Research Progress on the Multi-Target Modulation of the Gut-Brain Axis by Traditional Chinese Medicine to Improve Type 2 Diabetes Complicated by Obesity, Based on the ‘Spleen-Stomach–Heart-Mind’ Axis

Abstract

Type 2 diabetes mellitus complicated by obesity has gradually emerged as a major global public health issue of increasing concern in recent years; its pathogenesis is closely linked to disturbances in energy metabolism within the endocrine system and dysfunction of the gut-brain axis resulting from long-term dietary indiscretion. Although Traditional Chinese Medicine (TCM) does not use this specific term for the condition, its theory of the ‘spleen-stomach–heart-mind’ axis aligns closely with the modern gut-brain axis theory in terms of core pathogenesis and the holistic perspective. This paper systematically proposes, for the first time, the ‘Spleen-Stomach–Mind-Spirit’ axis as a theoretical framework within Traditional Chinese Medicine, elucidating a new research paradigm in which Traditional Chinese Medicine improves T2DM complicated by obesity through multi-targeted, holistic regulation of the gut-brain axis. The paper outlines the theoretical correspondence between the spleen-stomach and mind-spirit system and the gut-brain axis, summarises the therapeutic advantages of numerous classical Chinese herbal formulae, and elucidates the mechanisms by which TCM improves glucose and lipid metabolism disorders through multi-target regulation. It also outlines future research directions for the multi-component, multi-network and holistic regulation of metabolic diseases by TCM, aiming to provide new theoretical foundations and research approaches for the integrated prevention and treatment of diabetes mellitus complicated by obesity using both Chinese and Western medicine.