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Abstract
Sepsis is a common but critical illness in patients admitted to the intensive care
unit and is associated with high mortality. Although there are many treatments for
sepsis, specific and effective therapies are still lacking. For over 2,000 years,
traditional Chinese medicine (TCM) has played a vital role in the treatment of infectious
diseases in Eastern countries. Both anecdotal and scientific evidence show that diverse
TCM preparations alleviate organ dysfunction caused by sepsis by inhibiting the inflammatory
response, reducing oxidative stress, boosting immunity, and maintaining cellular homeostasis.
This review reports on the efficacy and mechanism of action of various TCM compounds,
herbal monomer extracts, and acupuncture, on the treatment of sepsis and related multi-organ
injury. We hope that this information would be helpful to better understand the theoretical
basis and empirical support for TCM in the treatment of sepsis.
Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.
Summary Background Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. It is considered a major cause of health loss, but data for the global burden of sepsis are limited. As a syndrome caused by underlying infection, sepsis is not part of standard Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimates. Accurate estimates are important to inform and monitor health policy interventions, allocation of resources, and clinical treatment initiatives. We estimated the global, regional, and national incidence of sepsis and mortality from this disorder using data from GBD 2017. Methods We used multiple cause-of-death data from 109 million individual death records to calculate mortality related to sepsis among each of the 282 underlying causes of death in GBD 2017. The percentage of sepsis-related deaths by underlying GBD cause in each location worldwide was modelled using mixed-effects linear regression. Sepsis-related mortality for each age group, sex, location, GBD cause, and year (1990–2017) was estimated by applying modelled cause-specific fractions to GBD 2017 cause-of-death estimates. We used data for 8·7 million individual hospital records to calculate in-hospital sepsis-associated case-fatality, stratified by underlying GBD cause. In-hospital sepsis-associated case-fatality was modelled for each location using linear regression, and sepsis incidence was estimated by applying modelled case-fatality to sepsis-related mortality estimates. Findings In 2017, an estimated 48·9 million (95% uncertainty interval [UI] 38·9–62·9) incident cases of sepsis were recorded worldwide and 11·0 million (10·1–12·0) sepsis-related deaths were reported, representing 19·7% (18·2–21·4) of all global deaths. Age-standardised sepsis incidence fell by 37·0% (95% UI 11·8–54·5) and mortality decreased by 52·8% (47·7–57·5) from 1990 to 2017. Sepsis incidence and mortality varied substantially across regions, with the highest burden in sub-Saharan Africa, Oceania, south Asia, east Asia, and southeast Asia. Interpretation Despite declining age-standardised incidence and mortality, sepsis remains a major cause of health loss worldwide and has an especially high health-related burden in sub-Saharan Africa. Funding The Bill & Melinda Gates Foundation, the National Institutes of Health, the University of Pittsburgh, the British Columbia Children's Hospital Foundation, the Wellcome Trust, and the Fleming Fund.
Reducing the global burden of sepsis, a recognized global health challenge, requires comprehensive data on the incidence and mortality on a global scale.
[1]1
Department of Emergency Medicine , Tongji Hospital , Tongji Medical College , Huazhong University of Science and Technology , Wuhan, China
[2]2
Institute of Integrated Traditional Chinese and Western Medicine , Tongji Hospital , Tongji Medical College , Huazhong University of Science and Technology , Wuhan, China
Author notes
Edited by:Hanjun Cheng, Institute for Systems Biology (ISB), United States
Reviewed by:Yuxiang Fei, China Pharmaceutical University, China
Jiasi Wu, Chengdu University of Traditional Chinese Medicine, China
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History
Date
received
: 26
July
2022
Date
accepted
: 02
January
2023
Funding
This work was supported by Wuhan science and technology bureau, Wuhan Applied Basic
Research Project (No. 2017060201010177) and the program of Tongji-Rongcheng Center
for Biomedicine (HUST).
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