基于肠道菌群治疗代谢相关脂肪性肝病的研究进展

doi:10.3969/j.issn.1004-583X.2026.04.011

摘要/Abstract

摘要：

代谢相关脂肪性肝病(metabolic dysfunction-associated fatty liver disease, MAFLD),前称为非酒精性脂肪性肝病,作为全球最常见的慢性肝病,其患病率在逐年增加,且造成沉重的临床及社会经济负担。肠道菌群通过“肠-肝轴”与MAFLD形成紧密联系,靶向肠道菌群调节成为治疗MAFLD的新方向。相关措施包括粪便微生物群移植、补充益生菌/益生元/合生元、及部分抗生素和中药以及生活方式干预。本文重点对通过调节肠道菌群治疗MAFLD的各项干预措施研究进展进行综述,旨在为MAFLD的防治提供参考。

关键词: 非酒精性脂肪性肝病, 代谢相关脂肪性肝病, 肠-肝轴, 肠道菌群, 粪便微生物群移植, 益生元, 中药

中图分类号:

R575.5

车晓娜, 慕淑丽, 刘宁宁, 崔文婷, 陈金玥, 魏小果. 基于肠道菌群治疗代谢相关脂肪性肝病的研究进展[J]. 临床荟萃, 2026, 41(4): 352-362.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.04.011

