Objective: To evaluate the efficacy and safety of Xuanfei Baidu decoction for treating coronavirus disease 2019 (COVID-19).
Methods: Patients with COVID-19 were enrolled, and eligible patients were randomly allocated to three groups: group A (Xuanfei Baidu decoction combined with conventional treatment), group B (Ganlu Xiaodu decoction combined with conventional treatment), and group C (conventional treatment only). The duration of treatment was 14 days. The primary outcomes were the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid testing from positive to negative and hospitalization days. The secondary outcome was the rate of symptom resolution. The safety outcome was drug-related adverse events.
Results: In total, 103 patients with ordinary-type COVID-19 were included and randomly allocated to groups A (34 cases), B (35 cases), and C (34 cases). Duration for SARS-CoV-2 nucleic acid testing from positive to negative was shortest in group A [(9.88 ± 3.62) days], followed by groups C [(11.20 ± 2.93) days] and B [(12.69 ± 4.11) days]; differences between the three groups were statistically significant (P = 0.010). The number of hospitalization days was the least in group A [(14.00 ± 6.55) days], followed by groups B [(15.40 ± 4.02) days] and C [(16.38 ± 5.73) days], and differences between groups were statistically significant (P = 0.019). There was no statistically significant difference in the rate of symptom resolution between groups (P > 0.05). No deaths or serious adverse events occurred in either of the groups.
Conclusion: Considering the treatment of ordinary-type COVID-19, Xuanfei Baidu decoction can shorten the duration from a positive to negative SARS-CoV-2 nucleic acid test, as well as the duration of hospitalization. Moreover, there were no Xuanfei Baidu decoction-induced adverse reactions.

Objective: The surgical treatment of myocardial infarction often causes myocardial ischemia-reperfusion injury (MI/RI). Danhong injection (DHI) has curative effects on coronary heart disease and angina pectoris. However, its therapeutic effects on MI/RI still require further validation. This study aims to investigate the components involved and mechanism of action of DHI against MI/RI.
Methods: Primary metabolites (PM) and secondary metabolites (SM) were isolated from DHI. We established a rat model of MI/RI by administering PM, SM, and DHI. Cardiac morphology and functional parameters were evaluated using cardiac ultrasound. The metabolic effects of PM, SM, and DHI in the serum and myocardial tissue on MI/RI were investigated using ¹hydrogen-nuclear magnetic resonance.
Results: Our study showed that DHI, PM, and SM could improve cardiac function by correcting the dilated cardiac structure, alleviating inflammation by downregulating complement C2 expression, reducing reactive oxygen species (ROS) production by upregulating cyclooxygenase expression, and restoring normal energy supply by inhibiting fatty acid metabolism and stimulating glycometabolism. In addition, DHI and SM could attenuate the calcium overload and trigger an inflammatory response and oxidative stress by downregulating Ca²⁺/calmodulin-dependent protein kinase II expression.
Conclusions: This study suggests that DHI and its components exerts resistance against MI/RI by ameliorating cardiac dysfunction, energy metabolism, and oxidative stress.

