长期以来，由于肠道菌群本身的复杂性以及培养方法和分析技术的限制，肠道菌群在药物代谢和体内处置中的作用未得到应有的重视。近年来，随着技术的快速发展，围绕肠道菌群的大量研究将对肠道菌代谢和肠道菌 - 宿主共代谢的认识提高到前所未有的深度。肠道菌群不仅能够直接代谢许多药物，还通过宿主、菌群、药物之间复杂多维的相互作用间接改变药物代谢，从而影响个体对药物治疗的响应（效应、毒性、耐药性等）。肠道菌群结构及代谢功能受多种因素的影响。综述近期肠道菌群代谢药物研究领域的重要进展及研究趋势，以期推进精准治疗，促进药物发现及新的治疗策略的出现。For a long time, due to the complexity of the gut microbial community and the lack of suitable culture methods and analytical techniques, the importance of gut microbiota in drug metabolism and disposition has not received enough attention. In recent years, with the rapid development of technology, extensive research on gut microbiota has brought our understanding of gut microbial metabolism and gut microbiota-host co-metabolism to an unprecedented height. Gut microbiota can not only directly metabolize many drugs, but also alter drug metabolism indirectly through complex and multidimensional interactions among the host, gut microbiota and drugs, thereby affecting individual response to drug treatment (efficacy, toxicity, resistance, etc.). Its structure and metabolic function are affected by many factors. This article reviews the latest advances and trends in the research on gut microbial drug metabolism with an aim to advance precision medicine and promote discovery of new drugs and new therapeutic strategies.