Efficacy and safety of Chinese herbal medicine as adjunctive therapy in sepsis patients with bloodstream infection: a propensity-matched analysis

doi:10.19852/j.cnki.jtcm.20231204.002

Journal of Traditional Chinese Medicine ›› 2024, Vol. 44 ›› Issue (1): 197-204.DOI: 10.19852/j.cnki.jtcm.20231204.002

• Original articles • Previous Articles Next Articles

Efficacy and safety of Chinese herbal medicine as adjunctive therapy in sepsis patients with bloodstream infection: a propensity-matched analysis

ZHOU Xianshi¹, ZHONG Minlin², XI Xiaotu³, LI Jun⁴(), TANG Guanghua¹()

1 the Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Emergency Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China
2 Emergency Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
3 Emergency Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China; Guangzhou Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Emerging Infectious Diseases, Guangzhou 510120, China
4 Administration Department, the First Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China

Received:2022-11-11 Accepted:2023-02-18 Online:2024-02-15 Published:2023-12-04
Contact: LI Jun, Administration Department, the first hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China. junlilijun123@126.com;TANG Guanghua, the Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Emergency Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China. guanghuatang123@yeah.net. Telephone: +86-20-81887233
Supported by:
Clinical Research Program of Guangdong Provincial Hospital of Chinese Medicine: Exploring the Epidemiological Characteristics and Screening Key Prognostic Indicators of Sepsis Patients with Bloodstream Infection(2019KT1317);which is a sub-project of Guangdong Provincial Key Laboratory of Research on Emergency in TCM(2017B030314176)

1. .doc(63KB)

Abstract

Abstract:

OBJECTIVE: To investigate the efficacy and safety of Chinese herbal medicine in treating sepsis patients with bloodstream infection.

METHODS: A 6-year retrospective study was carried out at a university hospital in China. Adult sepsis patients with bloodstream infection were included. The primary outcome was 28-day mortality after admission. Propensity score method was used to adjust for possible confounding. 28-day mortality was estimated by Kaplan-Meier analysis and compared using the log-rank test. Cox regression analysis was carried out to identify factors impacting in-hospital mortality outcomes.

RESULTS: Following the application of the propensity score method, a total of 176 patients were included. The all-cause 28-day mortality in the control group and Chinese herbal medicine group was 21.6% and 14.8%, respectively. Kaplan-Meier survival analysis showed that Chinese herbal medicine was associated with a lower hazard ratio (HR) in all-cause 28-day death compared with the control group [HR = 0.44, 95% CI(0.22, 0.90), P < 0.05]. The complications were similar between the two groups (P >0.05). Blood-activating and stasis-eliminating herb administration was associated with reduced in-hospital mortality among sepsis patients with bloodstream infection [HR = 0.54, 95% CI(0.34, 0.94), P < 0.05].

CONCLUSIONS: Chinese herbal medicine, especially the blood-activating and stasis-eliminating herb, might have certain efficacy and safety in treating sepsis patients with bloodstream infection. Clinicians should prescribe blood-activating and stasis-eliminating herb in treating these two coalescent critical diseases as long as no contraindications exist. However, further studies are needed to validate our results.

Key words: bacteremia, medicine, Chinese traditional, herbal medicine, sepsis, propensity-matched analysis

ZHOU Xianshi, ZHONG Minlin, XI Xiaotu, LI Jun, TANG Guanghua. Efficacy and safety of Chinese herbal medicine as adjunctive therapy in sepsis patients with bloodstream infection: a propensity-matched analysis[J]. Journal of Traditional Chinese Medicine, 2024, 44(1): 197-204.

Figures/Tables 6

References 36.