Objective: Our study aimed to investigate the action of Xuanfei Baidu granules (XFBD) and their mechanism of action in a model of coronavirus pneumonia under cold and damp conditions.
Methods: A total of 60 Bagg Albino (BALB/c) mice were randomly assigned to different groups, including the control, model, low-dose XFBD (1.84 g/kg), medium-dose XFBD (3.67 g/kg), and high-dose XFBD (7.34 g/kg) groups. To simulate the model of coronavirus infection, a combination of cold and damp stimuli and coronavirus strain 229E (CoV 229E) was employed. Subsequently, XFBD was administered on the fifth day and lasted for 3 days. To evaluate the efficacy of XFBD in BALB/c mice, various parameters, including behavior, lung index, viral load, and pulmonary pathology, were observed. Levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were measured using enzyme-linked immunosorbent assay (ELISA). The fractions of CD4⁺ T cells, CD8⁺ T cells, and B cells were measured using flow cytometry.
Results: The mice in the control group were active, in good condition, and exhibited shiny hair. After modeling, the mice demonstrated less activity, low energy levels, messy and less shiny hair, poor appetite, and soft stools. The symptoms of coronavirus pneumonia were all significantly improved after the administration of different doses of XFBD. At three dosage levels, XFBD effectively increased gastrin (GAS) content, whereas medium and high doses of XFBD reduced motilin (MTL) content. The high-dose XFBD group showed a significant reduction in pathological damage to lung tissue. Treatment with three doses of XFBD demonstrated significant downregulation of inflammatory factors and regulation of CD4⁺ and CD8⁺ T cell and B cell expression. The high-dose XFBD group exhibited enhanced efficacy compared to the other doses.
Conclusions: XFBD showed a therapeutic effect on coronavirus pneumonia under cold and damp conditions, improved the behavioral characterization and gastrointestinal index, and reduced the lung virus titer and histopathology. This may be associated with the inhibition of inflammation and an increase in the number of lymphocytes.

The discovery of effective constituents of traditional Chinese medicine (TCM) is an important approach in new drug development. Several well-known drugs, such as artemisinin, berberine, and ephedrine have been developed using this approach. However, the efficacy and safety of TCM, two key issues for drug development based on TCM clinical experience, remain unclear worldwide. The discovery strategy of relevant constituents is the most important step for determining efficacy and safety, which still a key scientific problem that restricts the development of new drugs. Furthermore, TCM formulas used as clinical drugs address a specific TCM syndrome (Zheng), and the complexity of the formula and vagueness of the syndrome make the identification of the effective constituents related to clinical effectiveness challenging. Over decades, researchers have developed transdisciplinary technologies and research methodologies to identify effective constituents in vivo. In this paper, the history of strategy development for identifying the effective constituents related to the clinical efficacy of TCM is reviewed and summarized. The main approaches include the phytochemical method, which involves the classical systematic separation and screening (extraction, separation, purification, structure identification, and activity test); bioactivity-guided separation; serum pharmacochemistry of TCM in vivo; and Chinmedomics, which connects in vivo constituents with the biomarkers of the relevant TCM syndrome. Chinmedomics is a promising strategy that conforms to the theory and characteristics of TCM. By clarifying the effective constituents, targets and pathways of medicines, it can promote the discovery of lead compounds and the research of innovative drugs, and continuously promote the modernization of TCM.

Following peripheral nerve injury, the sympathetic nervous system responds to noxious inputs that induce or exacerbate pain. Dorsal root ganglion (DRG) sympathetic sprouting after peripheral nerve injury may induce abnormal firing of neurons. Moreover, the areas of the brain that respond to nociceptive stimuli overlap with those areas activated by the sympathetic nervous system. Acupuncture is a widely used alternative therapy for neuropathic pain. It has been demonstrated that it has positive effects on the regulation of function in the autonomic nervous system. Based on previous studies, there are several possibilities for the regulation of sympathetic nerves by using acupuncture to relieve neuropathic pain. Acupuncture may act on the brain areas of pain and the sympathetic nervous system, decrease sympathetic nerve activity during neuropathic pain, attenuate sympathetic sprouting, and reduce the abnormal firing of neurons. Further studies are required to confirm these hypotheses. This review will help to better understand the potential mechanisms of acupuncture in neuropathic pain.

