Application of Chinese Medicine in the Management of Critical Conditions: A Review on Sepsis

Am J Chin Med. 2020;48(6):1315-1330. doi: 10.1142/S0192415X20500640. Epub 2020 Sep 9.

Abstract

Critical care medicine is a medical specialty engaging the diagnosis and treatment of critically ill patients who have or are likely to have life-threatening organ failure. Sepsis, a life-threatening condition that arises when the body responds to infection, is currently the major cause of death in intensive care units (ICU). Although progress has been made in understanding the pathophysiology of sepsis, many drawbacks in sepsis treatment remains unresolved. For example, antimicrobial resistance, controversial of glucocorticoids use, prolonged duration of ICU care and the subsequent high cost of the treatment. Recent years have witnessed a growing trend of applying traditional Chinese medicine (TCM) in sepsis management. The TCM application emphasizes use of herbal formulation to balance immune responses to infection, which include clearing heat and toxin, promoting blood circulation and removing its stasis, enhancing gastrointestinal function, and strengthening body resistance. In this paper, we will provide an overview of the current status of Chinese herbal formulations, single herbs, and isolated compounds, as an add-on therapy to the standard Western treatment in the sepsis management. With the current trajectory of worldwide pandemic eruption of newly identified Coronavirus Disease-2019 (COVID-19), the adjuvant TCM therapy can be used in the ICU to treat critically ill patients infected with the novel coronavirus.

Keywords: Artemisinin; Astragalus membranaceus; Baicalein; Berberine; Chinese Herbal Formulation; Cordyceps sinensis; Coronavirus Disease-2019 (COVID-19); Emodin; Rhubarb; Salvia miltiorrhiza; Sepsis.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Artemisinins / therapeutic use
  • Astragalus propinquus
  • Berberine / therapeutic use
  • Betacoronavirus
  • COVID-19
  • COVID-19 Drug Treatment
  • Coronavirus Infections / drug therapy*
  • Critical Illness
  • Drugs, Chinese Herbal / therapeutic use*
  • Emodin / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use*
  • Intensive Care Units
  • Intestinal Mucosa
  • Medicine, Chinese Traditional*
  • Microcirculation
  • Pandemics
  • Permeability
  • Pneumonia, Viral / drug therapy*
  • Rheum
  • SARS-CoV-2
  • Salvia miltiorrhiza
  • Sepsis / drug therapy*

Substances

  • Anti-Inflammatory Agents
  • Artemisinins
  • Drugs, Chinese Herbal
  • Immunologic Factors
  • Xuebijing
  • huanglian-jie-du decoction
  • qingwen baidu
  • sini tang
  • Berberine
  • artemisinin
  • Emodin