Promise and challenges of traditional Chinese medicine,specifically Calculus bovis,in liver cancer treatment

Liver cancer,one of the most common malignancies worldwide,ranks sixth in incidence and third in mortality.Liver cancer treatment options are diverse,inclu-ding surgical resection,liver transplantation,percutaneous ablation,transarterial chemoembolization,radiotherapy,chemotherapy,targeted therapy,immuno-therapy,and traditional Chinese medicine(TCM).A multidisciplinary team(MDT)is essential to customize treatment plans based on tumor staging,liver function,and performance status(PS),ensuring individualized patient care.Treatment decisions require a MDT to tailor strategies based on tumor staging,liver function,and PS,ensuring personalized care.The approval of new first-line and second-line drugs and the establishment of standard treatments based on immune checkpoint inhibitors have significantly expanded treatment options for advanced liver cancer,improving overall prognosis.However,many patients do not respond effectively to these treatments and ultimately succumb to the disease.Modern oncology treatments,while extending patient survival,often come with severe side effects,resistance,and damage to the body,negatively impacting quality of life.Huang et al's study published at World Journal of Gastroenterology rigorously validates the anticancer properties of Calculus bovis,enhancing our understanding of TCM and contributing to new liver cancer treatment strategies.For over 5000 years,TCM has been used in East Asian countries like China to treat various diseases,including liver conditions.Analysis of real-world clinical data suggests that for patients with advanced-stage tumors lacking effective treatments,integrated TCM therapies could provide significant breakthroughs.

Potential of traditional Chinese medicine in the treatment of nonalcoholic fatty liver disease:A promising future

In this editorial,we provide insights into the publication by Niu et al featured in the latest edition of the World Journal of Gastroenterology.Specifically,our focus was on exploring the potential of traditional Chinese medicine(TCM)in treating nonalcoholic fatty liver disease(NAFLD)induced by a high-fat diet through various mechanisms.NAFLD is a common liver condition,affecting approximately 25%of the world's population.It is closely linked to metabolic syndrome,insulin resistance,excessive body weight,and irregular lipid processing,leading to fat accumulation in the liver,as well as oxidative stress and inflammation.While maintaining a healthy diet and active lifestyle are essential for managing NAFLD,treatment options are limited due to undefined pathogenesis and a lack of specific medications.TCM,rooted in traditional Chinese practices,presents a promising alternative through its"syndrome differentiation and treatment"principles,enhancing liver lipid metabolism,reducing inflammation,and addressing fibrosis.Certain herbs,such as Poria cocos,Puaria lobata,and Salvia miltiorrhiza,have shown significant efficacy in reducing fat deposition and improving liver function.Due to systematic research and analysis of mechanisms,TCM is anticipated to yield new approaches to prevent and treat NAFLD,increasing its clinical application.

From traditional Chinese medicine formulations to effective anticancer agents:Insights from Calculus bovis

This editorial examines the therapeutic potential of traditional Chinese medicine(TCM)for aggressive cancers,particularly liver cancer.It highlights the study by Huang et al,which shows how Calculus bovis,a component of the TCM Pien Tze Huang,suppresses liver cancer by inhibiting M2 macrophage polarization via the Wnt/β-catenin pathway.This research emphasizes the importance of transitioning from effective TCM formulations to isolating active components and understanding their mechanisms.While the study provides valuable insights,it primarily focuses on the Wnt/β-catenin pathway and does not delve deeply into the mechanisms of individual components.Future research should aim to comprehensively study these components,explore their interactions,and validate findings through clinical trials.This approach will integrate traditional wisdom with modern scientific validation,advancing the development of innovative cancer treatments based on TCM formulations.