The etiology and exact molecular mechanisms of primary hepatocellular carcinoma (HCC) remain unclear, and its incidence has continued to increase in recent years. Despite tremendous advances in systemic therapies such as molecularly targeted drugs, HCC has some of the worst prognoses owing to drug resistance, frequent recurrence, and metastasis. Hepatocellular carcinoma is a widespread disease and its progression is regulated by the immune system. Traditional Chinese medicine (TCM) has been gradually theorized and systematized to have a holistic regulatory role for use in the prevention and treatment of tumors. Although half of the patients with HCC receive systemic therapy, traditionally sorafenib or lenvatinib are used as first-line treatment modalities. TCM is also widely used in the treatment of HCC, and the same immune checkpoint inhibitors (ICIs) such as PD-L1 have also received much focus in the field of continuously changing cancer treatment. Owing to the high probability of resistance to specific drugs and unsatisfactory efficacy due to administration of chemotherapy in single doses, the combination of drugs is the newest therapeutic option for patients with tumors and has become increasingly prominent for treatment. In this article, the research progress on combination therapy in the immunology of HCC is reviewed and the unique advantages of synergistic anti-tumor therapy with combination drugs are highlighted to provide new solutions for the clinical treatment of tumors.

Senkyunolides are a group of phthalide molecules that exist in Umbelliferae plants, with the highest abundance in Ligusticum chuanxiong Hort, a medicinal herb with therapeutic applications in various diseases such as coronary heart disease, migraine, and rheumatism. Modern research has highlighted the anti-inflammatory, analgesic, and cardiovascular-protective properties of senkyunolides. Recently, some novel effects, such as antibacterial, anti-osteoporosis, and anti-fibrosis, have been reported for senkyunolides, indicating their diverse biological activities. In addition, because of its high bioavailability and ability to cross the blood-brain barrier (BBB), particularly exemplified by senkyunolide I (SEI), holds promise for the treatment of brain diseases. Multiple signaling pathways have been related to the pharmacological activities of senkyunolides, such as the toll-like receptor 4/nuclear factor-kappa B (NF-κB) signaling, extracellular signal-regulated kinase (ERK) pathway, p38 mitogen-activated protein kinase, and c-Jun N-terminal kinase (JNK) pathways. Here, we review the research progress on the pharmacokinetics and pharmacological effects of senkyunolides, which are promising candidates for future drug development and have significant clinical value in the treatment of various diseases.

Atrial fibrillation (AF) is the most common arrhythmia disease and is associated with several cardiovascular and cerebrovascular diseases. Consequently, the mortality rate of AF has increased in recent years. At present, the treatment of AF is mainly based on medication and radiofrequency ablation, but there are limitations such as adverse reactions and high recurrence rates. Recently, autonomic nervous regulation has become a new treatment for AF. Our previous study showed that acupuncture at Neiguan (PC6) point can treat AF by regulating autonomic balance. The autonomic nervous system can be structurally divided into the central autonomic nervous (CAN) and the peripheral autonomic nervous (PAN). Several studies have shown a correlation between acupuncture and the treatment of AF and CAN. In the clinic, the positive effect of acupuncture on AF has been realized gradually, and growing experimental studies have further discovered the potential mechanism of acupuncture on AF by regulating the CAN. Therefore, this review mainly focuses on summarizing the CAN mechanism related to acupuncture in the treatment of AF to provide new ideas and directions for the treatment of AF.

Medicinal plants are renowned for their abundant production of secondary metabolites, which exhibit notable pharmacological activities and great potential for drug development. The biosynthesis of secondary metabolites is highly intricate and influenced by various intrinsic and extrinsic factors, resulting in substantial species diversity and content variation. Consequently, precise regulation of secondary metabolite synthesis is of utmost importance. In recent years, genome sequencing has emerged as a valuable tool for investigating the synthesis and regulation of secondary metabolites in medicinal plants, facilitated by the widespread use of high-throughput sequencing technologies. This review highlights the latest advancements in genome sequencing within this field and presents several strategies for studying secondary metabolites. Specifically, the article elucidates how genome sequencing can unravel the pathways for secondary metabolite synthesis in medicinal plants, offering insights into the functions and regulatory mechanisms of participating enzymes. Comparative analyses of plant genomes allow identification of shared pathways of metabolite synthesis among species, thereby providing novel avenues for obtaining cost-effective biosynthetic intermediates. By examining individual genomic variations, genes or gene clusters associated with the synthesis of specific compounds can be discovered, indicating potential targets and directions for drug development and the exploration of alternative compound sources. Moreover, the advent of gene-editing technology has enabled the precise modifications of medicinal plant genomes. Optimization of specific secondary metabolite synthesis pathways becomes thus feasible, enabling the precise editing of target genes to regulate secondary metabolite production within cells. These findings serve as valuable references and lessons for future drug development endeavors, conservation of rare resources, and the exploration of new resources.