https://www.lchc.cn/CN/Y2026/V41/I4/352

参考文献 129

[1]	南月敏, 范建高, 徐小元. 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版)[J]. 中华肝胆病杂志, 2024, 32(5):418-458. doi: 10.3760/cma.j.cn112481-20240325-00123.
[2]	Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2022, 7(9):851-861. doi:10.1016/S2468-1253(22)00230-4.
[3]	Portincasa P, Khalil M, Mahdi L, et al. Metabolic dysfunction-associated steatotic liver disease: From pathogenesis to current therapeutic options[J]. Int J Mol Sci, 2024, 25(11):5640. doi:10.3390/ijms25115937.
[4]	Milosevic I, Vujovic A, Barac A, et al. Gut-liver axis, gut microbiota, and its modulation in the management of liver diseases: A review of the literature[J]. Int J Mol Sci, 2019, 20(2):395. doi:10.3390/ijms20020345.
[5]	Leung C, Rivera L, Furness JB, et al. The role of the gut microbiota in NAFLD[J]. Nat Rev Gastroenterol Hepatol, 2016, 13(7):412-425. doi:10.1038/nrgastro.2016.83. pmid: 27273168
[6]	Stanislawski MA, Lozupone CA, Wagner BD, et al. Gut microbiota in adolescents and the association with fatty liver: The EPOCH study[J]. Pediatr Res, 2018, 84(2):219-227. doi:10.1038/s41390-018-0034-5. pmid: 29538359
[7]	Oh TG, Kim SM, Caussy C, et al. A universal gut-microbiome-derived signature predicts cirrhosis[J]. Cell Metab, 2020, 32(5):878-888. doi:10.1016/j.cmet.2020.09.007. pmid: 32610095
[8]	Zhai Q, Wu H, Zheng S, et al. Association between gut microbiota and NAFLD/NASH: A bidirectional two-sample Mendelian randomization study[J]. Front Cell Infect Microbiol, 2023, 13:1294826. doi:10.3389/fcimb.2023.1294826.
[9]	Clifford BL, Sedgeman LR, Williams KJ, et al. FXR activation protects against NAFLD via bile-acid-dependent reductions in lipid absorption[J]. Cell Metab, 2021, 33(8):1671-1684. doi:10.1016/j.cmet.2021.07.008. pmid: 34270928
[10]	Liu J, Sun J, Yu J, et al. Gut microbiome determines therapeutic effects of OCA on NAFLD by modulating bile acid metabolism[J]. NPJ Biofilms Microbiomes, 2023, 9(1):29. doi:10.1038/s41522-023-00384-8.
[11]	Larabi AB, Masson HLP, Bäumler AJ. Bile acids as modulators of gut microbiota composition and function[J]. Gut microbes, 2023, 15(1):2172671. doi:10.1080/19490976.2023.2172671.
[12]	Inagaki T, Choi M, Moschetta A, et al. Fibroblast growth factor 15 functions as an enterohepatic signal to regulate bile acid homeostasis[J]. Cell Metab, 2005, 2(4):217-225. doi:10.1016/j.cmet.2005.09.003. pmid: 16213224
[13]	Collins SL, Stine JG, Bisanz JE, et al. Bile acids and the gut microbiota: Metabolic interactions and impacts on disease[J]. Nat Rev Microbiol, 2023, 21(4):236-247. doi:10.1038/s41579-022-00800-8.
[14]	Jiao N, Loomba R, Yang Z, et al. Alterations in bile acid metabolizing gut microbiota and specific bile acid genes as a precision medicine to subclassify NAFLD[J]. Physiol Genomics, 2021, 53(8):336-348. doi:10.1152/physiolgenomics.00100.2021. pmid: 34151600
[15]	Morrison DJ, Preston T. Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism[J]. Gut Microbes, 2016, 7(3):189-200. doi:10.1080/19490976.2016.1157799. pmid: 26963409
[16]	Ji Y, Yin Y, Li Z, et al. Gut microbiota-derived components and metabolites in the progression of non-alcoholic fatty liver disease (NAFLD)[J]. Nutrients, 2019, 11(8):1712. doi:10.3390/nu11081712.
[17]	Li F, Ye J, Shao C, et al. Compositional alterations of gut microbiota in nonalcoholic fatty liver disease patients: A systematic review and meta-analysis[J]. Lipids Health Dis, 2021, 20(1):22. doi:10.1186/s12944-021-01460-8. pmid: 33637088
[18]	Chen X, Qiu W, Ma X, et al. Roles and mechanisms of choline metabolism in nonalcoholic fatty liver disease and cancers[J]. Front Biosci (Landmark Ed), 2024, 29(5):182. doi:10.52586/4945. pmid: 38812309
[19]	Moradzad M, Ghaderi D, Abdi M, et al. Gut microbiota dysbiosis contributes to choline unavailability and NAFLD development[J]. J Diabetes Metab Disord, 2025, 24(1):37. doi:10.1007/s40200-024-01375-7.
[20]	Spencer MD, Hamp TJ, Reid RW, et al. Association between composition of the human gastrointestinal microbiome and development of fatty liver with choline deficiency[J]. Gastroenterology, 2011, 140(3):976-986. doi:10.1053/j.gastro.2010.12.047. pmid: 21129376
[21]	Wang J, Kuo C, Kuo F, et al. Fecal microbiota transplantation: Review and update[J]. J Formos Med Assoc, 2019, 118(Suppl 1):S23-S31. doi:10.1016/j.jfma.2019.08.005.
[22]	Yadegar A, Bar-Yoseph H, Monaghan TM, et al. Fecal microbiota transplantation: Current challenges and future landscapes[J]. Clin Microbiol Rev, 2024, 37(2):e0006022. doi: 10.1128/cmr.00060-22 URL
[23]	Lee JY, Kim Y, Kim J, et al. Fecal microbiota transplantation: Indications, methods, and challenges[J]. J Microbiol, 2024, 62(12):1057-1074. doi:10.1007/s12275-024-00123-4. pmid: 39557804
[24]	Qiu X, Cheng S, Liu Y, et al. Fecal microbiota transplantation for treatment of non-alcoholic fatty liver disease: Mechanism, clinical evidence, and prospect[J]. World J Gastroenterol, 2024, 30(8):833-842. doi:10.3748/wjg.v30.i8.833.
