药物难治性癫痫是一种使用抗癫痫药物难以有效控制的慢性脑部疾病，占全球癫痫患者总数的近 1/3。近年研究发现，药物难治性癫痫患者的肠道菌群组成与健康人群存在显著差异，提示肠道菌群可能通 过微生物-肠-脑轴影响调控神经递质代谢、炎症反应及血脑屏障功能，从而参与癫痫发作的调控。本文系 统综述了调节肠道菌群治疗DRE的相关研究机制进展，以期为开发新型药物难治性癫痫治疗策略提供理 论依据。

Drug-resistant epilepsy (DRE) is a chronic brain disorder that is difficult to effectively control with antiepileptic drugs, accounting for nearly one-third of the global epilepsy patient population. Recent studies have revealed significant differences in the gut microbiota (GM) composition between DRE patients and healthy individuals, suggesting that the gut microbiota may influence and regulate neurotransmitter metabolism, inflammatory responses, and blood-brain barrier function through the microbiota-gut-brain axis (MGBA), thereby participating in the modulation of seizure activity. This article systematically reviews the research progress on the mechanisms underlying the regulation of gut microbiota for the treatment of DRE, aiming to provide a theoretical basis for the development of novel therapeutic strategies for DRE.