High-content screening (HCS) technology combines automated high-speed imaging hardware and single-cell quantitative analysis. It can greatly accelerate data acquisition in cellular fluorescence imaging and is a powerful research technique in traditional Chinese medicine (TCM). An increasing number of laboratories and platforms, including TCM laboratories, have begun utilizing HCS systems. However, this technology is still in its infancy in TCM research and there is a lack of sufficient experience with the associated concepts, instrument configurations, and analysis methods. To improve the understanding of HCS among researchers in the field of TCM, this paper summarizes the concept of HCS, software and hardware configuration, the overall research process, as well as common problems and related solutions of HCS in TCM research based on our team's previous research experience, providing several research examples and an outlook on future perspectives, aiming to provide a technical guide for HCS in TCM research.

Chinese guideline has proven effective in the fight against coronavirus disease 2019 (COVID-19) during the global spread of the epidemic. Traditional Chinese medicine (TCM) is widely recognized for its effectiveness in alleviating symptoms, inhibiting disease progress, reducing mortality, and improving the cure rate of patients with COVID-19. During the pandemic, “three medicines and three formulas” (TMTFs) stood out from hundreds of others in registered clinical studies, which became highly recommended as TCM for COVID-19 treatment. The TMTFs not only effectively relieve the clinical symptoms of fever, cough, fatigue, and phlegm, but also substantially shorten the time of nucleic acid negative conversion, improve lung computed tomography imaging features and inflammation, ameliorate clinical biochemical indicators, and reduce sequelae. Their potential pharmacological mechanisms are mainly related to the crosstalk between viral toxicity, endothelial damage, cytokine storm, immune response, and microthrombus. In brief, the clinical effects and the potential mechanisms of TMTFs on COVID-19 were systematically analyzed and summarized covering the entirety of disease development, including virus invasion and replication, immune response and cytokine storm, and acute respiratory distress syndrome and multiple organ dysfunction syndrome. This review provides a theoretical basis and reference for the in-depth understanding of the positive role of TMTFs in COVID-19 treatment.

Objective: Inhibition of tumor angiogenesis has become a new targeted tumor therapy. In this study, we established a micellar carrier with a tumor neovascularization-targeting effect modified by the neovascularization-targeting peptide NGR.

Methods: The targeted polymer poly(ethylene glycol)-b-poly(lactide-co-glycolide) (PEG-PLGA) modified with Asn-Gly-Arg (NGR) peptide was prepared and characterized by ¹H nuclear magnetic resonance and Fourier-transform infrared spectrometry. NGR-PEG-PLGA was used to construct curcumin (Cur)-loaded micelles by the solvent evaporation method. The physicochemical properties of the micelles were also investigated. Additionally, we evaluated the antitumor efficacy of the polymer micelles (PM) using in vitro cytology experiments and in vivo animal studies.

Results: The particle size of Cur-NGR-PM was 139.70β±β2.51 nm, and the drug-loading capacity was 14.37β±β0.06%. In vitro cytological evaluation showed that NGR-modified micelles showed higher cellular uptake through receptor-mediated endocytosis pathways than did unmodified micelles, leading to the apoptosis of tumor cells. Then, in vivo antitumor experiments showed that the modified micelles significantly inhibited tumor growth and were safe.

