【摘要】 药物难治性癫痫（DRE）是指经两种适当的抗癫痫发作药物（ASMs）规范治疗后仍未实现有效控制的癫痫类型，约占所有癫痫病例的1/3。该疾病发病机制复杂，病情迁延反复，严重影响患者的生活质量。肠-脑轴理论的兴起为DRE的干预提供了新视角。益生菌可能通过逆转药物耐药性、减轻神经炎症和氧化应激、调节肠道菌群结构等多重途径，参与维持胃肠道与中枢神经系统间的动态平衡。本文系统综述益生菌在DRE治疗中的潜在作用机制和临床研究进展，分析了目前面临的挑战，并展望未来的临床应用方向，以期为DRE的微生态干预策略提供理论参考。更多还原

【Abstract】 Drug-resistant epilepsy(DRE) refers to a type of epilepsy that remains inadequately controlled after standardized treatment with two appropriately selected anti-seizure medications(ASMs), accounting for approximately onethird of all epilepsy cases. Characterized by a complex pathogenesis and recurrent clinical course, DRE severely compromises patients’ quality of life. Recent advancements in the gut-brain axis theory have provided novel insights into potential interventions for DRE. Studies indicate that probiotics may contribute to the maintenance of homeostatic equilibrium between the gastrointestinal tract and the central nervous system through multiple mechanisms, including the reversal of drug resistance, mitigation of neuroinflammation and oxidative stress, and modulation of intestinal flora composition. This systematic review summarizes the potential mechanistic roles and progress in clinical research on probiotics in DRE treatment, analyzes current challenges, and explores future clinical applications, thereby offering a theoretical foundation for microecological intervention strategies in DRE management.更多还原