An interpretability model for syndrome differentiation of HBV-ACLF in traditional Chinese medicine using small-sample imbalanced data

Objective Clinical medical record data associated with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF)generally have small sample sizes and a class imbalance.However,most machine learning models are designed based on balanced data and lack interpretability.This study aimed to propose a traditional Chinese medicine(TCM)diagnostic model for HBV-ACLF based on the TCM syndrome differentiation and treatment theory,which is clinically interpretable and highly accurate.Methods We collected medical records from 261 patients diagnosed with HBV-ACLF,including three syndromes:Yang jaundice(214 cases),Yang-Yin jaundice(41 cases),and Yin jaundice(6 cases).To avoid overfitting of the machine learning model,we excluded the cases of Yin jaundice.After data standardization and cleaning,we obtained 255 relevant medical records of Yang jaundice and Yang-Yin jaundice.To address the class imbalance issue,we employed the oversampling method and five machine learning methods,including logistic regression(LR),support vector machine(SVM),decision tree(DT),random forest(RF),and extreme gradient boosting(XGBoost)to construct the syndrome diagnosis models.This study used precision,F1 score,the area under the receiver operating characteristic(ROC)curve(AUC),and accuracy as model evaluation metrics.The model with the best classification performance was selected to extract the diagnostic rule,and its clinical significance was thoroughly analyzed.Furthermore,we proposed a novel multiple-round stable rule extraction(MRSRE)method to obtain a stable rule set of features that can exhibit the model’s clinical interpretability.Results The precision of the five machine learning models built using oversampled balanced data exceeded 0.90.Among these models,the accuracy of RF classification of syndrome types was 0.92,and the mean F1 scores of the two categories of Yang jaundice and Yang-Yin jaundice were 0.93 and 0.94,respectively.Additionally,the AUC was 0.98.The extraction rules of the RF syndrome differentiation model based on the MRSRE method revealed that the common features of Yang jaundice and Yang-Yin jaundice were wiry pulse,yellowing of the urine,skin,and eyes,normal tongue body,healthy sublingual vessel,nausea,oil loathing,and poor appetite.The main features of Yang jaundice were a red tongue body and thickened sublingual vessels,whereas those of Yang-Yin jaundice were a dark tongue body,pale white tongue body,white tongue coating,lack of strength,slippery pulse,light red tongue body,slimy tongue coating,and abdominal distension.This is aligned with the classifications made by TCM experts based on TCM syndrome differentiation and treatment theory.Conclusion Our model can be utilized for differentiating HBV-ACLF syndromes,which has the potential to be applied to generate other clinically interpretable models with high accuracy on clinical data characterized by small sample sizes and a class imbalance.

Herbal Traditional Chinese Medicine and suspected liver injury: A prospective study

AIM To analyze liver tests before and following treatment with herbal Traditional Chinese Medicine(TCM) in order to evaluate the frequency of newly detected liver injury.METHODS Patients with normal values of alanine aminotransferase(ALT) as a diagnostic marker for ruling out pre-existing liver disease were enrolled in a prospective study of a safety program carried out at the First German Hospital of TCM from 1994 to 2015. All patients received herbal products, and their ALT values were reassessed 1-3 d prior to discharge. To verify or exclude causality for suspected TCM herbs, the Roussel Uclaf Causality Assessment Method(RUCAM) was used.RESULTS This report presents for the first time liver injury data derived from a prospective, hospital-based and largescale study of 21470 patients who had no liver disease prior to treatment with herbal TCM. Among these, ALT ranged from 1 × to < 5 × upper limit normal(ULN) in 844 patients(3.93%) and suggested mild or moderate liver adaptive abnormalities. However, 26 patients(0.12%) experienced higher ALT values of ≥ 5 × ULN(300.0 ± 172.9 U/L, mean ± SD). Causality for TCM herbs was RUCAM-based probable in 8/26 patients, possible in 16/26, and excluded in 2/26 cases. Bupleuri radix and Scutellariae radix were the two TCM herbs most commonly implicated. CONCLUSION In 26(0.12%) of 21470 patients treated with herbal TCM, liver injury with ALT values of ≥ 5 × ULN was found, which normalized shortly following treatment cessation, also substantiating causality.

