Research Progress on the Correlation between Gut Microbiota‑Mediated Spleen‑transportation Dysfunction and Endocrine‑metabolic Disorders and Regulation by Traditional Chinese Medicine

Abstract

Endocrine‑metabolic diseases with high morbidity and frequent comorbidities severely threaten human health, and gut microbiota dysbiosis is closely involved in their pathogenesis. The TCM theory of “the spleen governs transportation‑transformation” is highly consistent with intestinal microecology. A bidirectional regulatory relationship exists between spleen‑transportation dysfunction and gut microbiota imbalance. Spleen deficiency disrupts microbiota homeostasis, and microbial dysbiosis further impairs spleen‑stomach function, mediating chronic low‑grade inflammation and insulin resistance via the intestinal barrier and gut‑metabolic axis, thereby inducing type 2 diabetes mellitus, obesity, metabolic syndrome and polycystic ovary syndrome. With the core strategy of spleen‑tonifying and microbiota‑regulating, traditional Chinese medicine improves metabolic disorders by regulating gut microbiota and repairing intestinal barrier through herbal compounds, active ingredients and non‑pharmacological therapies, showing unique advantages in preventing and treating metabolic diseases. Current studies are limited by unclear syndrome biomarkers, insufficient high‑quality clinical evidence and incomplete mechanistic interpretation. Future standardized research combined with multi‑omics techniques is required to explore spleen deficiency‑related microbial characteristics, clarify TCM regulatory mechanisms, and promote clinical translational application.