Abstract: OBJECTIVE:To evaluate the add-on effect of Qinbei Qingfei Yiqi(QBQFYQ) granules for ventilator-associated pneumonia(VAP) in non-infectious critically ill patients.METHODS:In this randomized controlled trial, 80non-infectious critically ill patients undergoing mechanical ventilation in the intensive care unit(ICU)were randomly divided into two groups:those receiving QBQFYQ granules plus usual treatment(experimental group, n = 50) and those receiving only the usual treatment(control group, n = 30).The main outcome measures were VAP rate, time of VAP occurrence, duration of mechanical ventilation,and length of ICU stay.Interleukin-6(IL-6), C-reactive protein(CRP), and T-lymphocyte(CD4+, CD8+,and CD4+/CD8+ ratio) serum levels were also evaluated before and after treatment.RESULTS:Compared with the control group treatment, QBQFYQ administration significantly reduced the duration of mechanical ventilation [(9.58± 3.14) vs(12.52 ± 4.33) days] and length of ICU stay [(14.57 ± 3.72) vs(17.82 ± 5.24) days] and delayed VAP occurrence [(4.31 ± 0.86) vs(2.43 ± 0.27)days].Additionally, CRP and IL-6 serum levels and CD4+/CD8+ ratio were significantly lower in the experimental group(P < 0.05) than in the control group.However, there were no significant differences in hospital mortality rate(30.0% vs 33.3%) and adverse events(4.0% vs 6.7%).CONCLUSION:QBQFYQ delays the time of VAP occurrence and shortens the duration of mechanical ventilation in non-infectious critically ill patients,possibly through anti-inflammatory and immunomodulatory mechanisms.

Key words: Qinbei Qingfei Yiqi granules, Pneumonia, Ventilator-associated, Interleukin-6, C-reactive protein, T-lymphocytes, Randomized controlled trial