Therapeutic effect of traditional Chinese medicine on coagulation disorder and accompanying intractable jaundice in hepatitis B virus-related liver cirrhosis patients

AIM： TO observe the therapeutic effects of new traditional Chinese medicine （TClVl） therapy on coagulation disorder and accompanying intractable jaundice in HBV-related liver cirrhosis patients. METHODS： Using stratified random sampling according to fibrinogen （Fib） levels, 145 liver cirrhosis patients due to hepatitis B complicated by coagulation disorder were treated. Of them, 70 in research group were treated with TCM by ＂nourishing yin, cooling blood and invigorating blood circulation＂ and Western medicine, 75 in control group were treated with conventional Western medicine. The indexes of liver function, coagulation function and bleeding events were observed and compared. RESULTS： The prothrombin time （PT） was shorter and the fibrinogen （Fib） level was higher in the research group than in the control group （Fib = 1.6-2.0 g/L, 1.1-1.5 g/L, and ≤ 1.0 g/L）. The total bilirubin （TBIL） level was significantly lower in the research group than in the control group, except for the subgroup of FIB ≤ 1.0 g/L. CONCLUSION： TCM therapy can improve coagulation fuction and decrease TBIL.

CLINICAL STUDY ON IRRADIATION COMBINED WITH TRADITIONAL CHINESE MEDICINE IN THE TREATMENT OF LARGE PRIMARY LIVER CANCER

This paper resports the response of inoperable primary liver cancer to whole liver irradiation(WLI)by movingstrip technique(MST)during the period from 1980- 1988.The results showed that WLI by MST gave good response in this malignancy.The 5-year survival after treatment was 30.83% and median survival 25.8 months.The analysis of prognostic factors indicated that the higher the midplane tissue dose(mTD),the longer the survival(P<0.001),and that the survival of those patients tumor diameter was>8 to<13 cm and/or tumor volume>50% to <75% of liver volume was longer than that of there with tumor diameter of≥13 cm and/or tumor volume≥75% of the liver volume(P<0. 001 ).Traditional Chinese medicine is an indispensable therapy during the period of WLI by MST.Both clinical and experimental studies suggest that WLI by MST can enhance the therapeutic effect.

The advances of traditional Chinese medicine in the treatment of liver diseases in 2019

Background:Currently,the treatment of liver diseases remains an unsolved problem due to its complicated etiology and pathogenesis.Traditional Chinese medicine(TCM)has been used for liver disease treatment for thousands of years.Disease treatment using TCM compounds conforms to the concept of“holism”,which coincides with the complicated pathogenic mechanisms of liver diseases.However,the mechanisms have not been clearly explained due to the complex components and multi-targets,which is a big obstacle TCM’s popularity and application.In recent years,studying the mechanisms and identifying the novel ingredients in herbal medicines are becoming a hot spot for many researchers.Therefore,we obtained literature in PubMed and summarized the progress of TCM’s active ingredients and formulas in treating various liver diseases in 2019.Based on the literature,flavonoids,polysaccharides,saponins,and alkaloids,as well as Chinese medicine formulas,such as Ba-Bao pill and Yin-Chen-Hao decoction,have attracted much attention.In addition,we also focused on the application of new omics analysis techniques,such as metabolomics,network pharmacology,and other omics analyses in the study of TCM formulas.

Advances in traditional Chinese medicine for liver disease therapy in 2020

Liver diseases are gradually becoming a serious threat to human health worldwide.Although a number of medications have been introduced for the prophylaxis,diagnosis,and treatment of liver diseases,several limitations and challenges remain.Traditional Chinese medicine is frequently used to treat liver diseases and well known to protect hepatocytes and inhibit inflammation,oxidative stress,and fibrosis.However,given the complex composition of traditional Chinese medicine,clarifying the mechanisms behind its curative and protective effects is difficult.In this review,research progress on traditional Chinese medicine for the treatment of liver diseases in 2020 is summarized on the basis of the literature available in the PubMed database.Herbal extracts derived from traditional Chinese medicine,including flavonoids,polysaccharides,saponins,and alkaloids,and Chinese medicinal formulas,such as the classic decoctions Chaihu Shugan powder,Linggui Zhugan decoction,and Huanglian Jiedu decoction,have shown promising therapeutic efficacy in liver disease treatment.We summarized the findings of several studies on the active ingredients of traditional Chinese herbs used for liver disease treatment in 2020,focusing mainly on their ability to confer antiviral effects to treat hepatitis,regulate antioxidant levels and apoptosis to treat liver injury,inhibit inflammation and improve dysfunctions in amino acids and energy metabolism to treat alcoholic liver disease,reduce hepatic lipid deposition to treat nonalcoholic fatty liver disease,promote activated hepatic stellate cells to treat liver fibrosis,inhibit the proliferation or promote the apoptosis of liver cancer cells to treat hepatocellular carcinoma,and improve bile acid metabolism to treat cholestasis.