1.	Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315: 801-10. DOI PMID
2.	Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Intensive Care Med 2003; 29: 530-8. DOI URL
3.	Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med 2021; 47: 1181-247. DOI PMID
4.	Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med 2016; 193: 259-72. DOI URL
5.	Biwersi C, Hepping N, Bode U, et al. Bloodstream infections in a German paediatric oncology unit: prolongation of inpatient treatment and additional costs. Int J Hyg Environ Health 2009; 212: 541-6. DOI URL
6.	Mehl A, Åsvold BO, Lydersen S, et al. Burden of bloodstream infection in an area of Mid-Norway 2002-2013: a prospective population-based observational study. BMC Infect Dis 2017; 17: 205. DOI PMID
7.	Ababneh MA, Rababa'h AM, Almomani BA, Ayoub AM, Al-Azzam SI. A ten-year surveillance of P aeruginosa bloodstream infections in a tertiary care hospital: trends and risk factors for mortality. Int J Clin Pract 2021; 75: e14409.
8.	Amanati A, Sajedianfard S, Khajeh S, et al. Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance. BMC Infect Dis 2021; 21: 636. DOI PMID
9.	Laupland KB, Davies HD, Church DL, et al. Bloodstream infection-associated sepsis and septic shock in critically ill adults: a population-based study. Infection 2004; 32: 59-64. DOI PMID
10.	Rodríguez-Baño J, de Cueto M, Retamar P, Gálvez-Acebal J. Current management of bloodstream infections. Expert Rev Anti Infect Ther 2010; 8: 815-29. DOI PMID
11.	Liu QQ. Based on the four segments and treatment by syndrome differentiation to lower the mortality of sepsis. Chin J Integr Med 2009; 15: 16-8. DOI URL
12.	Lai F, Zhang Y, Xie DP, et al. A systematic review of Rhubarb (a Traditional Chinese Medicine) used for the treatment of experimental sepsis. Evid Based Complement Alternat Med 2015; 2015: 131283.
13.	Wang Z, Chen W, Li Y, et al. Reduning injection and its effective constituent luteoloside protect against sepsis partly via inhibition of HMGB1/TLR4/NF-κB/MAPKs signaling pathways. J Ethnopharmacol 2021; 270: 113783. DOI URL
14.	Fan TT, Cheng BL, Fang XM, Chen YC, Su F. Application of Chinese medicine in the management of critical conditions: a review on sepsis. Am J Chin Med 2020; 48: 1315-30. DOI URL
15.	Zhao GZ, Chen RB, Li B, et al. Clinical practice guideline on Traditional Chinese Medicine therapy alone or combined with antibiotics for sepsis. Ann Transl Med 2019; 7: 122. DOI URL
16.	Vincent JL, Moreno R, Takala J, et al. The SOFA (sepsis-related organ failure assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European society of intensive care medicine. Intensive Care Med 1996; 22: 707-10. DOI URL
17.	Fried L, Bernardini J, Piraino B. Charlson comorbidity index as a predictor of outcomes in incident peritoneal dialysis patients. Am J Kidney Dis 2001; 37: 337-42. DOI PMID
18.	Al Mohajer M, Darouiche RO. Sepsis syndrome, bloodstream infections, and device-related infections. Med Clin North Am 2012; 96: 1203-23. DOI URL
19.	Lelubre C, Vincent JL. Mechanisms and treatment of organ failure in sepsis. Nat Rev Nephrol 2018; 14: 417-27. DOI PMID
20.	Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. BMJ 2016; 353: i1585.
