Study on the Mechanism by Which Traditional Chinese Herbal Formulations Improve Insulin Resistance via Regulation of the Gut Microbiota–Adipose Tissue Oxidative Stress–Glucose and Lipid Metabolism Axis

Abstract

Type 2 diabetes mellitus (T2DM), a globally prevalent metabolic disorder, has its core pathological mechanisms—specifically the development and progression of insulin resistance—closely associated with gut microbiota dysbiosis, adipose tissue oxidative stress, and dysregulation of glucose and lipid metabolism. Traditional Chinese herbal compound prescriptions offer unique advantages in ameliorating insulin resistance and preventing or treating T2DM, owing to their multi-target and holistic regulatory properties. This review systematically examines the mechanisms by which traditional Chinese herbal formulas alleviate insulin resistance through three interrelated pathways: modulating gut microbiota composition, inhibiting adipose tissue oxidative stress, and improving glucose and lipid metabolism. Particular emphasis is placed on the regulatory effects of specific compound prescriptions—such as Ge Gen Qin Lian Tang, Huang Qin Tang, and Shou Hui Tong Ban Capsules—and their active constituents on gut microbiota, as well as their comprehensive regulation of insulin signaling pathways via the microbiota-metabolism-immunity axis. Furthermore, this study explores the pharmacological mechanisms by which active components of traditional Chinese medicine, including polysaccharides and flavonoids, restore gut microecological balance, mitigate systemic chronic inflammatory states, and enhance insulin sensitivity, thereby providing a scientific foundation for the clinical application of traditional Chinese medicine in the prevention and treatment of T2DM [1].