肺炎是呼吸系统疾病中的常见疾病，发病率高，可伴有多种并发症，严重时可危及生命健康。肺炎患者多伴有肠道菌群失调，表现为有益菌减少，且益生菌可通过“肠-肺轴”影响肺部免疫参与肺炎的发生发展。中医以“肺”与“大肠”两者之间的生理及病理关系为基础，通过整体观念和辨证论治发挥了治疗肺炎的独特的优势。近年来，许多研究表明中医药在治疗肺炎的过程中具有改善肠道微生态作用，但肺炎的中医辨证分型与肠道菌群的相关性尚不明确。本文从中医辨证分型论治肺炎的角度出发，总结不同辨证分型的肺炎与肠道菌群结构特征，阐述中医治疗肺炎过程中对于益生菌的调节作用和“证型—中药—益生菌”的对应关系。通过讨论益生菌在防治肺炎中的关键作用，展望中医辩证联合益生菌治疗肺炎的应用前景，以期为肺炎的防治提供新思路和新靶点，也为将来指导不同肺炎证型患者选择适合的中药及益生菌提供理论依据。

As common respiratory disease, pneumonia attacks frequently, and often have severe complications, which lead to life-threatening conditions. Most pneumonia patients have gut microbiota imbalance, which is characterized by the reduction of probiotics; conversely, they participate in the occurrence and development of pneumonia by affecting lung immunity through the "gut-lung axis". Based on the physiological and pathological relationship between "lung" and "large intestine", traditional Chinese medicine (TCM) has great advantages in the prevention and treatment of pneumonia via syndrome differentiation. Recently, many studies have shown that TCM can improve intestinal microecology of pneumonia, but the correlation between TCM syndrome differentiation and gut microbiota is still unclear. Thus, we aim to summarize the gut microbiota community features of pneumonia with different syndrome differentiation, reveal the regulatory effect of TCM on probiotics in the treatment of pneumonia and the corresponding relationship between "syndrome - TCM - probiotics". By discussing the key role of probiotics in the prevention and treatment of pneumonia, we also look forward to the application prospect of combination use of probiotics and TCM. This review would like to provide new ways for the treatment of pneumonia and provide theoretical basis for guiding patients with different pneumonia syndrome to choose suitable TCM and probiotics in the future.

国家科学技术部国家重点研发计划（2021YFE0200300）：宣肺败毒方治疗新冠肺炎作用机制的国际合作研究，负责人：王彧。