Metabonomics study on the treatment of sepsis by Supplemented Xijiao Dihuang Tang

INTERVENTION: Supplemented Xijiao Dihuang Tang combined with conventional Western medicine treatment group:Oral or nasal feeding Supplemented Xijiao Dihuang Tang combined with conventional Western medicine treatment, including (1) initial fluid resuscitation: patients with hypoperfusion or shock due to sepsis should be given at least 30ml/kg crystal solution intravenously within 3 hours; (2) Use dynamic monitoring to guide fluid resuscitation, such as stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), and echocardiography; (3) The use of antibiotics: for suspected septic shock or sepsis patients, anti‐infection therapy should be carried out immediately within 1 hour of definite diagnosis; (4) Use of vasoactive agents: norepinephrine is the first choice for patients with septic shock. The mean arterial pressure (MAP) level after norepinephrine was still not up to the standard, and vasopressin was used in combination. (5) Mechanical ventilation: For patients with acute respiratory distress syndrome(ARDS) caused by sepsis, pulmonary protective ventilation strategies, including small tidal volume (6ml/kg), high positive end expiratory pressure (PEEP), and the upper target is set at 30cmH2O. For moderate and severe ARDS patients caused by sepsis, ventilation time should be =12 hours per day in prone position. For severe ARDS patients caused by sepsis, veno‐venous extracorporeal membrane oxygenation (VV‐ECMO) can be used when conventional mechanical ventilation fails. (6) Supplementary treatment: In patients with septic shock requiring continued use of pressors (norepinephrine =0.25mg·kg‐1·min‐1), corticosteroids should be administered, low molecular weight heparin should be administered to prevent deep vein thrombosis after contraindications are excluded, CONDITION: Sepsis PRIMARY OUTCOME: Length of stay in intensive care unit;metabolome(blood);28‐day mortality rate;Traditional Chinese Medicine clinical symptom score; SECONDARY OUTCOME: hemoglobin;Acute Physiology and Chronic Health Evaluation ? score;Hypersensitive C‐reactive protein;Sequential Organ Failure Assessment score;White blood cell count;Modified Marshall score;Platelet count; INCLUSION CRITERIA: 1) Meet the Berlin criteria for Sepsis 3.0; 2) Traditional Chinese Medicine clinical syndrome differentiation was syndrome of heat entering nutrient‐blood aspects, and the syndrome type was determined by 2 intermediate professional titles or above; 3) Age =18 years old, gender unlimited; 4) Good compliance, follow‐up, voluntary participation in the study, and informed consent signed by oneself or their family members.