21.	Yin J, Yu Z, Hou C, Peng Y, Xiao J, Jiang J. Protective Effect of Zuojin Fang on lung injury induced by sepsis through downregulating the JAK1/STAT3 signaling pathway. Biomed Res Int 2021; 2021: 1419631.
22.	Ma H, Kou J, Zhu D, Yan Y, Yu B. Liu-Shen-Wan, a Traditional Chinese Medicine, improves survival in sepsis induced by cecal ligation and puncture via reducing TNF-alpha levels, MDA content and enhancing macrophage phagocytosis. Int Immunopharmacol 2006; 6: 1355-62. DOI URL
23.	Liu J, Wang Z, Lin J, et al. Xuebijing injection in septic rats mitigates kidney injury, reduces cortical microcirculatory disorders, and suppresses activation of local inflammation. J Ethnopharmacol 2021; 276: 114199. DOI URL
24.	Gao M, Ou H, Jiang Y, et al. Tanshinone ⅡA attenuates sepsis-induced immunosuppression and improves survival rate in a mice peritonitis model. Biomed Pharmacother 2019; 112: 108609. DOI URL
25.	Xing X, Zhi Y, Lu J, et al. Traditional Chinese Medicine bundle therapy for septic acute gastrointestinal injury: a multicenter randomized controlled trial. Complement Ther Med 2019; 47: 102194. DOI URL
26.	Li C, Wang P, Zhang L, et al. Efficacy and safety of Xuebijing injection (a Chinese patent) for sepsis: a Meta-analysis of randomized controlled trials. J Ethnopharmacol 2018; 224: 512-21. DOI PMID
27.	Li MQ, Pan CG, Wang XM, et al. Effect of the Shenfu injection combined with early goal-directed therapy on organ functions and outcomes of septic shock patients. Cell Biochem Biophys 2015; 72: 807-12. DOI URL
28.	Liang X, Zhou M, Ge XY, et al. Efficacy of Traditional Chinese Medicine on sepsis: a systematic review and Meta-analysis. Int J Clin Exp Med 2015; 8: 20024-34. PMID
29.	Zhang Y, Du M, Chang Y, Chen LA, Zhang Q. Incidence, clinical characteristics, and outcomes of nosocomial enterococcus spp. bloodstream infections in a tertiary-care hospital in Beijing, China: a four-year retrospective study. Antimicrob Resist Infect Control 2017; 6: 73. DOI URL
30.	Raghunathan K, Shaw A, Nathanson B, et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis. Crit Care Med 2014; 42: 1585-91. DOI PMID
31.	Iba T, Umemura Y, Wada H, Levy JH. Roles of coagulation abnormalities and microthrombosis in sepsis: pathophysiology, diagnosis, and treatment. Arch Med Res 2021; 52: 788-97. DOI URL
32.	Giustozzi M, Ehrlinder H, Bongiovanni D, et al. Coagulopathy and sepsis: pathophysiology, clinical manifestations and treatment. Blood Rev 2021; 50: 100864. DOI URL
33.	Tsao CM, Ho ST, Wu CC. Coagulation abnormalities in sepsis. Acta Anaesthesiol Taiwan 2015; 53: 16-22. DOI URL
34.	Ying J, Wu J, Zhang Y, et al. Ligustrazine suppresses renal NMDAR1 and caspase-3 expressions in a mouse model of sepsis-associated acute kidney injury. Mol Cell Biochem 2020; 464: 73-81. DOI PMID
35.	Meng ZJ, Wang C, Meng LT, Bao BH, Wu JH, Hu YQ. Sodium tanshinone ⅡA sulfonate attenuates cardiac dysfunction and improves survival of rats with cecal ligation and puncture-induced sepsis. Chin J Nat Med 2018; 16: 846-55.
36.	Zhu W, Lu Q, Wan L, Feng J, Chen HW. Sodium tanshinone Ⅱ A sulfonate ameliorates microcirculatory disturbance of small intestine by attenuating the production of reactie oxygen species in rats with sepsis. Chin J Integr Med 2016; 22: 745-51. DOI URL