Advances in traditional Chinese medicine for liver disease therapy in 2021

Liver diseases and their co-morbidities represent a major public health problem.Owing to its progressive pathogenesis and lack of effective treatment,liver disease has become one of the most important causes of death worldwide.Traditional Chinese medicine(TCM)has potential advantages in the prevention and treatment of liver diseases,including high safety,remarkable curative effects,and low toxicity and side effects.In 2021,TCM extracts and their derivatives,TCM compounds,and ethnic medicines showed good efficacy in the treatment of liver diseases.The main mechanisms and representative drugs of TCM can be summarized by the use of amygdalin,dicoumarol,quercetin,and ancient ephedrine decoction to treat hepatitis by inhibiting viral replication,as well as the use of Gentianae Radix,lupeol,Zornia diphylla(L.)Pers.,and Chinese patent medicine Liuwei Wuling tablet to alleviate acute liver injury by improving oxidative stress and inflammatory responses in the body.In the treatment of alcoholic liver disease and metabolic-associated fatty liver disease,the mechanism of TCM is the inhibition of oxidative stress,improving metabolism,regulating intestinal microflora,and enhancing intestinal barrier function.The representative TCM for alcoholic liver disease includes astragaloside,puerarin,patchouli alcohol,and Mori Fructus polysaccharide,while those for metabolic-associated fatty liver disease include saikosaponin,dehydroabietic acid,hesperetin,berberine,and Panax Notoginseng saponins.Additionally,germacrone,forsythin,geniposide,and protocatechuic acid can inhibit the activation or migration of stellate cells and improve liver fibrosis.Toosendanin,paeoniflorin,chrysin,and the classical prescription Huanglian decoction can significantly inhibit the proliferation of liver cancer cells and promote their apoptosis for the treatment of hepatocellular carcinoma.The activation of the farnesol X receptor pathway can improve bile metabolism in the liver,thus,significantly alleviating cholestatic liver disease.Its representative drugs include the TCM extracts pterostilbene and arbutin.In this review,we summarize the advances made in research on TCM used in the treatment of liver diseases in 2021,providing a reference for further development of TCM for the prevention and treatment of liver diseases.

Pharmacological Action and Research Progress of Traditional Chinese Medicine on Liver Injury

According to the different types of liver damage,there should also be different Chinese medicine and dose for different degrees of treatment and protection.This paper studies the Chinese medicine treatment of different types of liver injury,and is expected to provide a reference for the further application of Chinese medicine in liver injury.

A Traditional Chinese Medicine Approach in Treating Depression by Promoting Liver Qi Circulation: A Western Medicine Perspective

Depression is a prevalent mental illness in developed countries. In Western medicine, experimental and clinical investigations have demonstrated that depression is associated with the dysregulation of neurotransmitter signaling, and symptoms of depression can be alleviated by therapeutic intervention. However, patients taking antidepressant drugs often experience serious side effects and high relapse rates. On the other hand, traditional Chinese medicine (TCM) views depression as a manifestation of liver qi stagnation. Practitioners of TCM have long been treating depression with herbs that promote qi circulation in the liver. In this article, we offer a hypothesis stating the biochemical basis of the linkage between liver qi stagnation and depression. Liver qi is involved in the processing of macronutrients into molecules to fuel energy metabolism in brain neurons, as well as the synthesis of plasma proteins that maintain blood circulation to the brain, thereby enabling these fuel molecules to be delivered to the brain. In cases of liver qi stagnation, the failure in delivering sufficient fuel molecules to the brain disrupts mitochondrial ATP production in neurons. Because neurotransmitter release and neurotropin transport are driven by ATP, the deficiency in release and transport processes resulting from insufficient ATP production could lead to depression. Therefore, if liver qi stagnation is causally related to the pathogenesis of depression, the promotion of liver qi circulation by Chinese herbs might offer a promising prospect for the effective treatment of depression.

