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Abstract：
The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.
摘要：
温和苦味中药（MB-TCM）是一类重要的中药，已在临床实践中广泛使用，并被认为是慢性疾病的安全长期治疗方法。然而,作为一类重要的中药，目前尚未对MB-TCM的药理作用和机制进行系统综述.令人信服的研究表明，肠道菌群可以介导TCM的治疗活性，并有助于阐明中医医学理论的核心原理。在这次系统审查中，我们发现MB-TCM通常参与代谢综合征的调节，肠道炎症，神经系统疾病和心血管系统疾病与促进有益菌的生长有关拟杆菌，Akkermansia,乳酸菌,双歧杆菌,Roseburia以及抑制有害细菌螺杆菌的增殖，肠球菌,脱硫弧菌和大肠杆菌志贺氏菌。这些改动,相应地,增强保护性代谢物的产生，主要包括短链脂肪酸（SCFA），胆汁酸（BAs），5-羟色胺（5-HT），吲哚和γ-氨基丁酸（GABA），并抑制有害代谢物的产生，如促炎因子三甲胺氧化物（TAMO）和脂多糖（LPS），通过几种不同的信号通路进一步发挥对维持人类健康的倍增效应。总之,本文试图通过建立TCMs-肠道菌群-代谢产物-信号通路-疾病轴来全面总结MB-TCMs与肠道菌群的关系,这可能为中医理论研究及其临床应用提供新的见解。
