Traditional Chinese Medicine Ameliorates Depression via the Gut-Brain Axis: A Review Focus on NLRP3/TLR4-Mediated Inflammatory Pathways and Gut Microbiota Modulation

Mar 20, 2026Neuropsychiatric disease and treatment

Traditional Chinese Medicine may improve depression by reducing inflammation and balancing gut bacteria through the gut-brain connection

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Abstract

A total of 307 eligible studies indicate that traditional Chinese medicine (TCM) may alleviate depression through modulation.

  • TCM may regulate gut microbiota composition by increasing beneficial bacteria such as Lactobacillus and Bifidobacterium while decreasing harmful types.
  • Herbs like Astragalus membranaceus and formulas like Xiaoyaosan could inhibit inflammatory pathways by reducing levels of IL-6, TNF-α, and IL-1β.
  • TCM may enhance levels of anti-inflammatory IL-10 and elevate neurotransmitters like serotonin and dopamine.
  • BDNF, a protein associated with neuroprotection, may be upregulated by TCM treatments.
  • Acupuncture is associated with reduced plasma levels of IL-6 and TNF-α, as well as restoration of microbial balance, which could improve depressive behaviors.

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Key numbers

280 million
Global Depression Prevalence
Estimated number of people affected worldwide according to WHO.
$2 trillion
Annual Economic Burden
Estimated economic burden due to depression globally.
42%
CUMS-Induced IL-1β Reduction
Decrease in hippocampal IL-1β levels in CUMS mice treated with TCM.

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