【摘要】 中医学认为“土病及金”是小儿哮喘的基本病机之一。肠道菌群是脾胃功能的重要组成部分，肠道菌群失调影响小儿哮喘的发生与发展。通过调节肠道菌群微生态以治疗小儿哮喘，与培土生金法有相通之处。从肠道菌群调节免疫细胞（T细胞、树突状细胞、巨噬细胞等）分化及组胺分泌影响小儿哮喘、经短链脂肪酸与维生素D代谢保护气道上皮并减轻重塑、调控迷走神经缓解气道炎症与高反应性等视角，探究脾胃功能失调导致小儿哮喘发作的机制。同时探讨培土生金法，如应用单味中药人参、复方四君子汤及外治法等，通过调节肠道菌群构成比治疗小儿哮喘的内在机制，明确其在治疗该病中的重要意义。更多还原

【Abstract】 Traditional Chinese Medicine posits that “earth disease affecting metal” is one of the fundamental pathogenic mechanisms of pediatric asthma. Gut microbiota is a crucial component of spleen-stomach function,and its dysbiosis influences the onset and progression of pediatric asthma. Treating pediatric asthma by modulating the gut microbiota ecosystem shares common ground with the therapeutic principle of “strengthening earth to generate metal”. This article explores the mechanisms by which spleen-stomach dysfunction leads to pediatric asthma attacks from several perspectives:how gut microbiota regulates the differentiation of immune cells(such as T cells,dendritic cells,and macrophages)and histamine secretion;its protective effects on airway epithelium and reduction of remodeling through short-chain fatty acids and vitamin D metabolism;and its modulation of the vagus nerve to alleviate airway inflammation and hyperresponsiveness. Concurrently,it discusses the intrinsic mechanisms through which the “strengthening earth to generate metal” method——such as using single herbs like ginseng,compound formulas like Sijunzi Tang（四君子汤）,and external therapies——treats pediatric asthma by regulating the composition of gut microbiota,thereby clarifying its significant role in the management of this condition.更多还原