A Clinical Study of Integrated Traditional Chinese and Western Medicine in the Treatment of Liver-Stomach Disharmony Functional Dyspepsia

Objective:To explore the clinical effect of integrated traditional Chinese and Western medicine in the treatment of liver-stomach disharmony functional dyspepsia.Methods:Sixty patients with functional dyspepsia of liver-stomach disharmony type admitted to our hospital from January to August 2022 were selected as research subjects and randomly divided into two groups,a study group and a control group,with 30 cases in each group.The main observations were stomachache or pain over bilateral flanks,emotionally depressed,belching,fullness and discomfort over the abdomen and flanks,acid regurgitation,loss of appetite,frequent sighing,noisy epigastric,and the treatment effect.Results:According to the classification of symptom severity on the traditional Chinese medicine(TCM)symptom score table,statistics were made on the corresponding severity of the main symptoms and secondary symptoms of the two groups of patients,and the data of the two groups were compared by Wilcoxon test.The results showed that there was no significant difference in the distribution of TCM symptoms between the two groups;the study group’s total effective rate of pain relief(recovery+markedly effective+effective)was 96.67%,and Fisher’s χ^(2) test indicated a significant difference in the total effective rate of pain relief between the two groups(P=0.027<0.05).Conclusion:The use of integrated traditional Chinese and western medicine is clearly better than the simple application of western medicine.It is safe and has no side effects.It can be used as a treatment for patients with functional dyspepsia.

Relationship between symptoms of traditional Chinese medicine and indicator of western medicine about liver cirrhosis

Traditional Chinese medicine (TCM) is one of the safe and effective methods to treat liver cir-rhosis. The practitioners of TCM assess hepatic function in term of syndrome. But the course of syndrome differentiation is subjectivity. At pre-sent most of all the researches are focused on the relationship between the syndrome and the Western medicine objective indicators such as child-pugh grade. In fact syndrome is the syn-thesis of signs and symptoms and collecting signs, symptoms is easy than syndrome differ-entiation. We try to explore the relationship be-tween the objective Western medicine standard such as child-pugh grade, decompensation or compensation stage, active or inactive period and the signs and symptoms of TCM by using the data mining method. We use the information gain method to assess the attributes and use five typical classifiers such as logistic, Bayes-Net, NaiveBayes, RBF and C4.5 to obtain the classification accuracy. After attribute selection, we obtain the main symptoms and signs of TCM relating to the stage, period and child-pugh grade about liver cirrhosis. The experiment re-sults show the classification accuracy is im-proved after filtering some symptoms and signs.

Research progress of external therapies of traditional Chinese medicine in the treatment of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is a common chronic liver disease characterized by diffuse hepatic steatosis.With the improvement of people's living standard,the incidence rate of NAFLD has been increasing,which has become one of the global health problems in 21st Century.However,there is no specific drug or standard treatment for NAFLD,which brings challenges to treatment.Acupuncture,moxibustion,massage and other external therapies based on the characteristics of traditional Chinese medicine have obvious curative effect in the clinical treatment of NAFLD,but the mechanism has not been systematically explained,which makes the clinical promotion evidence insufficient.This paper aims to summarize the researches on the treatment of NAFLD by external therapies of traditional Chinese medicine in recent years,and analyze its possible mechanism,so as to provide a scientific theoretical basis for future basic experiments and clinical research,and form a set of standardized clinical diagnosis and treatment scheme with the characteristics of traditional Chinese medicine.

Traditional Chinese medicine combined with chemotherapy in the treatment ofliver cancer： a meta-analysis

Objective： To analyze the clinical efficacy of traditional Chinese medicine （TCM） combined with chemotherapy inthe treatment of primary liver cancer on the basis of meta-analysis software. Method： Retrieval randomizedcontrolled trials （RCT） of TCM combined with chemotherapy in the treatment of the liver cancer from the networkdatabase （such as MEDLINE, EMBASE, PUBMED, Chinese CNKI database, Wanfang database, VIP databaseetc.）. The retrieval period was from January 2011 to July 2017. Results： A total of 16 RCT studies were includedand involving 1873 patients, with 949 patients in the treatment （TCM with chemotherapy） group and 924 patientsin the control group （chemotherapy alone）. Meta-analysis results suggest that TCM combined with chemotherapyin the treatment of primary hepatocellular carcinoma can improve curative effect, improve the degree of ascites ofpatients, improve the quality of life of patients and alleviate chemotherapy side effects. Conclusion： TCMcombined with chemotherapy in the treatment of primary liver cancer is helpful to improve the short term curativeeffect, improve the quality of life of patients, and alleviate the toxic and side effects.

