自古以来，中药在疾病预防、症状缓解和健康改善等方面发挥了重要作用。然而，复杂的成分和尚未明确的机制阻碍了中药的广泛推广和应用。越来越多的研究表明，和人体健康息息相关的肠道微生态与中药的疗效有关，因此从肠道微生态的角度去探索中药可能是打开中药奥秘的金钥匙。肠道菌群主要通过以下4个生理途径中发挥作用：参与宿主代谢、调节系统免疫、维持胃肠道稳态以及影响脑功能和宿主行为。本文回顾了中药与慢性肝病、溃疡性结肠炎、肥胖和2型糖尿病等疾病之间的联系，从肠道微生态的角度阐明其潜在的机制。未来，我们需要进一步的研究和更完善的实验设计，以揭示中药与肠道菌群之间相互作用的具体机制，并为中药的创新研究提供新的思路。

Traditional Chinese medicines (TCMs) have a long history of playing a vital role in disease prevention, symptom alleviation, and health improvement. However, their complex ingredients and as-yet-unknown mechanisms restrict their application. With increasing evidence indicating that the gut microbiota is important in host health and may be associated with the therapeutic activity of TCM components, it may now be possible to assess the effects of TCMs from the perspective of the gut microbiota. The gut microbiota functions within four major physiological pathways as follows: It participates in host metabolism, forms global immunity, maintains homeostasis of the gastrointestinal tract, and affects brain function and host behavior. This article reviews the reported correlations between TCMs and certain diseases, such as chronic liver disease, ulcerative colitis, obesity, and type 2 diabetes, and elucidates the underlying mechanisms, with a focus on changes in the gut microbiota. In future, further studies are required with more advanced experimental design in order to reveal the interactions between TCMs and the gut microbiota, and provide new insight into and guidance for TCM-based drug discovery.