Chronic obstructive pulmonary disease (COPD) and bronchial asthma are heterogeneous chronic airway diseases that share pathological processes such as airway inflammation, epithelial injury, oxidative stress, and aberrant repair, but differ in major risk factors, inflammatory phenotypes, and natural history. Gut microbiota-related metabolites are important functional mediators of the gut-lung axis, and their production and circulating levels are influenced by multiple factors, including microbial composition, dietary substrates, and host metabolism. Current studies have mainly focused on short-chain fatty acids, microbiota-related tryptophan metabolites, bile acids, and trimethylamine N-oxide, while microbe-derived signals such as lipopolysaccharide are also associated with inflammatory responses. Studies of COPD and asthma have shown differences in immune-inflammatory phenotypes, epithelial and structural injury, and local and systemic metabolic profiles. This review summarizes the sources and biological effects of major gut microbiota-related metabolites and microbe-derived signals, their associations with COPD and asthma, as well as changes in related metabolites, microbe-derived signals, and overall metabolic profiles following traditional Chinese medicine interventions. The aim is to provide a theoretical reference for understanding the metabolic links of the gut-lung axis in COPD and asthma and for further research on traditional Chinese medicine interventions.

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