关键词: 非酒精性脂肪性肝病；益生菌；肠道菌群；肠-肝轴

Abstract: Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases worldwide. Its pathogenesis is closely related to gut microbiota dysbiosis and it is a typical metabolic liver disease. Currently, there are no specific therapeutic drugs, and clinical intervention is still mainly based on lifestyle modifications, with limited efficacy and a high relapse rate. Dysfunction of the gut-liver axis plays a crucial role in the occurrence and progression of NAFLD. Gut microbiota dysbiosis can drive hepatic lipid metabolism disorders and fibrosis by disrupting the intestinal barrier, promoting endotoxin translocation, and inducing systemic low-grade inflammation. This article systematically reviews the structural and functional characteristics of the gut microbiota associated with NAFLD, focusing on the gut-liver axis, a core pathological regulatory axis. It highlights recent progress in understanding how probiotics alleviate NAFLD through multiple mechanisms, including regulating gut microbiota homeostasis, enhancing intestinal barrier function, and regulating short-chain fatty acid and bile acid metabolism. This paper further discusses the applicability and limitations of various microecological intervention strategies, including traditional probiotics, next-generation probiotics, prebiotics, synbiotics, and fecal microbiota transplantation, under different research backgrounds, emphasizing the decisive influence of strain specificity, individual differences, and intervention timing on efficacy. Based on this, this paper points out that current clinical research still lacks significant evidence regarding long-term efficacy verification and precise microecological intervention. Taking into account the development trends of multi-omics technologies and synthetic biology, this article proposes that future efforts should focus on integrating host-microbe interaction network data and constructing individualized efficacy prediction models to promote the transformation of probiotic intervention from empirical application to a precise microecological treatment model with clear mechanisms and hierarchical management, providing a systematic and forward-looking theoretical basis for the prevention and treatment of NAFLD.

Key words: non-alcoholic fatty liver disease; probiotics; gut microbiota; gut-liver axis