One mechanism of Sishen Pill on diarrhea with kidney Yang deficiency syndrome: influencing metabolic function by intestinal microorganisms and enzyme activity mediates the gut-kidney axis

The SSP may alleviate diarrhea with kidney Yang deficiency syndrome by reducing E. coli count, enhancing specific enzyme activities, and regulating organ indices and oxidative stress, with the regulatory effects on organ indices and oxidative stress potentially associated with its modulation of E. coli and enzyme activity. This cascade of microbial-enzymatic regulation likely contributes to the normalization of organ indices (e.g., spleen and thymus indices) and alleviation of oxidative stress, as reflected by enhanced superoxide dismutase activity. These findings highlight the multitarget therapeutic potential of SSP in addressing dysfunction in the intestinal-microbiome-enzymatic-organ axis in diarrhea with kidney Yang deficiency syndrome.