（21ZDKA0014）