[25]	Zhou D, Pan Q, Shen F, et al. Total fecal microbiota transplantation alleviates high-fat diet-induced steatohepatitis in mice via beneficial regulation of gut microbiota[J]. Sci Rep, 2017, 7(1):1529. doi:10.1038/s41598-017-01689-0. pmid: 28484247
[26]	Abenavoli L, Maurizi V, Rinninella E, et al. Fecal microbiota transplantation in NAFLD treatment[J]. Medicina (Kaunas), 2022, 58(11):1582. doi:10.3390/medicina58111582.
[27]	Hu D, Zhao J, Zhang H, et al. Fecal microbiota transplantation for weight and glycemic control of obesity as well as the associated metabolic diseases: Meta-analysis and comprehensive assessment[J]. Life (Basel), 2023, 13(7):1488. doi:10.3390/life13071523.
[28]	Stols-Goncalves D, Mak AL, Madsen MS, et al. Faecal microbiota transplantation affects liver DNA methylation in non-alcoholic fatty liver disease: A multi-omics approach[J]. Gut Microbes, 2023, 15(1):2223330. doi:10.1080/19490976.2023.2223330.
[29]	Gupta M, Krishan P, Kaur A, et al. Mechanistic and physiological approaches of fecal microbiota transplantation in the management of NAFLD[J]. Inflamm Res, 2021, 70(7):765-776. doi:10.1007/s00011-021-01486-1. pmid: 34212214
[30]	Lee DH, Jee JJ, Lee YS, et al. Fecal microbiota transplantation improves hepatic fibro-inflammation via regulating oxidative stress in experimental NASH[J]. Dig Liver Dis, 2023, 55(11):1521-1532. doi:10.1016/j.dld.2023.07.015.
[31]	Shou D, Luo Q, Tang W, et al. Hepatobiliary and pancreatic: Multi-donor fecal microbiota transplantation attenuated high-fat diet-induced hepatic steatosis in mice by remodeling the gut microbiota[J]. J Gastroenterol Hepatol, 2023, 38(12):2195-2205. doi:10.1111/jgh.16277.
[32]	Xue L, Deng Z, Luo W, et al. Effect of fecal microbiota transplantation on non-alcoholic fatty liver disease: A randomized clinical trial[J]. Front Cell Infect Microbiol, 2022, 12:759306. doi:10.3389/fcimb.2022.759306.
[33]	Groenewegen B, Ruissen MM, Crossette E, et al. Consecutive fecal microbiota transplantation for metabolic dysfunction-associated steatotic liver disease: A randomized controlled trial[J]. Gut microbes, 2025, 17(1):2541035. doi:10.1080/19490976.2025.2541035.
[34]	Wang S, Xu M, Wang W, et al. Systematic review: Adverse events of fecal microbiota transplantation[J]. PLoS One, 2016, 11(8):e0161174. doi:10.1371/journal.pone.0161174.
[35]	Youngster I, Russell GH, Pindar C, et al. Oral, capsulized, frozen fecal microbiota transplantation for relapsing clostridium difficile infection[J]. JAMA, 2014, 312(17):1772-1778. doi:10.1001/jama.2014.11802. pmid: 25322359
[36]	Binda S, Hill C, Johansen E, et al. Criteria to qualify microorganisms as “probiotic” in foods and dietary supplements[J]. Front Microbiol, 2020, 11:1662. doi:10.3389/fmicb.2020.01662.
[37]	Yadav MK, Kumari I, Singh B, et al. Probiotics, prebiotics and synbiotics: Safe options for next-generation therapeutics[J]. Appl Microbiol Biotechnol, 2022, 106(2):505-521. doi:10.1007/s00253-022-11946-8. pmid: 35015145
[38]	Mozaffari S, Aliari M, Emamgholipour S, et al. The effect of probiotic consumption on lipid profile, glycemic index, inflammatory markers, and liver function in NAFLD patients: A systematic review and meta-analysis of randomized controlled trials[J]. J Diabetes Complications, 2024, 38(8):108780. doi:10.1016/j.jdiacomp.2024.108780.
[39]	Mohamad Nor MH, Ayob N, Mokhtar NM, et al. The effect of probiotics (MCP(^®) BCMC(^®) Strains) on hepatic steatosis, small intestinal mucosal immune function, and intestinal barrier in patients with non-alcoholic fatty liver disease[J]. Nutrients, 2021, 13(9):3192. doi:10.3390/nu13093192.
[40]	Kobyliak N, Abenavoli L, Mykhalchyshyn G, et al. A multi-strain probiotic reduces the fatty liver index, cytokines and aminotransferase levels in NAFLD patients: Evidence from a randomized clinical trial[J]. J Gastrointest Liver Dis, 2018, 27(1):41-49. doi:10.15403/jgld.2018.2701.N5.
[41]	Carpi RZ, Barbalho SM, Sloan KP, et al. The effects of probiotics, prebiotics and synbiotics in non-alcoholic fat liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): A systematic review[J]. Int J Mol Sci, 2022, 23(15):8456. doi:10.3390/ijms23158456.
[42]	Huang W, Wang G, Xia Y, et al. Bile salt hydrolase-overexpressing lactobacillus strains can improve hepatic lipid accumulation in vitro in an NAFLD cell model[J]. Food Nutr Res, 2020, 64:4332. doi:10.29219/fnr.v64.4332.
[43]	Zhang Z, Zhou H, Zhou X, et al. Lactobacillus casei YRL577 ameliorates markers of non-alcoholic fatty liver and alters expression of genes within the intestinal bile acid pathway[J]. Br J Nutr, 2021, 125(5):521-529. doi:10.1017/S000711452000347X.
[44]	Kim DY, Park JY, Gee HY. Lactobacillus plantarum ameliorates NASH-related inflammation by upregulating L-arginine production[J]. Exp Mol Med, 2023, 55(11):2332-2345. doi:10.1038/s12276-023-01067-8. pmid: 37907736
