脓毒症是由感染引发的全身炎症反应综合征，其异常炎症反应会引发肠黏膜屏障损伤。肠黏膜屏障由生物屏障、化 学屏障、机械屏障和免疫屏障四部分构成，其损伤被认为是脓毒症多器官功能障碍的“始动器官”，其中免疫屏障在脓毒症 的病情进展中尤为重要。小檗碱（又称黄连素）是从黄连等小檗科植物中提取的有效生物碱，具有抗菌、抗炎等多重药理作 用，已被广泛应用于包括腹泻、心律失常等在内的多种疾病的治疗。该文综述了近年来有关小檗碱对脓毒症肠黏膜免疫屏 障损伤的保护作用及其机制研究进展。近年来的研究表明，小檗碱可通过调节肠黏膜的TLRs信号通路、Notch信号通路、树 突状细胞功能，诱导肠黏膜的巨噬细胞铁死亡，调控脓毒症的肠道菌群失衡等途径，调节脓毒症的肠黏膜免疫功能，有效 保护和修复肠黏膜屏障，从而缓解脓毒症引起的损伤，显示出其在脓毒症治疗中的独特优势和良好应用前景。对其作用机 制进行深入研究并探索优化小檗碱防治脓毒症肠黏膜屏障损伤的应用策略，将对提高脓毒症临床疗效具有重要意义，可为 脓毒症防治提供新思路和方向。

Sepsis is a systemic inflammatory response syndrome triggered by infection， and the abnormal inflammatory response leads to the damage of intestinal mucosal barrier. The intestinal mucosal barrier consists of four parts，namely biological barrier，chemical barrier，mechanical barrier，and immune barrier. The injured intestinal mucosal barrier is considered as the “initiating organ” of multiple organ dysfunctions in sepsis，with the immune barrier being particularly critical to the progression of sepsis. Berberine （also known as berberine hydrochloride） is an active alkaloid extracted from Berberaceae plants such as Coptidis Rhizoma，and possesses multiple pharmacological actions including antibacterial and anti-inflammatory effects. It has been widely used in the treatment of various diseases，including diarrhea and arrhythmias. This article reviewed the progress in recent research on the protective effects and mechanism of Berberine against sepsis-induced intestinal mucosal immune barrier damage. The recent studies have shown that berberine can modulate intestinal mucosal immune function in sepsis via regulating the TLRs signaling pathway，Notch signaling pathway，and dendritic cell （DC） function，by inducing ferroptosis of macrophages in intestinal mucosa， and by regulating the imbalance of gut microbiota in sepsis patients. The unique advantages of berberine and its promising application prospects in the treatment of sepsis have been demonstrated by its effects on protecting and repairing the intestinal mucosal barrier and on improving the sepsis-induced intestinal mucosal barrier damage. The in-depth research into its therapeutic mechanisms and the exploration of optimized strategies for using berberine to prevent and treat sepsis-induced intestinal mucosal barrier damage are of great significance for enhancing clinical outcomes in sepsis treatment，and will provide new insights and directions for the prevention and treatment of sepsis.

R259.153

国家自然科学基金项目（编号：82274288）；广东省自然科学基金项目（编号：2022A1515011641）；深圳市科技计划项目（编号： JCYJ20210324121808024，JCYJ20240813160617023）；深圳市福田区临床重点专科建设项目