The goal of this clinical trial is to learn if Chinese medicine - Yiqilishui formula works to treat sepsis-induced myocardial dysfunction (SIMD). It will also learn about the safety of Yiqilishui formula. The main questions it aims to answer are: * Compared with conventional western traetment alone, can supplementing conventional Western treatment with Yiqilishui formula better improve the heart function and reduce mortality of participants with SIMD? * What medical problems do participants have when taking Yiqilishui formula? Researchers will compare Yiqilishui formula to a placebo (a look-alike substance that contains no drug) to see if Yiqilishui formula works to treat SIMD. Participants will: * Take Yiqilishui formula granules or placebo twice daily for 7 days, while receiving standard conventional Western treatment. * Undergo blood drawing, electrocardiogram and transthoracic echocardiography at enrollment, on the 3rd day, the 7th day, and the 14th day after enrollment.
Sepsis-induced myocardial dysfunction (SIMD) is characterized by high morbidity and mortality rates and remains a challenging issue in the field of critical care that has not yet been resolved. The main pathogenesis involves deficiency of Qi with water overflow and blood stasis and toxin blocking the channels. The use of a Qi-invigorating and diuretic formula has the effect of invigorating Qi, promoting diuresis, and detoxifying and unblocking the channels. This study employed a two-center prospective parallel randomized double-blind controlled trial, selecting a total of 80 SIMD subjects from the ICU of Tongzhou District Traditional Chinese Medicine Hospital and the ICU of Dongzhimen Hospital of Beijing University of Chinese Medicine, who met the inclusion and exclusion criteria. The subjects were randomly and evenly divided into a treatment group and a control group. Both groups received basic SIMD treatment, with the treatment group additionally receiving the oral or nasogastric administration of a granule preparation of Yiqilishui formula, and the control group receiving a placebo orally or nasogastrically. The intervention period was 7 days, with a follow-up period of 28 days. The primary efficacy indicators compared between the two groups were BNP and NT-proBNP, and the secondary efficacy indicators were echocardiography, myocardial injury markers, inflammatory markers, critical illness severity scores, ICU length of stay and costs, and 28-day survival rate. The study aimed to evaluate the clinical efficacy and safety of the Yiqilishui formula for SIMD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
80
Astragalus Root 30g, Angelica sinensis 30g, Honeysuckle Flower 30g, Capillary Artemisia Herb 15g, Giant Knotweed Rhizome 15g, Lepidium Seed 30g, Sichuan Lovage Rhizome 15g, Salvia Root 15g, Jujube Fruit 15g;
5% Yiqilishui Granules + 95% Dextrin;
Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine
Beijing, China
RECRUITINGBNP（B-type natriuretic peptide） decline rate
Blood samples were taken from the median cubital vein of the subjects at enrollment, on the 3rd day, the 7th day, and the 14th day to measure the BNP levels in the subjects' venous blood, calculate the patient's BNP decline rate, assess the severity of heart failure in the subjects, and predict their prognosis.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
The levels of cTnI
Cardiac injury markers-Blood samples from the median cubital vein of the subjects were taken at enrollment, on the 3rd day, the 7th day, and the 14th day to detect the levels of cardiac troponin I (cTnI)
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
The levels of CK-MB
Cardiac injury markers-Blood samples from the median cubital vein of the subjects were taken at enrollment, on the 3rd day, the 7th day, and the 14th day to detect the levels of creatine kinase MB isoenzyme
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Concentration of H-FABP
Cardiac injury markers-Blood samples from the median cubital vein of the subjects were taken at enrollment, on the 3rd day, the 7th day, and the 14th day to detect the levels of heart-type fatty acid-binding protein
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Tei index
At the time of subject enrollment, on the 3rd day, 7th day, and 14th day, Tei index were measured using transthoracic echocardiography to evaluate the subjects' cardiac function and structure.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
MEE
At the time of subject enrollment, on the 3rd day, 7th day, and 14th day, myocardial energy expenditure
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
LVMI
At the time of subject enrollment, on the 3rd day, 7th day, and 14th day, left ventricular mass index (LVMI) were measured using transthoracic echocardiography to evaluate the subjects' cardiac function and structure.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
The levels of WBC
Blood is drawn from the median cubital vein of the subjects at enrollment, on the 3rd day, the 7th day, and the 14th day. The levels of white blood cells (WBC) in the subjects' venous blood is detected.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
The percentage of NE%
Blood is drawn from the median cubital vein of the subjects at enrollment, on the 3rd day, the 7th day, and the 14th day. The percentage of neutrophils (NE%) in the subjects' venous blood is detected.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
The levels of CRP
Blood is drawn from the median cubital vein of the subjects at enrollment, on the 3rd day, the 7th day, and the 14th day. The levels of C-reactive protein (CRP) in the subjects' venous blood is detected.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
The levels of PCT
Blood is drawn from the median cubital vein of the subjects at enrollment, on the 3rd day, the 7th day, and the 14th day. The levels of procalcitonin (PCT) in the subjects' venous blood is detected.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Concentration of IL-6
The supernatant serum is obtained by centrifugation, and the levels of interleukin-6 (IL-6) is measured by ELISA.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Concentration of TNF-α
The supernatant serum is obtained by centrifugation, and the levels of tumor necrosis factor-α (TNF-α) is measured by ELISA.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Concentration of ROS
The supernatant serum is obtained by centrifugation, and reactive oxygen species (ROS)is measured by ELISA.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Concentration of ATP
The supernatant serum is obtained by centrifugation, and the levels of ATP content in the subjects' serum is measured by ELISA.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
Platelet aggregation rate
At enrollment, D3, D7, and D14, venous blood from patients is collected, platelet-rich plasma is prepared using differential centrifugation, and the platelet aggregation rate is determined by optical turbidimetry.
Time frame: At enrollment, on the 3rd day, the 7th day, and the 14th day
SOFA score
Sequential Organ Failure Assessment (SOFA score) is performed at the time of enrollment, on the 7th day, and on the 14th day. The SOFA score includes six systems: respiratory, circulation, liver, coagulation, kidney and central nervous system. Each system is scored according to different variables, with a score of 0 to 4 points, and a total score of 0 to 24 points. The higher the score, the worse the outcome.
Time frame: At enrollment, the 7th day, and the 14th day
Apache II score
Acute Physiology and Chronic Health Evaluation (Apache II score) is performed at the time of enrollment, on the 7th day, and on the 14th day. The Apache II score is scored from 0 to 71, and the higher the score, the worse the outcome.
Time frame: At enrollment, the 7th day, and the 14th day
ICU length of stay;
ICU length of stay，up to 100 weeks.
Time frame: From the date the participant is transferred to the ICU to the date he or she is finally transferred out of the ICU, assessed up to 100 weeks.
Outcome indicator
28-day mortality rate
Time frame: 28th day
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.