Intestinal barrier defense: the protective effect of plant-based traditional Chinese medicine

Abstract Traditional Chinese medicine (TCM) plays a crucial role in maintaining the intestinal barrier, which is considered integral to overall health and is connected with the functions of the spleen and stomach and the balance of qi and blood. TCM principles, such as "separating the pure from the turbid," are related to gut flora equilibrium, with imbalances corresponding to the "struggle between good and evil." TCM supports the intestinal barrier through methods such as invigorating qi and strengthening the spleen. In this review, authoritative databases such as PubMed, Web of Science, and Google Scholar were systematically searched for studies on the protective effects of TCM and its constituents on the intestinal barrier from 2018 to 2025. The results show that TCM and its components have multiple advantages in maintaining intestinal barrier function. Classic formulations such as Qingchang Wenzhong and Huangqin decoction protect the intestines through various pathways, including regulating the gut microbiota and enhancing immune function. Single herbs such as Coptis chinensis (Huang Lian) and Scutellaria baicalensis (Huang Qin), whose properties include clearing heat and detoxifying and tonifying qi, directly or indirectly promote intestinal health. Additionally, active compounds in TCM, such as flavonoids and saponins, contribute to intestinal homeostasis through mechanisms such as anti-inflammatory and antioxidant effects. The multicomponent, multitarget characteristics of TCM provide comprehensive and long-lasting efficacy in intestinal barrier protection. This article summarizes the current research status of TCM in treating intestinal barrier injury and highlights future research directions, offering a theoretical foundation and research insights for further exploration of the role of TCM in safeguarding intestinal barrier function. Graphical Abstract