Uncovering the Potential of Yiqi Huoxue Jiedu Formula: A Promising Adjunct in Sepsis and Septic Shock Management

Peiying Huang^1,2*Bingrui Chen B#¹Xiaorong Yang B#¹Houguang Chen²Jiaqi Tang²Rui Chen^2*Jun Li^3*Ye Ye^2*

• ¹Guangzhou University of Chinese Medicine, Guangzhou, China
• ²The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
• ³The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

Background: Sepsis and septic shock represent severe infectious conditions with challenging treatmentssignificant clinical challenges under current treatment paradigms. Preliminary animal studies indicate that Yiqi Huoxue Jiedu Formula (YHJF) may enhance sepsis outcomes, but no clinical trials have been conducted.. However, there are still no clinical studies exploring its efficacy on sepsis. This research aims to substantiate the efficacy of YHJF in treating sepsis and septic shock. Materials and methods: Mass spectrometry was used to identify the absorbed chemical constituents of YHJF. A retrospective cohort study included sepsis patients from four sub-centers (Feb 24, 2016 - Oct 31, 2024), divided into Western treatment and YHJF plus Western care groups.This retrospective cohort study enrolled sepsis patients in 4 sub-centers from February 24, 2016, to October 31, 2024and divided them into two groups: one receiving Western treatment and the other receiving YHJF alongside Western care. Propensity score matching ensured baseline comparability. The primary outcome was 28-day mortality, with secondary outcomes including intensive care units (ICU)ICU and hospital stay duration, mechanical ventilation and renal replacement therapy duration, fever duration, and changes in SOFA and APACHE II scores, blood procalcitonin, white blood cell count, and lactate levels after 5 days of treatment. Sepsis shock was analyzed as a subgroup. Results: YHJF absorption mainly includes Shikimates and Phenylpropanoids (33%), Terpenoids (21%), Alkaloids (14%), and Polyketides (11%). A total of 389 sepsis patients were enrolled, with 82 patients being identified as septic shock in the retrospective cohort clinical study. The clinical results indicated that YHJF may shorten hospital stay duration, reduce ventilator duration, and improve SOFA score in sepsis. For septic shock, YHJF administration could reduce the duration of non-invasive ventilator use. Notably, YHJF has no effect on improving 28-day mortality for sepsis and septic shock. Conclusion: The main components of YHJF are Shikimates, Phenylpropanoids, and Terpenoids. This formulaYHJF can reduce the SOFA score, ventilator use duration, and hospital stay length in sepsis cases and improve non-invasive ventilator use time in septic shock patients, which might attribute to the absorbed components after YHJF administration.. Further high-quality trials are needed for confirmation.