Item	Total (n = 973)	Control group (n = 93)	CHM group (n = 880)	P value
Age (years)	68.0 (57.0, 80.0)	67.0 (56.5, 79.5)	68.0 (57.0, 80.0)	0.894
Male [n (%)]	527 (54.2)	49 (52.7)	478 (54.3)	0.764
Sepsis 3.0 [n (%)]	542 (55.7)	67 (72.0)	475 (54.0)	0.001
Septic shock [n (%)]	19 (2.0)	6 (6.5)	13 (1.5)	0.006
Vital signs
Temperature (celsius)	36.7 (36.5, 37.6)	36.9 (36.5, 38.0)	36.7 (36.4, 37.6)	0.035
Pulse rate (beats/min)	88.0 (78.0, 102.0)	92.0 (80.0, 112.0)	88.0 (78.0, 102.0)	0.019
Respiratory rate (beats/min)	20.0 (20.0, 22.0)	20.0 (20.0, 23.0)	20.0 (20.0, 21.0)	0.084
SBP (mm Hg)	127.0 (110.0, 143.0)	126.0 (106.5, 141.5)	127.0 (110.0, 143.0)	0.407
DBP (mm Hg)	73.0 (63.0, 82.0)	72.0 (59.5, 83.5)	73.5 (63.0, 82.0)	0.311
SOFA score	2.0 (0.0, 4.0)	3.0 (1.0, 5.0)	2.0 (0.0, 4.0)	< 0.001
Charlson corbidity index	6.0 (4.0, 8.0)	6.0 (4.0, 8.0)	6.0 (4.0, 8.0)	0.301
Underlying diseases [n (%)]
Myocardial infarction	60 (6.2)	10 (10.8)	50 (5.7)	0.053
Cerebrovascular disease	264 (27.1)	24 (25.8)	240 (27.3)	0.762
Dementia	43 (4.4)	6 (6.5)	37 (4.2)	0.290
COPD	67 (6.9)	3 (3.2)	64 (7.3)	0.143
Diabetes mellitus	309 (31.8)	29 (31.2)	280 (31.8)	0.900
Chronic kidney disease	115 (11.8)	13 (14.0)	102 (11.6)	0.498
Leukemia	47 (4.8)	5 (5.4)	42 (4.8)	0.798
Solid Tumor	308 (31.7)	23 (24.7)	285 (32.4)	0.131
Liver cirrhosis	83 (8.5)	3 (3.2)	80 (9.1)	0.054
Suspected Source of infection [n (%)]
Respiratory tract	504 (51.8)	51 (54.8)	453 (51.5)	0.537
Genitourinary tract	340 (34.9)	33 (35.5)	307 (34.9)	0.908
Catheter related	75 (7.7)	10 (10.8)	65 (7.4)	0.247
Liver and biliary tract	90 (9.2)	6 (6.5)	84 (9.5)	0.327
GI and pancreas	67 (6.9)	7 (7.5)	60 (6.8)	0.797
Skin and soft tissue	31 (3.2)	1 (1.1）	30 (3.4)	0.352
Other	36 (3.7)	2 (2.2)	34 (3.9)	0.569
Laboratory indexes
WBC	7.8 (5.7, 11.6)	8.4 (5.8, 14.6)	7.7 (5.7, 11.4)	0.067
Hb	113.0 (94.0, 129.0)	104.0 (81.5, 122.5)	114.0 (95.0, 129.0)	0.005
PLT	200.0 (140.0, 263.5)	168.0 (105.5, 239.5)	203.5 (145.0, 264.8)	0.003
CRP	37.2 (9.9, 103.0)	53.2 (11.2, 134.7)	35.9 (9.8, 101.6)	0.178
PCT	0.5 (0.1, 3.6)	0.9 (0.2, 11.2)	0.5 (0.1, 3.0)	0.018
ALB	36.2 (31.1, 40.2)	34.0 (29.1, 40.1)	36.4 (31.4, 40.3)	0.035
ALT	18.0 (11.8, 31.0)	18.9 (11.0.30.3)	17.4 (12.0, 31.0)	0.951
AST	22.0 (17.0, 38.0)	21.0 (17.0, 37.0)	22.4 (16.0, 38.0)	0.780
TBIL	10.1 (6.7, 16.6)	10.3 (6.4, 16.9)	10.1 (6.8, 16.6)	0.997
Cr	85.0 (65.9, 122.0)	93.0 (69.1, 187.0)	84.6 (65.0, 117.0)	0.004
Pathogens
Gram-negative bacteria [n (%)]
Escherichia coli	281 (28.9)	21 (22.6)	260 (29.5)	0.159
Klebsiella pneumoniae	101 (10.4)	12 (12.9)	89 (10.1)	0.402
Pseudomonas aeruginosa	60 (6.2)	7 (7.5)	53 (6.0)	0.566
Acinetobacter baumannii	55 (5.7)	8 (8.6)	47 (5.3)	0.195
Proteus mirabilis	14 (1.4)	1 (1.1)	13 (1.5)	1.000
Stenotrophomonas Maltophilia [n (%)]	13 (1.3)	1 (1.1)	12 (1.4)	1.000
Enterobacter cloacae	13 (1.3)	0 (0)	13 (1.5)	0.626
Serratia marcescens	8 (0.8)	0 (0)	8 (0.9)	1.000
Salmonella species	8 (0.8)	1 (1.1)	7 (0.8)	0.554
Others	57 (5.9)	4 (4.3)	53 (6.0)	0.645
Gram-negative bacteria [n (%)]
Staphylococcus aureus	87 (8.9)	13 (14.0)	74 (8.4)	0.073
Streptococcus pneumoniae	7 (0.7）	0 (0)	7 (0.8)	1.000
Enterococcus faecium	22 (2.3)	3 (3.2)	19 (2.2)	0.459
Enterococcus faecalis	16 (1.6)	2 (2.2)	14 (1.6)	0.660
Streptococcus agalactiae	11 (1.1)	0 (0)	11 (1.3)	0.613
Others	55 (5.7)	3 (3.2)	52 (5.9)	0.287
Fungi [n (%)]
Candida albicans	4 (0.4)	1 (1.1)	3 (0.3)	0.331
Multiple bacteria	143 (14.7)	15 (16.1)	128 (14.5)	0.682

