Abstract: Objective To explore the therapeutic efficacy, pharmacological mechanisms, and clinical value of three herbal pairs (Radix et Rhizoma Rhei-Fructus Trichosanthis Radix Astragali-Radix Angelicae Sinensis Radix et Rhizoma Ginseng-Radix Ophiopogonis) in the staged intervention of sepsis based on the “herbal-syndrome correspondence” theory in order to provide new therapeutic strategies for treating sepsis with TCM. Methods Given the evolution of heat toxicity through stasis toxicity to deficiency of positive qi in the course of sepsis, Rhubarb and Fructus Trichosanthis were selected in the early stage to clear heat, remove toxins and drain heat from organs. In the progressive stage, Astragali and Angelicae Sinensis were used to activate blood circulation and enhance vital qi. In the late stage, Ginseng and Ophiopogon japonicus were used to consolidate vital qi and strengthen the root of qi and nourish yin. Results The three herbal pairs, Radix et Rhizoma Rhei-Fructus Trichosanthis, Radix Astragali-Radix Angelicae Sinensis, Radix et Rhizoma Ginseng-Radix Ophiopogonis could effectively inhibit inflammation, oxidative stress, apoptosis, and regulate immunity and coagulation through multi-targets and multi-channels, which might significantly alleviate the clinical symptoms of fever, chills, panic, shortness of breath, and impaired consciousness of patients, reduce the APACHEⅡand SOFA scores, and shorten hospital stay, and improve the survival of patients. Conclusion The paired herbal therapy based on the theory of “herbal-syndrome correspondence” can meet demands of sepsis treatment for “layered precision intervention” by inhibiting sepsis-induced inflammation, immune dysregulation, coagulation disorders, and multiple organ dysfunction at multiple points indifferent stages of the disease, offering a safe and effective approach.

Key words: Medicinal Evidence Correspondence, Sepsis, Radix et Rhizoma Rhei-Fructus Trichosanthis, Radix Astragali-Radix Angelicae Sinensis, Radix et Rhizoma Ginseng-Radix Ophiopogonis, Drug Pair, Pharmacological Effect, Clinical Application