The gut microbiota plays a pivotal role in maintaining host metabolic homeostasis and overall physiological functions. Shenling Baizhu San (SLBZS), a time-honored classical prescription for tonifying Qi, strengthening the spleen, removing dampness, and arresting diarrhea, has shown broad clinical efficacy in digestive disorders. Emerging evidence indicates that the metabolic fate, pharmacokinetics, and bioavailability of SLBZS's complex herbal constituents are profoundly influenced by interactions with specific intestinal microorganisms and their enzymatic repertoire. This review systematically summarizes advances in five key areas:(1) the major bioactive components of SLBZS and their modern therapeutic applications; (2) characterization of gut microbial communities and their relevant degradative enzymes; (3) in vitro and in vivo studies elucidating microbe-mediated biotransformation of SLBZS constituents; (4) modulation of host signaling pathways—such as NF-κB, peroxisome proliferator-activated receptor, and AMPK—by SLBZS metabolites; and (5) the pharmacological implications of these microbial conversions for enhancing compound bioactivity and therapeutic outcomes. By integrating phytochemical analyses, microbial genomics, and metabolomics data, researchers have begun to identify the specific microbial taxa responsible for key hydrolysis, reduction, and deglycosylation reactions. Understanding these host-microbe-herb interactions not only sheds light on the mechanistic basis of SLBZS's efficacy, but also informs strategies to optimize its formulation and dosing. Such insights will facilitate the modernization and precision application of traditional Chinese medicine, ultimately improving patient prognosis in gastrointestinal and systemic diseases.

Rheumatoid arthritis (RA) is a common autoimmune disease with bone destruction as the core pathology, which belongs to the category of "impediment disease" in traditional Chinese medicine (TCM), and its etiology and pathogenesis are still not completely clear. It is characterized by high prevalence, high disability rate, and high recurrence rate, which seriously affects human health and has become a worldwide research hot spot. At present, although modern medicine has made significant progress in the treatment of RA bone destruction, such as biologics and small-molecule targeted drugs, it still faces problems such as poor efficacy, drug resistance, drug side effects, and long-term treatment costs. It has been found that the use of TCM decoction and acupuncture in combination with Western medicine for the treatment of RA bone destruction can enhance the efficacy of the treatment while reducing the adverse effects of Western medicine. However, no one has systematically reviewed the current research status on the combination of Chinese and Western medicine in the treatment of RA bone destruction. Therefore, this paper reviews the research progress of combined Chinese and Western medicine in the treatment of RA bone destruction, aiming to promote the application of combined Chinese and Western medicine in clinical practice and provide new treatment ideas for the clinical treatment of RA bone destruction.

Rheumatoid arthritis (RA) is a chronic, highly disabling autoimmune disease. Although modern medical treatments have made progress, challenges such as suboptimal efficacy, relapse, difficulties in comorbidity management, and side effects persist. Traditional Chinese medicine (TCM) demonstrates unique advantages in the treatment of RA throughout the entire course of the disease, particularly in early intervention, consolidation during remission, reducing the side effects of Western medicines, and preventing relapse. Based on this, the article explores the research paradigm and scientific and technological strategic approaches for RA, which is recognized as a disease with clinical advantages in TCM. It proposes a three-pronged approach: optimizing the integrated traditional Chinese and Western medicine diagnostic and treatment system, strengthening comprehensive prevention and control of RA-related complications and comorbidities, and establishing a chronic disease management system for RA based on TCM theories. Through the synergy of clinical and basic research, the aim is to clarify the advantageous aspects of TCM in RA diagnosis and treatment, develop effective treatment protocols, enhance RA prevention and management, and underscore the value of TCM.