Item	Total (n = 973)	Control group (n = 93)	CHM group (n = 880)	P value
Age (years)	68.0 (57.0, 80.0)	67.0 (56.5, 79.5)	68.0 (57.0, 80.0)	0.894
Male [n (%)]	527 (54.2)	49 (52.7)	478 (54.3)	0.764
Sepsis 3.0 [n (%)]	542 (55.7)	67 (72.0)	475 (54.0)	0.001
Septic shock [n (%)]	19 (2.0)	6 (6.5)	13 (1.5)	0.006
Vital signs
Temperature (celsius)	36.7 (36.5, 37.6)	36.9 (36.5, 38.0)	36.7 (36.4, 37.6)	0.035
Pulse rate (beats/min)	88.0 (78.0, 102.0)	92.0 (80.0, 112.0)	88.0 (78.0, 102.0)	0.019
Respiratory rate (beats/min)	20.0 (20.0, 22.0)	20.0 (20.0, 23.0)	20.0 (20.0, 21.0)	0.084
SBP (mm Hg)	127.0 (110.0, 143.0)	126.0 (106.5, 141.5)	127.0 (110.0, 143.0)	0.407
DBP (mm Hg)	73.0 (63.0, 82.0)	72.0 (59.5, 83.5)	73.5 (63.0, 82.0)	0.311
SOFA score	2.0 (0.0, 4.0)	3.0 (1.0, 5.0)	2.0 (0.0, 4.0)	< 0.001
Charlson corbidity index	6.0 (4.0, 8.0)	6.0 (4.0, 8.0)	6.0 (4.0, 8.0)	0.301
Underlying diseases [n (%)]
Myocardial infarction	60 (6.2)	10 (10.8)	50 (5.7)	0.053
Cerebrovascular disease	264 (27.1)	24 (25.8)	240 (27.3)	0.762
Dementia	43 (4.4)	6 (6.5)	37 (4.2)	0.290
COPD	67 (6.9)	3 (3.2)	64 (7.3)	0.143
Diabetes mellitus	309 (31.8)	29 (31.2)	280 (31.8)	0.900
Chronic kidney disease	115 (11.8)	13 (14.0)	102 (11.6)	0.498
Leukemia	47 (4.8)	5 (5.4)	42 (4.8)	0.798
Solid Tumor	308 (31.7)	23 (24.7)	285 (32.4)	0.131
Liver cirrhosis	83 (8.5)	3 (3.2)	80 (9.1)	0.054
Suspected Source of infection [n (%)]
Respiratory tract	504 (51.8)	51 (54.8)	453 (51.5)	0.537
Genitourinary tract	340 (34.9)	33 (35.5)	307 (34.9)	0.908
Catheter related	75 (7.7)	10 (10.8)	65 (7.4)	0.247
Liver and biliary tract	90 (9.2)	6 (6.5)	84 (9.5)	0.327
GI and pancreas	67 (6.9)	7 (7.5)	60 (6.8)	0.797
Skin and soft tissue	31 (3.2)	1 (1.1）	30 (3.4)	0.352
Other	36 (3.7)	2 (2.2)	34 (3.9)	0.569
Laboratory indexes
WBC	7.8 (5.7, 11.6)	8.4 (5.8, 14.6)	7.7 (5.7, 11.4)	0.067
Hb	113.0 (94.0, 129.0)	104.0 (81.5, 122.5)	114.0 (95.0, 129.0)	0.005
PLT	200.0 (140.0, 263.5)	168.0 (105.5, 239.5)	203.5 (145.0, 264.8)	0.003
CRP	37.2 (9.9, 103.0)	53.2 (11.2, 134.7)	35.9 (9.8, 101.6)	0.178
PCT	0.5 (0.1, 3.6)	0.9 (0.2, 11.2)	0.5 (0.1, 3.0)	0.018
ALB	36.2 (31.1, 40.2)	34.0 (29.1, 40.1)	36.4 (31.4, 40.3)	0.035
ALT	18.0 (11.8, 31.0)	18.9 (11.0.30.3)	17.4 (12.0, 31.0)	0.951
AST	22.0 (17.0, 38.0)	21.0 (17.0, 37.0)	22.4 (16.0, 38.0)	0.780
TBIL	10.1 (6.7, 16.6)	10.3 (6.4, 16.9)	10.1 (6.8, 16.6)	0.997
Cr	85.0 (65.9, 122.0)	93.0 (69.1, 187.0)	84.6 (65.0, 117.0)	0.004
Pathogens
Gram-negative bacteria [n (%)]
Escherichia coli	281 (28.9)	21 (22.6)	260 (29.5)	0.159
Klebsiella pneumoniae	101 (10.4)	12 (12.9)	89 (10.1)	0.402
Pseudomonas aeruginosa	60 (6.2)	7 (7.5)	53 (6.0)	0.566
Acinetobacter baumannii	55 (5.7)	8 (8.6)	47 (5.3)	0.195
Proteus mirabilis	14 (1.4)	1 (1.1)	13 (1.5)	1.000
Stenotrophomonas Maltophilia [n (%)]	13 (1.3)	1 (1.1)	12 (1.4)	1.000
Enterobacter cloacae	13 (1.3)	0 (0)	13 (1.5)	0.626
Serratia marcescens	8 (0.8)	0 (0)	8 (0.9)	1.000
Salmonella species	8 (0.8)	1 (1.1)	7 (0.8)	0.554
Others	57 (5.9)	4 (4.3)	53 (6.0)	0.645
Gram-negative bacteria [n (%)]
Staphylococcus aureus	87 (8.9)	13 (14.0)	74 (8.4)	0.073
Streptococcus pneumoniae	7 (0.7）	0 (0)	7 (0.8)	1.000
Enterococcus faecium	22 (2.3)	3 (3.2)	19 (2.2)	0.459
Enterococcus faecalis	16 (1.6)	2 (2.2)	14 (1.6)	0.660
Streptococcus agalactiae	11 (1.1)	0 (0)	11 (1.3)	0.613
Others	55 (5.7)	3 (3.2)	52 (5.9)	0.287
Fungi [n (%)]
Candida albicans	4 (0.4)	1 (1.1)	3 (0.3)	0.331
Multiple bacteria	143 (14.7)	15 (16.1)	128 (14.5)	0.682

