脓毒症是由宿主对感染反应失调引发的危及生命的器官功能障碍综合征,其高发病率与死亡率对全球公共卫生构成严峻挑战。当前治疗以对症支持为主,但存在疗效局限及不良反应。人参皂苷作为人参的核心活性成分,具有抗炎、免疫调节、抗氧化等药理活性,近年来在脓毒症治疗中的多靶点、多途径作用机制逐渐受到关注。通过对脓毒症的发病机制及病理特点进行总结,并详细探讨人参皂苷在调节炎症反应、纠正免疫功能紊乱、改善凝血功能和微循环障碍、抑制氧化应激、协调神经-内分泌-免疫网络、减轻线粒体损伤及缓解内质网应激等方面的研究进展。此外,以参麦注射液等为代表的制剂,通过人参皂苷与其他活性成分的协同增效,在临床与实验研究中表现出改善器官功能、重建免疫稳态的整合优势。为人参皂苷及其制剂作为脓毒症治疗新策略提供理论依据和研究方向。未来需通过深化分子机制解析、明确药动学特征及开展高质量临床试验,进一步验证其疗效,推动其在脓毒症中西医结合精准治疗中的转化应用。

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 (参麦注射液), 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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天津中医药大学第一附属医院“拓新工程”基金科研课题（院YB202116）