[45]	Wen X, Liu H, Luo X, et al. Supplementation of lactobacillus plantarum ATCC14917 mitigates non-alcoholic fatty liver disease in high-fat-diet-fed rats[J]. Front Microbiol, 2023, 14:1146672. doi:10.3389/fmicb.2023.1146672.
[46]	Teng Q, Lv H, Peng L, et al. Lactiplantibacillus plantarum ZDY2013 Inhibits the development of non-alcoholic fatty liver disease by regulating the intestinal microbiota and modulating the PI3K/Akt pathway[J]. Nutrients, 2024, 16(7):958. doi:10.3390/nu16072876.
[47]	Ritze Y, Bardos G, Claus A, et al. Lactobacillus rhamnosus GG protects against non-alcoholic fatty liver disease in mice[J]. PLoS One, 2014, 9(1):e80169. doi:10.1371/journal.pone.0080169.
[48]	Arellano-Garcia LI, Milton-Laskibar I, Martinez JA, et al. Comparative effects of viable Lactobacillus rhamnosus GG and its heat-inactivated paraprobiotic in the prevention of high-fat high-fructose diet-induced non-alcoholic fatty liver disease in rats[J]. Biofactors, 2025, 51(1):e2116. doi:10.1002/biof.1998.
[49]	Yoon SJ, Yu JS, Min BH, et al. Bifidobacterium-derived short-chain fatty acids and indole compounds attenuate nonalcoholic fatty liver disease by modulating gut-liver axis[J]. Front Microbiol, 2023, 14:1129904. doi:10.3389/fmicb.2023.1129904.
[50]	Zhang X, Xu J, Dong X, et al. Bifidobacterium longum BL-19 inhibits oxidative stress and inflammatory damage in the liver of mice with NAFLD by regulating the production of butyrate in the intestine[J]. Food Sci Nutr, 2024, 12(9):6442-6460. doi:10.1002/fsn3.3707. pmid: 39554323
[51]	Wang L, Jiao T, Yu Q, et al. Bifidobacterium bifidum shows more diversified ways of relieving non-alcoholic fatty liver compared with bifidobacterium adolescentis[J]. Biomedicines, 2021, 10(1) : 178. doi:10.3390/biomedicines10010178.
[52]	Xu J, Xia Q, Wu T, et al. Prophylactic treatment with Bacteroides uniformis and Bifidobacterium bifidum counteracts hepatic NK cell immune tolerance in nonalcoholic steatohepatitis induced by high fat diet[J]. Gut Microbes, 2024, 16(1):2302065. doi:10.1080/19490976.2024.2302065.
[53]	Zhao H, Zhou J, Yuan L, et al. Exploring the alleviating effects of Bifidobacterium metabolite lactic acid on non-alcoholic steatohepatitis through the gut-liver axis[J]. Front Microbiol, 2024, 15:1518150. doi:10.3389/fmicb.2024.1518150.
[54]	Nian F, Wu L, Xia Q, et al. Akkermansia muciniphila and bifidobacterium bifidum prevent NAFLD by regulating FXR expression and gut microbiota[J]. J Clin Transl Hepatol, 2023, 11(4):763-776. doi:10.14218/JCTH.2023.00075.
[55]	Qu D, Chen M, Zhu H, et al. Akkermansia muciniphila and its outer membrane protein Amuc_1100 prevent high-fat diet-induced nonalcoholic fatty liver disease in mice[J]. Biochem Biophys Res Commun, 2023, 684:149131. doi:10.1016/j.bbrc.2023.149131.
[56]	Han Y, Ling Q, Wu L, et al. Akkermansia muciniphila inhibits nonalcoholic steatohepatitis by orchestrating TLR2-activated gammadeltaT17 cell and macrophage polarization[J]. Gut Microbes, 2023, 15(1):2221485. doi:10.1080/19490976.2023.2221485.
[57]	Zhang J, Zhou J, He Z, et al. Bacteroides and NAFLD: Pathophysiology and therapy[J]. Front Microbiol, 2024, 15:1288856. doi:10.3389/fmicb.2024.1288856.
[58]	Fabersani E, Portune K, Campillo I, et al. Bacteroides uniformis CECT 7771 alleviates inflammation within the gut-adipose tissue axis involving TLR5 signaling in obese mice[J]. Sci Rep, 2021, 11(1):11788. doi:10.1038/s41598-021-91368-8. pmid: 34083551
[59]	Sun C, Xiong X, Liu M, et al. Bacteroides ovatus alleviates high-fat and high-cholesterol-induced nonalcoholic fatty liver disease via gut-liver axis[J]. Biomed Pharmacother, 2024, 178:117156. doi:10.1016/j.biopha.2024.117156.
[60]	Li H, Wang X, Tang M, et al. Bacteroides thetaiotaomicron ameliorates mouse hepatic steatosis through regulating gut microbial composition, gut-liver folate and unsaturated fatty acids metabolism[J]. Gut Microbes, 2024, 16(1):2304159. doi:10.1080/19490976.2024.2304159.
[61]	Arellano-García L, Portillo MP, Martínez JA, et al. Usefulness of probiotics in the management of NAFLD: Evidence and involved mechanisms of action from preclinical and human models[J]. Int J Mol Sci, 2022, 23(6):3167. doi:10.3390/ijms23063167.
[62]	Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, types, sources, mechanisms, and clinical applications[J]. Foods, 2019, 8(3):92. doi:10.3390/foods8030101.
[63]	Yao F, Jia R, Huang H, et al. Effect of lactobacillus paracasei N1115 and fructooligosaccharides in nonalcoholic fatty liver disease[J]. Arch Med Sci, 2019, 15(5):1336-1344. doi:10.26355/ams201901505018.
[64]	Takai A, Kikuchi K, Ichimura M, et al. Fructo-oligosaccharides ameliorate steatohepatitis, visceral adiposity, and associated chronic inflammation via increased production of short-chain fatty acids in a mouse model of non-alcoholic steatohepatitis[J]. BMC Gastroenterol, 2020, 20(1):46. doi:10.1186/s12876-020-1124-7. pmid: 32103741
