肠-肌肉-脑轴作为介导神经退行性疾病与肌少症的三维交互网络，在帕金森病病理演进中起核心调 控作用。本文系统综述该轴系中肠道菌群失调通过代谢产物影响肌肉蛋白质合成与降解平衡，骨骼肌分 泌的肌因子反向调节神经炎症及肠屏障的功能和完整性，以及α-突触核蛋白在肠、肌、脑三器官间双向传播 的分子机制。结合最新临床证据，进一步探讨益生菌、运动-营养联合方案等靶向干预策略，旨在为老年帕 金森病并肌少症的患者精准防控提供新视角。

The gut-muscle-brain axis, acting as a three-dimensional interactive network that mediates neurodegenerative diseases and sarcopenia, plays a core regulatory role in the pathological progression of Parkinson’s disease (PD). This article provides a systematic review of how gut microbiota dysbiosis within this axis influences the balance of muscle protein synthesis and degradation via microbial metabolites, how myokines secreted by skeletal muscle in turn modulate neuroinflammation and the function and integrity of the intestinal barrier, and the molecular mechanisms underlying the bidirectional propagation of α-synuclein among the gut, muscle, and brain. Incorporating the latest clinical evidence, it further explores targeted intervention strategies such as probiotics and combined exercise-nutrition approaches, aiming to offer new perspectives for the precision prevention and management of sarcopenia in elderly PD patients.