Item	Total group (n = 176)	Control group (n = 88)	CHM group (n = 88)	P value
Age (years)	67.0 (57.3, 79.0)	67.5 (57.3, 79.0)	67.0 (57.3, 78.8)	0.731
Male sex [n (%)]	84 (47.7)	43 (48.9)	41 (46.6)	0.763
SOFA score	3.0 (1.0, 5.0)	3.0 (1.0, 5.0)	3.0 (1.0, 5.0)	0.751
CCI	6.0 (4.0, 9.0)	6.0 (4.0, 8.0)	6.5 (4.0, 9.0)	0.193
Sepsis 3.0 [n (%)]	122 (69.3)	62 (70.5)	60 (68.2)	0.744
Septic shock [n (%)]	6 (3.4)	4 (4.5)	2 (2.3)	0.682
Temperature (℃)	36.8 (36.5, 37.7)	36.9 (36.5, 38.0)	36.7 (36.4, 37.5)	0.169
Pulse rate (beats/min)	91.0 (79.3, 110.0)	92.0 (79.3, 111.5)	90.5 (79.3, 109.0)	0.932
Hb (g/L)	106.0 (82.5, 127.0)	103.5 (80.5, 124.5)	107.0 (84.0, 129.0)	0.485
PLT (10⁹/L)	187.0 (119.3, 253.5)	171.0 (108.8, 241.8)	220.5 (123.5, 274.0)	0.053
PCT (ng /mL)	0.7 (0.2, 6.2)	0.8 (0.2, 8.1)	0.7 (0.2, 3.6)	0.823
ALB (g/L)	34.3 (29.3, 38.8)	34.0 (29.2, 40.4)	34.8 (30.4, 38.7)	0.933
Cr (μmol/L)	90.5 (67.1, 177.6)	91.4 (68.1, 180.3)	90.5 (63.1, 156.9)	0.443