[65]	Yau YF, El-Nezami H, Galano J, et al. Lactobacillus rhamnosus GG and oat beta-glucan regulated fatty acid profiles along the gut-liver-brain axis of mice fed with high fat diet and demonstrated antioxidant and anti-inflammatory potentials[J]. Mol Nutr Food Res, 2020, 64(18):e2000566. doi:10.1002/mnfr.202000566.
[66]	You S, Hu X, Zhao Q, et al. Oat beta-glucan inhibits lipopolysaccharide-induced nonalcoholic steatohepatitis in mice[J]. Food Funct, 2013, 4(9):1360-1368. doi:10.1039/c3fo60136a.
[67]	Hashmi A, Naeem N, Farooq Z, et al. Effect of prebiotic galacto-oligosaccharides on serum lipid profile of hypercholesterolemics[J]. Probiotics Antimicrob Proteins, 2016, 8(1):19-30. doi:10.1007/s12602-016-9216-0. pmid: 26905736
[68]	Chappuis E, Morel-Depeisse F, Bariohay B, et al. Alpha-galacto-oligosaccharides at low dose improve liver steatosis in a high-fat diet mouse model[J]. Molecules, 2017, 22(10) : 1682. doi:10.3390/molecules22101682.
[69]	Mistry RH, Liu F, Borewicz K, et al. Long-term beta-galacto-oligosaccharides supplementation decreases the development of obesity and insulin resistance in mice fed a Western-type diet[J]. Mol Nutr Food Res, 2020, 64(12):e1900922. doi:10.1002/mnfr.201900922.
[70]	Gokcen P, Ozturk O, Adali G, et al. A novel therapeutic approach to NASH: Both polyethylene glycol 3350 and lactulose reduce hepatic inflammation in C57BL/6J mice[J]. Adv Clin Exp Med, 2021, 30(11):1167-1174. doi:10.17219/avd/130045. pmid: 34549558
[71]	Fan J, Xu Z, Wang G. Effect of lactulose on establishment of a rat non-alcoholic steatohepatitis model[J]. World J Gastroenterol, 2005, 11(32):5053-5056. doi:10.3748/wjg.v11.i32.5053.
[72]	Yang X, Zhang M, Liu Y, et al. Inulin-enriched megamonas funiformis ameliorates metabolic dysfunction-associated fatty liver disease by producing propionic acid[J]. NPJ Biofilms Microbiomes, 2023, 9(1):84. doi:10.1038/s41522-023-00420-0.
[73]	Perez-Monter C, Alvarez-Arce A, Nuno-Lambarri N, et al. Inulin improves diet-induced hepatic steatosis and increases intestinal Akkermansia genus level[J]. Int J Mol Sci, 2022, 23(2) : 987. doi:10.3390/ijms23020987.
[74]	Wei W, Wong CC, Jia Z, et al. Parabacteroides distasonis uses dietary inulin to suppress NASH via its metabolite pentadecanoic acid[J]. Nat Microbiol, 2023, 8(8):1534-1548. doi:10.1038/s41564-023-01420-8. pmid: 37386075
[75]	Zhu W, Zhou Y, Tsao R, et al. Amelioratory effect of resistant starch on non-alcoholic fatty liver disease via the gut-liver axis[J]. Front Nutr, 2022, 9:861854. doi:10.3389/fnut.2022.861854.
[76]	Ni Y, Qian L, Siliceo SL, et al. Resistant starch decreases intrahepatic triglycerides in patients with NAFLD via gut microbiome alterations[J]. Cell Metab, 2023, 35(9):1530-1547. doi:10.1016/j.cmet.2023.07.009. pmid: 37673036
[77]	Malaguarnera M, Vacante M, Antic T, et al. Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis[J]. Dig Dis Sci, 2012, 57(2):545-553. doi:10.1007/s10620-011-9987-4.
[78]	Juarez-Fernandez M, Porras D, Petrov P, et al. The synbiotic combination of akkermansia muciniphila and quercetin ameliorates early obesity and NAFLD through gut microbiota reshaping and bile acid metabolism modulation[J]. Antioxidants (Basel), 2021, 10(12): 1907. doi:10.3390/antiox10121907.
[79]	Mantri A, Kohlmoos A, Schelski DS, et al. Impact of synbiotic intake on liver metabolism in metabolically healthy participants and its potential preventive effect on metabolic-dysfunction-associated fatty liver disease (MAFLD): A randomized, placebo-controlled, double-blinded clinical trial[J]. Nutrients, 2024, 16(9) : 3827. doi:10.3390/nu16093827.
[80]	Kang Y, Ren P, Shen X, et al. A newly synbiotic combination alleviates obesity by modulating the gut microbiota-fat axis and inhibiting the hepatic TLR4/NF-kappaB signaling pathway[J]. Mol Nutr Food Res, 2023, 67(24):e2300141. doi:10.1002/mnfr.202300141.
[81]	Miao G, Guo J, Zhang W, et al. Remodeling intestinal microbiota alleviates severe combined hyperlipidemia-induced nonalcoholic steatohepatitis and atherosclerosis in LDLR(-/-) hamsters[J]. Research (Wash D C), 2024, 7:363. doi:10.34133/2024/363.
[82]	Jian J, Nie M, Xiang B, et al. Rifaximin ameliorates non-alcoholic steatohepatitis in mice through regulating gut microbiome-related bile acids[J]. Front Pharmacol, 2022, 13:841132. doi:10.3389/fphar.2022.841132.
[83]	Wan Y, Li S, Li D, et al. Study on the molecular mechanisms of rifaximin in the treatment of non-alcoholic steatohepatitis based on the Helicobacter-DCA-Fxr-Hnf1alpha signalling pathway[J]. Mol Med Rep, 2025, 31(2):42. doi:10.3892/mmr.2024.13045.
[84]	Shu YY, Hu LL, Ye J, et al. Rifaximin alleviates MCD diet-induced NASH in mice by restoring the gut microbiota and intestinal barrier[J]. Life sciences, 2024, 357:123095. doi:10.1016/j.lfs.2024.123095.
[85]	Chong CYL, Orr D, Plank LD, et al. Randomised double-blind placebo-controlled trial of inulin with metronidazole in non-alcoholic fatty liver disease (NAFLD)[J]. Nutrients, 2020, 12(4):937. doi:10.3390/nu12040937.
