Clinical management of a severe pressure injury with Buzhong Yiqi Decoction in the ICU : A case report
4 affiliations
- 1Jiangjin Hospital, Chongqing University of Chinese Medicine, Chongqing, People’s Republic of China
- 2Intensive Care Unit, Chongqing Jiangjin District Hospital of Chinese Medicine, Chongqing, People’s Republic of China
- 3Department of Emergency Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- 4Department of Acupuncture and Moxibustion, Chongqing Jiangjin District Hospital of Chinese Medicine, Chongqing, People’s Republic of China.
Abstract
Rationale:: Severe pressure injuries in long-term intensive care unit (ICU) bedridden patients are often combined with multidrug-resistant infections and life-threatening complications, including sepsis. Standard Western therapies such as debridement and biological dressings frequently fail to heal refractory wounds, triggering recurrent fever and substantial clinical and economic burdens. Traditional Chinese Medicine (TCM) offers an alternative adjuvant approach via holistic syndrome differentiation to regulate systemic function and accelerate wound granulation.
Patient concerns:: A 60-year-old ICU male with severe pneumonia and type I respiratory failure developed a stage IV pressure injury. After 6 months of standardized Western interventions, including antibiotics, surgical debridement, and pressure-relief nursing, the wound worsened with persistent recurrent fever caused by multidrug-resistant pathogens.
Diagnoses:: Western diagnosis: stage IV pressure injury. TCM diagnosis: decubital wound with spleen deficiency and sunken qi complicated by phlegm-stasis-damp-toxin obstruction.
Interventions:: Modified Bu Zhong Yi Qi Tang was administered to tonify middle jiao, lift sunken yang, consolidate vital qi, and promote granulation.
Outcomes:: Continuous herbal treatment for over 20 days achieved complete wound healing, resolved fever, and allowed successful discontinuation of mechanical ventilation and antibiotics. The patient’s appetite and mental status improved remarkably without adverse hepatic or renal reactions. Notably, full recovery relied on combined Western supportive care rather than herbal medicine alone.
Lessons:: This TCM regimen may represent a potential adjunctive therapy for refractory ICU stage IV pressure injuries unresponsive to routine Western management. The favorable outcome resulted from integrated Chinese-Western multimodal treatment. Further large prospective trials are required to verify the independent efficacy of Modified Bu Zhong Yi Qi Tang.
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BibTeX
@article{liao2026clinical,
title = {{Clinical management of a severe pressure injury with Buzhong Yiqi Decoction in the ICU : A case report}},
author = {Dan Liao and Bangjiang Fang and Jianjian Li and Jing Wang and Wei He and Xiaosong Lyu and Yan Zhang},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051226},
url = {https://europepmc.org/article/PMC/PMC13727164},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical management of a severe pressure injury with Buzhong Yiqi Decoction in the ICU : A case report
AU - Dan Liao
AU - Bangjiang Fang
AU - Jianjian Li
AU - Jing Wang
AU - Wei He
AU - Xiaosong Lyu
AU - Yan Zhang
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051226
UR - https://europepmc.org/article/PMC/PMC13727164
AB - Rationale:: Severe pressure injuries in long-term intensive care unit (ICU) bedridden patients are often combined with multidrug-resistant infections and life-threatening complications, including sepsis. Standard Western therapies such as debridement and biological dressings frequently fail to heal refractory wounds, triggering recurrent fever and substantial clinical and economic burdens. Traditional Chinese Medicine (TCM) offers an alternative adjuvant approach via holistic syndrome differentiation to regulate systemic function and accelerate wound granulation. Patient concerns:: A 60-year-old ICU male with severe pneumonia and type I respiratory failure developed a stage IV pressure injury. After 6 months of standardized Western interventions, including antibiotics, surgical debridement, and pressure-relief nursing, the wound worsened with persistent recurrent fever caused by multidrug-resistant pathogens. Diagnoses:: Western diagnosis: stage IV pressure injury. TCM diagnosis: decubital wound with spleen deficiency and sunken qi complicated by phlegm-stasis-damp-toxin obstruction. Interventions:: Modified Bu Zhong Yi Qi Tang was administered to tonify middle jiao, lift sunken yang, consolidate vital qi, and promote granulation. Outcomes:: Continuous herbal treatment for over 20 days achieved complete wound healing, resolved fever, and allowed successful discontinuation of mechanical ventilation and antibiotics. The patient’s appetite and mental status improved remarkably without adverse hepatic or renal reactions. Notably, full recovery relied on combined Western supportive care rather than herbal medicine alone. Lessons:: This TCM regimen may represent a potential adjunctive therapy for refractory ICU stage IV pressure injuries unresponsive to routine Western management. The favorable outcome resulted from integrated Chinese-Western multimodal treatment. Further large prospective trials are required to verify the independent efficacy of Modified Bu Zhong Yi Qi Tang.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -