Evaluating traditional Chinese medicine modulation of the gut microbiota-bile acid axis in metabolic and inflammatory diseases: mechanistic evidence and translational priorities.

What To Know

This is a structured narrative review (abstract-level content provided) that uses the gut microbiota–bile acid axis as a framework to assess TCM interventions across MASLD, obesity/type 2 diabetes, and IBD.

The authors describe microbial enzymes and pathways (e.g., bile salt hydrolases, bai operon, hydroxysteroid dehydrogenases) and how those can affect bile-acid receptors like FXR and TGR5 and downstream immune signaling. Most evidence for IBD and metabolic disease presented here is preclinical or observational.

Only one human trial met the authors’ eligibility (Qushi Huayu in adults under an earlier NAFLD label) and reported both clinical and microbiota-related outcomes.

The review proposes an evidence hierarchy and a minimum translational package (chemical quality control, diet/co-medication assessment, strain- and gene-resolved microbiome analysis, targeted bile-acid metabolomics, and pathway-directed validation) to move findings toward clinical relevance.

Bottom line: the paper highlights mechanistic plausibility and research priorities but does not provide clinical support for TCM as a standard treatment for IBD.