[86]	Çirkin G, Aydemir S, Açıkgöz B, et al. Hepatic histopathological benefit, microbial cost: Oral vancomycin mitigates non-alcoholic fatty liver disease while disrupting the cecal microbiota[J]. Int J Mol Sci, 2025, 26(17):8616. doi:10.3390/ijms26178616.
[87]	Kasai K, Igarashi N, Tada Y, et al. Impact of vancomycin treatment and gut microbiota on bile acid metabolism and the development of non-alcoholic steatohepatitis in mice[J]. Int J Mol Sci, 2023, 24(4):4050. doi:10.3390/ijms24044050.
[88]	张莉. 非酒精性脂肪性肝病中医诊疗专家共识(2023)[J]. 临床肝胆病杂志, 2023, 39(12):2731-2740.
[89]	单娅, 赵淇, 程燕, 等. 中药活性成分共晶研究进展[J]药学学报, 2025, 60(6):1671-1681.doi: 10.16438/j.0513-4870.2024-0798.
[90]	Hu Y, Ma Q, Dong X, et al. Research progress on the therapeutic effects of polysaccharides on non-alcoholic fatty liver diseases[J]. Front Nutr, 2023, 10:1107551. doi:10.3389/fnut.2023.1107551.
[91]	Hao P, Yang X, Yin W, et al. A study on the treatment effects of Crataegus pinnatifida polysaccharide on non-alcoholic fatty liver in mice by modulating gut microbiota[J]. Front Vet Sci, 2024, 11:1383801. doi:10.3389/fvets.2024.1383801.
[92]	Tan Y, Yue S, Lu A, et al. The improvement of nonalcoholic steatohepatitis by Poria cocos polysaccharides associated with gut microbiota and NF-kappaB/CCL3/CCR1 axis[J]. Phytomedicine, 2022, 103:154208. doi:10.1016/j.phytomed.2022.154208.
[93]	Zhang L, Wang Y, Wu F, et al. MDG, an Ophiopogon japonicus polysaccharide, inhibits non-alcoholic fatty liver disease by regulating the abundance of Akkermansia muciniphila[J]. Int J Biol Macromol, 2022, 196:23-34. doi:10.1016/j.ijbiomac.2022.06.130. pmid: 34920070
[94]	Zhong M, Yan Y, Yuan H, et al. Astragalus mongholicus polysaccharides ameliorate hepatic lipid accumulation and inflammation as well as modulate gut microbiota in NAFLD rats[J]. Food Funct, 2022, 13(13):7287-7301. doi:10.1039/d2fo01234a.
[95]	Li P, Hu J, Zhao H, et al. Multi-omics reveals inhibitory effect of baicalein on non-alcoholic fatty liver disease in mice[J]. Front Pharmacol, 2022, 13:925349. doi:10.3389/fphar.2022.925349.
[96]	Duan R, Huang K, Guan X, et al. Tectorigenin ameliorated high-fat diet-induced nonalcoholic fatty liver disease through anti-inflammation and modulating gut microbiota in mice[J]. Food Chem Toxicol, 2022, 164:112948. doi:10.1016/j.fct.2022.112948.
[97]	Liu Y, Sun Z, Dong R, et al. Rutin ameliorated lipid metabolism dysfunction of diabetic NAFLD via AMPK/SREBP1 pathway[J]. Phytomedicine, 2024, 126:155437. doi:10.1016/j.phytomed.2024.155437.
[98]	Li X, Yao Y, Wang Y, et al. Effect of hesperidin supplementation on liver metabolomics and gut microbiota in a high-fat diet-induced NAFLD mice model[J]. J Agric Food Chem, 2022, 70(36):11224-11235. doi:10.1021/acs.jafc.2c03456.
[99]	Porras D, Nistal E, Martinez-Florez S, et al. Protective effect of quercetin on high-fat diet-induced non-alcoholic fatty liver disease in mice is mediated by modulating intestinal microbiota imbalance and related gut-liver axis activation[J]. Free Radic Biol Med, 2017, 102:188-202. doi:10.1016/j.freeradbiomed.2016.12.023.
[100]	Shi Z, Zhang C, Lei H, et al. Structural insights into amelioration effects of quercetin and its glycoside derivatives on NAFLD in mice by modulating the gut microbiota and host metabolism[J]. J Agric Food Chem, 2022, 70(46):14732-14743. doi:10.1021/acs.jafc.2c05678.
[101]	Sun W, Li X, Dou H, et al. Myricetin supplementation decreases hepatic lipid synthesis and inflammation by modulating gut microbiota[J]. Cell Rep, 2021, 36(9):109641. doi:10.1016/j.celrep.2021.109641.
[102]	Wang X, Jin Y, Di C, et al. Supplementation of silymarin alone or in combination with salvianolic acids b and puerarin regulates gut microbiota and its metabolism to improve high-fat diet-induced NAFLD in mice[J]. Nutrients, 2024, 16(8):2765. doi:10.3390/nu16082765.
[103]	Wang S, Li X, Ji H, et al. Modulation of gut microbiota by glycyrrhizic acid may contribute to its anti-NAFLD effect in rats fed a high-fat diet[J]. Life Sci, 2022, 310:121110. doi:10.1016/j.lfs.2022.121110.
[104]	Li Y, Liu T, Yan C, et al. Diammonium glycyrrhizinate protects against nonalcoholic fatty liver disease in mice through modulation of gut microbiota and restoration of intestinal barrier[J]. Mol Pharm, 2018, 15(9):3860-3870. doi:10.1021/acs.molpharmaceut.8b00447.
[105]	Xue C, Li Y, Lv H, et al. Oleanolic acid targets the gut-liver axis to alleviate metabolic disorders and hepatic steatosis[J]. J Agric Food Chem, 2021, 69(28):7884-7897. doi:10.1021/acs.jafc.1c03245.
[106]	Zhai Y, Zhou W, Yan X, et al. Astragaloside IV ameliorates diet-induced hepatic steatosis in obese mice by inhibiting intestinal FXR via intestinal flora remodeling[J]. Phytomedicine, 2022, 107:154444. doi:10.1016/j.phytomed.2022.154444.
[107]	Mohammadhasani K, Vahedi Fard M, Mottaghi Moghaddam Shahri A, et al. Polyphenols improve non-alcoholic fatty liver disease via gut microbiota: A comprehensive review[J]. Food Sci Nutr, 2024, 12(8):5341-5356. doi:10.1002/fsn3.3986. pmid: 39139973
