参附注射液对脓毒症急性呼吸窘迫综合征患者肠肺菌群的影响

左小淑; 江贵军; 张迪; 李光; 詹丽英; 邹捍东; 夏文芳; 高文蔚; 宋振举; 张召才; 王璐

doi:10.14188/j.1671-8852.2024.0494

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参附注射液对脓毒症急性呼吸窘迫综合征患者肠肺菌群的影响

急性呼吸窘迫综合征专题研究 | 更新时间：2026-11-05

- 参附注射液对脓毒症急性呼吸窘迫综合征患者肠肺菌群的影响
- Effect of Shenfu injection on intestinal and lung flora in patients with sepsis⁃induced acute respiratory distress syndrome
- 武汉大学学报（医学版） 2025年46卷第2期页码：166-175
- 作者机构：
  
  1.武汉大学人民医院重症医学科湖北武汉 430060
  2.复旦大学附属中山医院急诊科/复旦大学应急救援与急危重症研究所上海 200032
  3.浙江大学医学院附属第二医院重症医学科/浙江省急危重症临床医学研究中心浙江杭州 310009
- 作者简介：
  
  左小淑，女，1984—，医学博士，副主任医师，主要从事脓毒症ARDS临床及分子机制研究，E⁃mail:zuoxiaoshu2016@whu.edu.cn
  王璐，女，1987—，医学博士，副主任医师，主要从事脓毒症心肌病临床及基础研究，E⁃mail:wanglu@whu.edu.cn
- 基金信息：
  
  国家重点研发计划(2021YFC2501800);国家自然科学基金面上项目(82272226);武汉市知识创新专项项目(2023020201010165);武汉大学人民医院交叉创新人才项目(JCRCZN⁃2022⁃017);吴阶平医学基金会重症医学润泽基金
- DOI：10.14188/j.1671-8852.2024.0494
  中图分类号： R453.9
- 收稿：2024-07-03，
  
  纸质出版：2025-02-25
- 稿件说明：
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左小淑,江贵军,张迪等.参附注射液对脓毒症急性呼吸窘迫综合征患者肠肺菌群的影响[J].武汉大学学报（医学版）,2025,46(02):166-175.

ZUO Xiaoshu,JIANG Guijun,ZHANG Di,et al.Effect of Shenfu injection on intestinal and lung flora in patients with sepsis⁃induced acute respiratory distress syndrome[J].Medical Journal of Wuhan University,2025,46(02):166-175.
左小淑,江贵军,张迪等.参附注射液对脓毒症急性呼吸窘迫综合征患者肠肺菌群的影响[J].武汉大学学报（医学版）,2025,46(02):166-175. DOI： 10.14188/j.1671-8852.2024.0494.

ZUO Xiaoshu,JIANG Guijun,ZHANG Di,et al.Effect of Shenfu injection on intestinal and lung flora in patients with sepsis⁃induced acute respiratory distress syndrome[J].Medical Journal of Wuhan University,2025,46(02):166-175. DOI： 10.14188/j.1671-8852.2024.0494.

摘要

目的

探讨参附注射液(SF)对脓毒症急性呼吸窘迫综合征（ARDS）患者肠、肺菌群的影响。

方法

纳入2022年1—12月武汉大学人民医院22例脓毒症ARDS患者，随机分为常规治疗组（Control组）和SF治疗组（SF组），收集两组患者的肺泡灌洗液（BALF）及粪便，通过16S rRNA及非靶向代谢组学技术，分析SF干预前、后肠道及肺部微生物菌群多样性及代谢产物的改变，寻找差异代谢产物及代谢通路。

结果

（1）SF组BALF微生物Alpha多样性较Control组显著改善、Shannon指数变大（

0.05），提示微生物物种丰富度增加；两组粪便Shannon指数和Beta多样性无显著差异。BALF微生物物种有29.97%来源于粪便，出现了粪便中常见的拟杆菌属。（2）液相色谱⁃质谱联用（LC⁃MS/MS）分析显示粪便及BALF在SF处理后，色氨酸代谢通路发生显著变化（

0.05）。粪便KEGG富集分析发现，色氨酸代谢和5⁃羟基吲哚乙酸盐均被下调（

0.05）。

结论

对于脓毒症ARDS患者，SF可丰富其BALF及粪便中菌群多样性，并参与色氨酸代谢途径，本研究为后续深入研究SF参与ARDS肠肺轴的作用机制提供一定参考和依据。

Abstract

Objective

To explore the effect of

Shenfu

injection(SF) on intestinal and lung flora in patients with sepsis⁃induced acute respiratory distress syndrome (ARDS).

Methods

From January to December 2022

twenty⁃two patients with sepsis⁃induced ARDS were enrolled at Renmin Hospital of Wuhan University. The patients were randomly divided into the conventional treatment group (control group) and the

Shenfu

injection treatment group (SF group). Bronchoalveolar lavage fluid (BALF) and fecal samples were collected from both groups. 16S rRNA and non⁃targeted metabolomics technologies were used to analyze the changes in microbial flora diversity and metabolites in the intestine and lungs before and after SF intervention

and to identify differential metabolites and metabolic pathways.

Results

(1) The BALF microbial Alpha diversity of the SF group was significantly improved as compared with that of the control group

and the Shannon index became larger (

0.05)

indicating that the richness of microbial species increased; there was no significant difference in fecal Shannon index and Beta diversity between the two groups. 29.97% of BALF microbial species originat

ed from feces

and

Bacteroidetes

which is common in feces

appeared in BALF. (2) LC⁃MS/MS showed that the tryptophan metabolism pathway in feces and BALF changed significantly after SF treatment (

0.05). Fecal KEGG enrichment analysis found that the expression of metabolite tryptophan and 5⁃hydroxyindoleacetate were both down⁃regulated (

0.05).

Conclusion

Shenfu

Injection has a tendency to enrich the diversity of BALF and fecal flora in patients with sepsis⁃induced ARDS

and participates in the tryptophan metabolic pathway

which provides a certain reference and basis for subsequent in⁃depth research on the mechanism of

Shenfu

Injection in the gut⁃lung axis of ARDS.

关键词

Keywords

references

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Evans L , Rhodes A , Alhazzani W , et al . Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 [J ] . Intensive Care Med , 2021 , 47 ( 11 ): 1181 ⁃ 1247 .

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Matthay M A , Zemans R L , Zimmerman G A , et al . Acute respiratory distress syndrome [J ] . Nat Rev Dis Primers , 2019 , 5 ( 1 ): 18 .

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Huang Z B , Hu Z , Lu C X , et al . Gut microbiota⁃derived indole 3⁃propionic acid partially activates aryl hydrocarbon receptor to promote macrophage phagocytosis and attenuate septic injury [J ] . Front Cell Infect Microbiol , 2022 , 12 : 1015386 .

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