膿毒癥是由宿主對(duì)感染反應(yīng)失調(diào)引發(fā)的危及生命的器官功能障礙綜合征,其高發(fā)病率與死亡率對(duì)全球公共衛(wèi)生構(gòu)成嚴(yán)峻挑戰(zhàn)。當(dāng)前治療以對(duì)癥支持為主,但存在療效局限及不良反應(yīng)。人參皂苷作為人參的核心活性成分,具有抗炎、免疫調(diào)節(jié)、抗氧化等藥理活性,近年來(lái)在膿毒癥治療中的多靶點(diǎn)、多途徑作用機(jī)制逐漸受到關(guān)注。通過(guò)對(duì)膿毒癥的發(fā)病機(jī)制及病理特點(diǎn)進(jìn)行總結(jié),并詳細(xì)探討人參皂苷在調(diào)節(jié)炎癥反應(yīng)、糾正免疫功能紊亂、改善凝血功能和微循環(huán)障礙、抑制氧化應(yīng)激、協(xié)調(diào)神經(jīng)-內(nèi)分泌-免疫網(wǎng)絡(luò)、減輕線粒體損傷及緩解內(nèi)質(zhì)網(wǎng)應(yīng)激等方面的研究進(jìn)展。此外,以參麥注射液等為代表的制劑,通過(guò)人參皂苷與其他活性成分的協(xié)同增效,在臨床與實(shí)驗(yàn)研究中表現(xiàn)出改善器官功能、重建免疫穩(wěn)態(tài)的整合優(yōu)勢(shì)。為人參皂苷及其制劑作為膿毒癥治療新策略提供理論依據(jù)和研究方向。未來(lái)需通過(guò)深化分子機(jī)制解析、明確藥動(dòng)學(xué)特征及開展高質(zhì)量臨床試驗(yàn),進(jìn)一步驗(yàn)證其療效,推動(dòng)其在膿毒癥中西醫(yī)結(jié)合精準(zhǔn)治療中的轉(zhuǎn)化應(yīng)用。

Sepsis is a life-threatening organ dysfunction syndrome triggered by a dysregulated host response to infection, posing a significant challenge to global public health due to its high morbidity and mortality rates. Current treatments primarily focus on symptomatic and supportive care but are limited by efficacy constraints and side effects. Ginsenosides, the core bioactive components of Renshen (Ginseng Radix et Rhizoma), exhibit various pharmacological activities, including anti-inflammatory, immunomodulatory, and antioxidant properties. In recent years, their multi-target and multi-pathway mechanisms in sepsis treatment have garnered increasing attention. This review summarizes the pathogenesis and pathological characteristics of sepsis, elaborates on the research progress of ginsenosides in regulating inflammatory responses, correcting immune dysfunction, improving coagulation and microcirculatory disturbances, inhibiting oxidative stress, coordinating the neuro-endocrine-immune network, alleviating mitochondrial damage, and mitigating endoplasmic reticulum stress. In addition, traditional Chinese medicine compound preparations represented by Shenmai Injection (參麥注射液), through the synergistic effect of ginsenosides and other active ingredients, have demonstrated integrated advantages in improving organ function and restoring immune homeostasis in clinical and experimental studies. This article aims to provide theoretical basis and research direction for ginsenosides and their preparations as new strategies for treatment of sepsis. In the future, it is necessary to further verify its efficacy by deepening the molecular mechanism analysis, clarifying the pharmacokinetic characteristics and conducting high-quality clinical trials, and promote its transformation and application in the precise treatment of sepsis with integrated traditional Chinese medicine and Western medicine.

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天津中醫(yī)藥大學(xué)第一附屬醫(yī)院“拓新工程”基金科研課題（院YB202116）