BACKGROUND: Polysaccharides and probiotics can play an outstanding role in the treatment of liver disease by regulating gut microbiota. Recently, the combined therapeutic effect of probiotics and polysaccharides has attracted the attention of researchers. Houttuynia cordata polysaccharide (HCP) combined with Lactiplantibacillus plantarum P101 was used to prevent carbon tetrachloride (CCl 4 )-induced acute liver injury (ALI) in mice, and its effect on gut microbiota regulation was explored.RESULTS: Results showed that, in mice, HCP combined with L. plantarum P101 significantly alleviated oxidative stress and inflammatory injury in the liver by activating Nrf2 signals and inhibiting NF-κB signals. The analysis of gut microbiota revealed that the combination of HCP and L. plantarum P101 increased the abundance of beneficial bacteria such as Alloprevotella, Roseburia, and Akkermansia, but reduced that of the pro-inflammatory bacteria Alistipes, Enterorhabdus, Anaerotruncus, and Escherichia-Shigella. Correlation analysis also indicated that the expression of Nrf2 and TLR4/NF-κB was connected to the changes in gut microbiota composition. Houttuynia cordata polysaccharide combined with L. plantarum P101 can regulate the gut microbiota and then mediate the gut-liver axis to activate the antioxidant pathway and inhibit inflammatory responses, thereby alleviating CCl 4 -induced ALI.CONCLUSION: Our study provided a new perspective on the use of polysaccharides combined with probiotics in the treatment of liver disease.