[108]	Tan J, Hu R, Gong J, et al. Protection against metabolic associated fatty liver disease by protocatechuic acid[J]. Gut Microbes, 2023, 15(1):2238959. doi:10.1080/19490976.2023.2238959.
[109]	Hong T, Jiang X, Zou J, et al. Hepatoprotective effect of curcumin against bisphenol A-induced hepatic steatosis via modulating gut microbiota dysbiosis and related gut-liver axis activation in CD-1 mice[J]. J Nutr Biochem, 2022, 109:109103. doi:10.1016/j.jnutbio.2022.109103.
[110]	Milton-Laskibar I, Marcos-Zambrano LJ, Gomez-Zorita S, et al. Gut microbiota induced by pterostilbene and resveratrol in high-fat-high-fructose fed rats: Putative role in steatohepatitis onset[J]. Nutrients, 2021, 13(5):1738. doi:10.3390/nu13051467.
[111]	Milton-Laskibar I, Cuevas-Sierra A, Portillo MP, et al. Effects of resveratrol administration in liver injury prevention as induced by an obesogenic diet: Role of Ruminococcaceae[J]. Biomedicines, 2022, 10(8):1023. doi:10.3390/biomedicines10081023.
[112]	Wang H, Zhang H, Gao Z, et al. The mechanism of berberine alleviating metabolic disorder based on gut microbiome[J]. Front Cell Infect Microbiol, 2022, 12:854885. doi:10.3389/fcimb.2022.854885.
[113]	He Y, Chen X, Li Y, et al. Curcumin supplementation alleviates hepatic fat content associated with modulation of gut microbiota-dependent bile acid metabolism in patients with nonalcoholic simple fatty liver disease: A randomized controlled trial[J]. Am J Clin Nutr, 2024, 120(1):66-79. doi:10.1016/j.ajcn.2024.01.012.
[114]	Chen D, Xiong J, Chen G, et al. Comparing the influences of metformin and berberine on the intestinal microbiota of rats with nonalcoholic steatohepatitis[J]. In Vivo, 2023, 37(5):2105-2127. doi:10.21873/invivo.13245. pmid: 37652508
[115]	Dai Y, Zhu W, Zhou J, et al. The combination of berberine and evodiamine ameliorates high-fat diet-induced non-alcoholic fatty liver disease associated with modulation of gut microbiota in rats[J]. Braz J Med Biol Res, 2022, 55:e12096. doi:10.1590/1414-431x20225512096.
[116]	谢伟宁, 彭红兵, 李烨, 等. 柴胡疏肝散对肝郁脾虚型非酒精性脂肪肝患者的临床疗效及肠道菌群的影响[J]. 中国实验方剂学杂志, 2021, 27(3):129-137. doi:10.13422/j.cnki.syfjx.20210212.
[117]	罗华兵, 何文忠, 李东生, 等. 加味茵陈蒿汤治疗非酒精性脂肪肝的临床疗效及对肠道菌群影响[J]. 世界中西医结合杂志, 2021, 16(9):1746-1750.doi: 10.13935/j.cnki.sjzx.210939.
[118]	沈月华, 刘加新. 降脂保肝汤治疗非酒精性脂肪性肝病的疗效观察及其对血清瘦素、脂多糖、肠道菌群的影响[J]. 中国中医药科技, 2023, 30(1):18-20.
[119]	Ross FC, Patangia D, Grimaud G, et al. The interplay between diet and the gut microbiome: implications for health and disease[J]. Nat Rev Microbiol, 2024, 22(11):671-686. doi:10.1038/s41579-024-00967-8.
[120]	Anania C, Perla FM, Olivero F, et al. Mediterranean diet and nonalcoholic fatty liver disease[J]. World J Gastroenterol, 2018, 24(19):2083-2094. doi:10.3748/wjg.v24.i19.2083.
[121]	Barber TM, Kabisch S, Pfeiffer AFH, et al. The effects of the Mediterranean diet on health and gut microbiota[J]. Nutrients, 2023, 15(9):2150. doi:10.3390/nu15092017.
[122]	Gomez-Perez AM, Ruiz-Limon P, Salas-Salvado J, et al. Gut microbiota in nonalcoholic fatty liver disease: A PREDIMED-Plus trial sub analysis[J]. Gut Microbes, 2023, 15(1):2223339. doi:10.1080/19490976.2023.2223339.
[123]	Di Renzo L, Frank G, Pala B, et al. Effects of Italian Mediterranean organic diet on the gut microbiota: A pilot comparative study with conventional products and free diet[J]. Microorganisms, 2025, 13(7): 1234. doi:10.3390/microorganisms13071234.
[124]	Merra G, Noce A, Marrone G, et al. I Influence of Mediterranean diet on human gut microbiota[J]. Nutrients, 2020, 13(1):7. doi:10.3390/nu13010245.
[125]	Prieto I, Hidalgo M, Segarra AB, et al. Influence of a diet enriched with virgin olive oil or butter on mouse gut microbiota and its correlation to physiological and biochemical parameters related to metabolic syndrome[J]. PLoS One, 2018, 13(1):e0190368. doi:10.1371/journal.pone.0190368.
[126]	Dong Y, Guo Y, Li Q, et al. Soluble dietary fiber from Dendrocalamus brandisii (Munro) Kurz shoot improves liver injury by regulating gut microbial disorder in mice[J]. Food Chem X, 2024, 22:101472. doi:10.1016/j.fochx.2024.101472.
[127]	Cheng R, Wang L, Le S, et al. A randomized controlled trial for response of microbiome network to exercise and diet intervention in patients with nonalcoholic fatty liver disease[J]. Nat Commun, 2022, 13(1):2555. doi:10.1038/s41467-022-30544-4. pmid: 35538056
[128]	Csader S, Chen X, Leung H, et al. Gut ecological networks reveal associations between bacteria, exercise, and clinical profile in non-alcoholic fatty liver disease patients[J]. mSystems, 2023, 8(5):e0022423. doi:10.1128/msystems.00224-23.
[129]	Wang J, Zhang Q, Xia J, et al. Moderate treadmill exercise modulates gut microbiota and improves intestinal barrier in high-fat-diet-induced obese mice via the AMPK/CDX2 signaling pathway[J]. Diabetes Metab Syndr Obes, 2022, 15:209-223. doi:10.2147/DMSO.S366445.

