Traditional Chinese Medicine (TCM) for Sepsis: A Modern Review

September 2, 2025

Sepsis remains one of the most challenging conditions in critical care medicine — a life-threatening state where the body’s immune response to infection spirals out of control, leading to organ dysfunction and high mortality. Conventional treatments focus on antibiotics, fluid resuscitation, and organ support, but outcomes are still poor for many patients.

A 2025 review in Critical Care examined how Traditional Chinese Medicine (TCM) could complement standard sepsis management. Drawing on meta-analyses, randomized trials, and pharmacological studies, the review highlights TCM’s potential to improve survival, reduce complications, and offer novel therapeutic pathways.

Clinical Efficacy: Beyond Survival Alone

Improved survival & reduced severity
Meta-analyses suggest that adding TCM to conventional care can lower APACHE II scores, shorten ICU stays, and raise 28-day survival rates.

Xuebijing Injection
In a large multicenter, placebo-controlled trial with over 1,800 patients, Xuebijing significantly lowered 28-day mortality — making it one of the most evidence-backed TCM interventions for sepsis.

Other promising injections
Shenfu and Shenmai injections, supported by smaller trials and pooled data, show benefits in survival, inflammation control, and septic shock recovery.

Targeted formulas for complications
Classical prescriptions such as Banxia Xiexin Decoction, Dahuang Fuzi Decoction, Huanglian Jiedu Tang, and Qingwen Baidu Decoction have shown therapeutic effects on septic gastrointestinal dysfunction and related syndromes, though many studies remain small in scale.

Safety Profile

Safety is crucial in critical illness. Encouragingly, TCM preparations — especially Xuebijing — demonstrated low rates of adverse events in large trials. This favorable safety profile supports their use as adjunctive therapies in ICU settings.

Mechanistic Insights: Why TCM Works

Unlike single-target drugs, TCM formulas act on multiple pathways at once, reflecting sepsis’s complexity. The review highlights several mechanisms:

Immune modulation
Compounds such as baicalein, curcumin, berberine, and astragaloside IV regulate excessive inflammation by suppressing key pathways like NF-κB, MAPKs, and JAK2/STAT3.
Endothelial protection
Kaempferol and salvianolic acid B help repair vascular barriers, while paeoniflorin safeguards blood vessels via RXRα activation.
Mitochondrial support
Berberine and paeoniflorin maintain energy production and limit oxidative stress, protecting organs from septic injury.
Cell death prevention
Ginsenosides, emodin, and baicalein reduce apoptosis, ferroptosis, and pyroptosis, while also relieving endoplasmic reticulum stress.

Together, these effects help stabilize patients at multiple levels — from immune balance to organ function.

Why TCM Brings Unique Advantages

Holistic & personalized
Pattern differentiation allows individualized treatment (e.g., “toxic heat,” “blood stasis”), aligning therapy with each patient’s presentation.

Synergistic, multi-target action
Rooted in the “sovereign-minister-assistant-courier” principle, TCM formulas offer system-wide regulation instead of isolated effects.

Innovation potential
Natural compounds from TCM — much like artemisinin and paclitaxel — can inspire the next generation of sepsis therapeutics.

Growing evidence base
With more trials and meta-analyses supporting efficacy and safety, TCM is moving from traditional practice toward integration with evidence-based critical care.

Traditional Chinese Medicine is more than an ancient practice — it is an evolving, evidence-backed partner in sepsis care. By modulating immunity, protecting organs, and improving survival rates, TCM offers complementary strengths where conventional medicine alone may not suffice.

The call for future high-quality, international studies is clear. But already, TCM stands out as a promising ally in the fight against one of critical care’s toughest conditions.

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Jasmine Angelique

Naturopathic Doctor in Traditional Chinese Medicine, Best Quantum Healer in the USA in 2025 and Scientific Copywriter.

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