Item	Total group (n = 176)	Control group (n = 88)	CHM group (n = 88)	P value
Age (years)	67.0 (57.3, 79.0)	67.5 (57.3, 79.0)	67.0 (57.3, 78.8)	0.731
Male sex [n (%)]	84 (47.7)	43 (48.9)	41 (46.6)	0.763
SOFA score	3.0 (1.0, 5.0)	3.0 (1.0, 5.0)	3.0 (1.0, 5.0)	0.751
CCI	6.0 (4.0, 9.0)	6.0 (4.0, 8.0)	6.5 (4.0, 9.0)	0.193
Sepsis 3.0 [n (%)]	122 (69.3)	62 (70.5)	60 (68.2)	0.744
Septic shock [n (%)]	6 (3.4)	4 (4.5)	2 (2.3)	0.682
Temperature (℃)	36.8 (36.5, 37.7)	36.9 (36.5, 38.0)	36.7 (36.4, 37.5)	0.169
Pulse rate (beats/min)	91.0 (79.3, 110.0)	92.0 (79.3, 111.5)	90.5 (79.3, 109.0)	0.932
Hb (g/L)	106.0 (82.5, 127.0)	103.5 (80.5, 124.5)	107.0 (84.0, 129.0)	0.485
PLT (10⁹/L)	187.0 (119.3, 253.5)	171.0 (108.8, 241.8)	220.5 (123.5, 274.0)	0.053
PCT (ng /mL)	0.7 (0.2, 6.2)	0.8 (0.2, 8.1)	0.7 (0.2, 3.6)	0.823
ALB (g/L)	34.3 (29.3, 38.8)	34.0 (29.2, 40.4)	34.8 (30.4, 38.7)	0.933
Cr (μmol/L)	90.5 (67.1, 177.6)	91.4 (68.1, 180.3)	90.5 (63.1, 156.9)	0.443

