Herbal medicines (HMs) are a major subset of complementary and alternative medicine. They have been employed for the efficient clinical management of type 2 diabetes mellitus (T2DM) for centuries. However, the related underlying mechanisms still remain to be elucidated. It has been found out that microbiota is implicated in the pathogenesis and treatment of T2DM. An interplay between gut microbiota and host occurs mainly at the gastrointestinal mucosal barrier. The host movements influence the composition and abundance of gut microbiota, whereas gut microbiota in turn modulate the metabolic and immunological activities of the host. Intestinal dysbiosis, endotoxin-induced metabolic inflammation, immune response disorder, bacterial components and metabolites, and decreased production of short-chain fatty acids are considered significant pathogenic mechanisms underlying T2DM. The interaction between gut microbiota and HMs during T2DM treatment has been investigated in human, animal, and in vitro studies. HMs regulate the composition of beneficial and harmful bacteria and decrease the inflammation caused by gut microbiota. Furthermore, the metabolism of gut microbiota modulates HM biotransformation. In this review, we have summarized such research findings, with the aim to improve our understanding of the pathogenesis and potential therapeutic mechanisms of HMs in T2DM and to provide new insights into specific targeted HM-based therapies and drug discovery.

草药（HMs）是补充和替代药物的主要子集。几个世纪以来，它们一直被用于2型糖尿病（T2DM）的有效临床管理。但是，相关的基本机制仍有待阐明。已经发现微生物群与T2DM的发病机理和治疗有关。肠道菌群与宿主之间的相互作用主要发生在胃肠道黏膜屏障处。宿主的运动会影响肠道菌群的组成和数量，而肠道菌群又会调节宿主的代谢和免疫活性。肠道营养不良，内毒素引起的代谢性炎症，免疫反应异常，细菌成分和代谢物，以及短链脂肪酸产量的下降被认为是T2DM的重要致病机制。在人类，动物和动物中，研究了T2DM治疗期间肠道菌群与HMs之间的相互作用。体外学习。HMs调节有益细菌和有害细菌的组成，并减少由肠道菌群引起的炎症。此外，肠道菌群的代谢调节HM生物转化。在这篇综述中，我们总结了此类研究结果，目的是增进我们对T2DM中HM的发病机理和潜在治疗机制的了解，并为基于HM的特定靶向治疗和药物发现提供新见解。