基于肠道菌群治疗代谢相关脂肪性肝病的研究进展

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 129

相关文章 15

编辑推荐

Metrics

本文评价

[1]	林涛, 吴玮君. 中高海拔地区帕金森病非运动症状的临床特征谱及其与肠道菌群-肠-脑轴关联机制[J]. 临床荟萃, 2026, 41(4): 301-306.
[2]	刘栋, 杨启昌, 李欣然. 抑郁症与肠道菌群关联性的研究进展及趋势分析[J]. 临床荟萃, 2026, 41(3): 285-288.
[3]	阎煜, 丁宁坡, 杨佳宁, 李雨浓, 齐正宇, 咸哲民. JAK/STAT信号通路调控支气管哮喘机制及中药治疗研究进展[J]. 临床荟萃, 2025, 40(7): 653-658.
[4]	肇雪婷, 白佳雯, 孙军. 代谢相关脂肪性肝病肝纤维化危险因素分析及构建预测模型[J]. 临床荟萃, 2025, 40(5): 417-422.
[5]	童明霞, 陈柯, 向小聪, 周丽峰. 中青年体检人群瘦型代谢相关脂肪性肝病及其危险因素分析[J]. 临床荟萃, 2025, 40(2): 128-132.
[6]	史双伟, 饶小娟, 解丽然, 方一凡, 王姗姗. 甲状腺功能正常的2型糖尿病患者甲状腺激素敏感性与非酒精性脂肪肝的相关性[J]. 临床荟萃, 2025, 40(2): 133-137.
[7]	苟彩霞, 张洁, 包依夏姆·阿巴拜克力, 王一鸣, 姚磊, 郑嵘炅, 潘金良, 鲁晓擘. 体检人群睡眠质量与代谢相关脂肪性肝病的影响因素分析[J]. 临床荟萃, 2025, 40(1): 33-38.
[8]	马苗苗, 王义艳, 温甜甜, 马丽群. 甘油三酯-葡萄糖指数与阻塞性睡眠呼吸暂停综合征相关性的研究进展[J]. 临床荟萃, 2024, 39(9): 851-854.
[9]	熊璐, 郭莲. 2型糖尿病患者25(OH)D和SUA/SCr与合并非酒精性脂肪肝的相关性[J]. 临床荟萃, 2024, 39(8): 706-711.
[10]	马一夫, 路鑫. 现代中药复方还脑益聪方治疗老年痴呆症作用机制的研究进展[J]. 临床荟萃, 2024, 39(8): 752-757.
[11]	延天美, 吴亚楠, 梁鹏, 魏立民. 粪便微生物移植:肥胖患者减重的新方案[J]. 临床荟萃, 2024, 39(5): 455-459.
[12]	杨小雄, 杨帆, 魏小果. 肠-微生物群-肝轴与代谢相关脂肪性肝病的研究进展[J]. 临床荟萃, 2023, 38(6): 559-563.
[13]	宗廷妮, 戴光荣, 赵晓宇, 李瑞风, 柴聪敏. 代谢相关脂肪性肝病靶向药物治疗进展[J]. 临床荟萃, 2023, 38(4): 373-376.
[14]	曹宇萌, 张海燕, 刘立新. 非酒精性脂肪性肝病的病理改变与血清铁蛋白和血清铁含量变化关系的meta分析[J]. 临床荟萃, 2023, 38(3): 197-207.
[15]	熊璐, 郭莲. 胰岛素样生长因子-1及其结合蛋白与非酒精性脂肪性肝病发生发展的研究进展[J]. 临床荟萃, 2023, 38(10): 935-939.