Item	Control group (n = 88)	CHM group (n = 88)	P value
28 d mortality	19 (21.6)	13 (14.8)	0.241
In-hospital mortality	23 (26.1)	24 (27.3)	0.865
7 d mortality	6 (6.80)	2 (2.3)	0.278
Noninvasive ventilation	24 (27.3)	27 (30.7)	0.618
Invasive ventilation	20 (22.7)	25 (28.4)	0.388
Vasoactive drugs	20 (22.7)	12 (13.6)	0.118
Cardiopulmonary resuscitation	12 (13.6)	12 (13.6)	1.000

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Efficacy and safety of Chinese herbal medicine as adjunctive therapy in sepsis patients with bloodstream infection: a propensity-matched analysis

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References 36.

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Item	Control group (n = 764)	BASEH group (n = 209)	P value
28 d mortality	106 (13.9)	15 (7.2)	0.009
In-hospital mortality	163 (21.3)	31 (14.8)	0.037
7 d mortality	27 (3.5)	1 (0.5)	0.019
Noninvasive ventilation	202 (26.4)	44 (21.1)	0.112
Invasive ventilation	168 (22.0)	51 (24.4)	0.459
Vasoactive drugs	115 (15.1)	21 (10.0)	0.064
Cardiopulmonary resuscitation	85 (11.1)	12 (5.7)	0.021

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[3]	YAN Lizhao, MAO Fuwei, CAO Yinghao, XIE Mao. Clinical effects of the combination of Traditional Chinese and Western Medicines on coronavirus disease 2019: a systematic review and Meta-analysis [J]. Journal of Traditional Chinese Medicine, 2021, 41(4): 499-506.
[4]	CHEN Jiayang, FENG Li. Traditional Chinese Medicine reverses resistance to epidermal growth factor receptor tyrosine kinase inhibitors in advanced non-small cell lung cancer: a narrative review [J]. Journal of Traditional Chinese Medicine, 2021, 41(4): 650-656.
[5]	Emel Akta?, Hilal Yildiran. Antioxidant and ntiinflammatory efficacy of curcumin on lung tissue in rats with sepsis [J]. Journal of Traditional Chinese Medicine, 2020, 40(5): 820-826.
[6]	Zhang Jinchao, Hu Jing, He Xiujuan, Meng Yujiao, Chen Guangkun, Chen Zhaoxia, Lü Jingjing, Li Ping. Effectiveness of Chinese herbal medicine for primary Raynaud's phenomenon: a systematic review and Meta-analysis of randomized controlled trials [J]. Journal of Traditional Chinese Medicine, 2020, 40(4): 509-517.
[7]	Liu Jin, Liu Fusheng, Liang Tengxiao, Cao Po, Li Jing, Zhang Yin, Liu Yang. Efficacy of Shenfu decoction on sepsis in rats with condition induced by cecal ligation and puncture [J]. Journal of Traditional Chinese Medicine, 2020, 40(4): 621-628.
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[9]	Hou Yi, Wang Tieshan, Guo Xiangyu, Sun Wen, Guo Xuan, Wu Lili, Qin Lingling, Zhang Chengfei, Liu Tonghua. Protective effects of Jiayan Kangtai granules on autoimmune thyroiditis in a rat model by modulating Th17/Treg cell balance [J]. Journal of Traditional Chinese Medicine, 2018, 38(03): 380-390.
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[11]	Zhang Hongwei, Wei Liyou, Zhao Gang, Liu Shuzheng, Zhang Zhenyu, Zhang Jing, Yang Yajing. Protective effect of Xuebijing injection on myocardial injury in patients with sepsis: a randomized clinical trial [J]. Journal of Traditional Chinese Medicine, 2016, 36(06): 706-710.
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[13]	Hongwei Zhang, Liyou Wei, Zhenyu Zhang, Shuzheng Liu, Gang Zhao, Jing Zhang, Yanling Hu. Protective effect of periplaneta americana extract on intestinal mucosal barrier function in patients with sepsis [J]. Journal of Traditional Chinese Medicine, 2013, 33(01): 70-73.