蛋白质能量消耗（PEW）是慢性肾脏病（CKD）的重要并发症，是CKD预后的独立危险因素之一。肠道菌群可能参与CKD-PEW发病发展，但具体机制不明。肾衰营养胶囊（SSYYJN）对PEW有良好的治疗作用，可以改变肠道菌群的结构，但肠道菌群复杂且中医理论缺乏现代阐释，SSYYJN的疗效和预后很难客观预测。肠道菌群结构丰富，既是揭示CKD-PEW发病机制的突破口，又是预测疗效和预后的信息基础。故本研究拟以CKD-PEW人群为研究对象，收集相关信息和生物标本，通过巢式队列研究筛选SSYYJN对PEW的有效人群，并通过对预后数据和16S rDNA测序信息的机器学习建立中药个体化判别模型；在此基础上预测与疗效预后相关的重要菌类，通过菌群移植完成体内实验验证。最终揭示CKD-PEW与肠道微生态的相关性和SSYYJN治疗靶点。

Protein-energy wasting (PEW) is an important complication of chronic kidney disease (CKD), which is one of the independent risk factors for CKD prognosis. Intestinal flora may be involved in the pathogenesis of CKD-PEW, but the specific mechanism is unclear. ShenShuaiYingYangJiaoNang (SSYYJN) has a good therapeutic effect on PEW and can change the structure of intestinal flora. However, due to the complexity of intestinal flora and the lack of modern tools in traditional Chinese medicine (TCM) theory, it is difficult to objectively predict the efficacy and prognosis of SSYYJN. Intestinal flora is rich in structure, which is not only a breakthrough to reveal the pathogenesis of CKD-PEW, but also an information basis for predicting curative effect and prognosis. Therefore, this study will take CKD-PEW patients as the research object, collect relevant information and biological specimens, screen the effective population of SSYYJN for PEW through nested cohort study, and establish the individualized discriminant model of TCM through machine learning of prognostic data and 16S rDNA sequencing information. Then predict the important flora related to the prognosis of curative effect, and complete in vivo experimental verification through bacterial group transplantation. Finally, the correlation between CKD-PEW and intestinal microecology and the therapeutic target of SSYYJN were revealed.