骨骼肌萎缩是多种生理和病理状态下的常见表现，严重影响患者的生活质量和预后。近年来，肠道 菌群及其与宿主形成的“肠-肌轴”被认为是影响骨骼肌稳态的关键因素。肠道菌群失调可通过多种途径促 进肌肉萎缩，包括破坏肠道屏障、诱发慢性炎症、改变代谢产物谱等。运动是维持骨骼肌质量和功能的有 效手段，同时也被证实能够显著调节肠道菌群的组成和功能。越来越多的研究提示，运动可能通过调节肠 道菌群，进而通过肠-肌轴对骨骼肌萎缩产生有益影响。本文旨在综述肠-肌轴在骨骼肌萎缩中的作用机 制，运动对肠道菌群的影响，并重点探讨运动如何介导肠道菌群变化，从而改善骨骼肌萎缩的潜在机制与 临床证据。深入理解这一复杂互作网络，将为开发基于运动和肠道菌群干预的肌肉萎缩防治策略提供新 的思路。

Skeletal muscle atrophy is a common manifestation across various physiological and pathological conditions, severely impairing patients’quality of life and prognosis. In recent years, the gut microbiota, together with the "gut-muscle axis" it forms with the host, has been recognized as a critical factor influencing skeletal muscle homeostasis. Gut dysbiosis can promote muscle atrophy through multiple pathways, including disruption of the intestinal barrier, induction of chronic inflammation, and alterations in the spectrum of metabolites. Exercise is an effective strategy for maintaining skeletal muscle mass and function, and it has also been demonstrated to significantly modulate the composition and function of the gut microbiota. Increasing evidence suggests that exercise may exert beneficial effects on skeletal muscle atrophy via the gut-muscle axis by modulating the gut microbiota. This article aims to review the mechanistic role of the gut-muscle axis in skeletal muscle atrophy and the impact of exercise on the gut microbiota, with a specific focus on exploring the potential mechanisms and clinical evidence regarding how exercise mediates gut microbiota changes to ameliorate skeletal muscle atrophy. A comprehensive understanding of this complex interaction network will provide novel insights for developing prevention and treatment strategies for muscle atrophy based on exercise and gut microbiota interventions.