Treatment and prevention of diabetes complicated with non-alcoholic fatty liver disease by integrated traditional Chinese and Western medicine

Today’s social economy and science and technology levels are developing rapidly.Type 2 diabetes mellitus(T2DM)is increasing in incidence,and T2DM promotes non-alcoholic fatty liver disease(NAFLD)through some mechanisms.The pathogenesis of T2DM and NAFLD is interconnected,interacted with,and promoted.While increasing the economic burden on patients,it also affects the quality and life of patients themselves.In the world,the current treatment methods include exercise and diet control,drugs(including sugar reduction,lipid-lowering drugs,etc.),weight loss surgery,etc.,but currently,researching drugs can only control the progress of the disease.At present,there is no drug for T2DM combined with NAFLD treatment.Therefore,it is necessary to find and study effective drugs for NAFLD.Based on the principle of“syndrome differentiation,”traditional Chinese medicine(TCM)played an important role in treating this disease.The theory of TCM believes that the cause of NAFLD is mostly diet disorders and imbalances in daily life,leading to liver Qi stagnation,spleen dysfunction,and liver and kidney deficiency,producing phlegm and stasis.During the treatment process,we must pay attention to the goal of phlegm turbidity,but also pay attention to the source of phlegm turbidity,strengthen the spleen and stomach,nourish the liver and kidney,and restore the physiological function of the body.The ingredients of Chinese medicine extracts have the effects of antagonist oxidation stress,protecting liver cells,improving fibrous soluble systems,and promoting lipid metabolism,thereby reducing inflammatory factors to release damage to liver cells.By combining the diagnosis of TCM syndromes with Western medical disease diagnosis,the model of disease diagnosis combined with syndrome differentiation can compensate for some of the limitations of TCM’s sole reliance on syndrome differentiation,allowing for a better grasp of the disease.In treatment,a dual approach using traditional Chinese and Western medicine can enhance efficacy and reduce toxicity,leveraging both complementary strengths.Chinese medicine explains its treatment of NAFLD from a macro and micro level,providing a safer and more effective method for treating the disease.

Reversal of non-alcoholic fatty liver disease complicated with cirrhosis by traditional Chinese medicine:a case report and experience

Non-alcoholic fatty liver disease(NAFLD)has become the world’s most common chronic liver disease and is considered one of the main causes of occult liver cirrhosis.To date,major guidelines in China and abroad have not recommended any drugs with precise efficacy and safety for NAFLD,especially for NAFLD-related liver fibrosis or cirrhosis,which lack effective drugs.Traditional Chinese medicine has significant curative effects and advantages in preventing and treating NAFLD.We retrospectively analyzed a case of liver cirrhosis due to NAFLD that was treated solely with traditional Chinese medicine for nearly one year at the Diagnosis and Treatment Center of Advantage Specific Diseases for Fatty Liver in our hospital to provide a reference for the prevention and treatment of non-alcoholic liver fibrosis and liver cirrhosis by traditional Chinese medicine.

Progress of mitochondrial and endoplasmic reticulum-associated signaling and its regulation of chronic liver disease by Chinese medicine

The endoplasmic reticulum(ER)is connected to mitochondria through mitochondria-associated ER membranes(MAMs).MAMs provide a framework for crosstalk between the ER and mitochondria,playing a crucial role in regulating cellular calcium balance,lipid metabolism,and cell death.Dysregulation of MAMs is involved in the development of chronic liver disease(CLD).In CLD,changes in MAMs structure and function occur due to factors such as cellular stress,inflammation,and oxidative stress,leading to abnormal interactions between mitochondria and the ER,resulting in liver cell injury,fibrosis,and impaired liver function.Traditional Chinese medicine has shown some research progress in regulating MAMs signaling and treating CLD.This paper reviews the literature on the association between mitochondria and the ER,as well as the intervention of traditional Chinese medicine in regulating CLD.

Enhancing Clinical Efficacy through the Gut Microbiota: A New Field of Traditional Chinese Medicine

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-yetunknown 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.