Conclusions: NGR-modified micelles significantly optimized the therapeutic efficacy of Cur. This strategy offers a viable avenue for cancer treatment.

Objective: Rheumatoid arthritis (RA) is a common autoimmune disease characterized by multiple joint lesions and systemic complications. Danggui Niantong decoction (DGNTT) has been clinically used for RA treatment; however, its beneficial effect on cardiopulmonary complications has not been reported.

Methods: Female tumor necrosis factor-transgenic (TNF-Tg) mice were used to evaluate the therapeutic effects of DGNTT on arthritis and cardiopulmonary complications. Methotrexate (MTX) served as a positive control. Histopathological assessment of the joint sections was performed using hematoxylin and eosin (HE), Alcian Blue/Orange G, and tartrate-resistant acid phosphatase staining. Bone mass was assessed by micro-computed tomography, inflammatory infiltrates in the heart and lungs were evaluated by HE staining, cardiopulmonary fibrotic injury was identified by Masson's trichrome staining, and hypertrophy of mouse cardiomyocytes was measured by wheat germ agglutinin (WGA) staining.

Results: DGNTT mitigated the inflammation of the ankle joint synovium, decreased the number of osteoclasts, and increased the area of cartilage and bone mass in TNF-Tg mice. In addition, DGNTT decreased the infiltration of inflammatory cells into the lung and heart tissues, accompanied by a reduction in cardiopulmonary fibrosis and myocardial cell hypertrophy in TNF-Tg mice. As a positive control drug, MTX attenuated the pathological changes in joints, but had no beneficial effect on cardiopulmonary inflammation and fibrosis in TNF-Tg mice.

Conclusions: DGNTT improved joint lesions and alleviated cardiopulmonary complications in TNF-Tg mice.

Azadirachtin, a complex tetratriterpenoid limonin with potent insecticidal properties, is the most widely used biological pesticide worldwide. Its versatile pharmacological applications include the inhibition of tumor growth and anti-malarial, anti-bacterial, and anti-inflammatory properties. Azadirachtin plays a pivotal role in pest control and novel drug development. The primary source of azadirachtin is the neem tree (Azadirachta indica A. Juss), with an azadirachtin content ranging from 0.3% to 0.5%. Despite the market demand for botanical pesticides reaching approximately 100,000 tons per year, the annual neem production in China is only 1.14 tons. Although azadirachtin can be obtained through plant extraction or chemical synthesis, the quantity obtained does not meet the market demand in China. The sluggish pace of azadirachtin biosynthesis results from the limited availability of genetic information and the complexity of the synthetic pathway. Recent advancements in azadirachtin biosynthesis hold promise as an efficient collection method. In this study, we explored the physicochemical properties, biological activities, mechanisms of action, and acquisition methods of azadirachtin. We also delved into recent progress in azadirachtin biosynthesis and assessed potential future usage challenges. This study aims to establish a theoretical foundation for the scientific application and efficient synthesis of azadirachtin, offering valuable reference information to the industry.

Acupuncture, a form of traditional Chinese medicine with a history of 2,000 years in China, has gained wider acceptance worldwide as a complementary therapy. Studies have examined its effectiveness in various health conditions and it is commonly used alongside conventional medical treatments. With the development of artificial intelligence (AI) technology, new possibilities for improving the efficacy and precision of acupuncture have emerged. This study explored the combination of traditional acupuncture and AI technology from three perspectives: acupuncture diagnosis, prescription, and treatment evaluation. The study aimed to provide cutting-edge direction and theoretical assistance for the development of an acupuncture robot.

The autonomic nervous system (ANS) includes the sympathetic, parasympathetic, and enteric nervous systems, and its senior regulatory center includes the brainstem, cingulate gyrus, and hypothalamus. Acupuncture can affect visceral, vascular, and glandular functions via the autonomic nervous regulatory pathway. In this paper, the relationship between pain and autonomic nervous function, the application of acupuncture guided by the autonomic nervous system, and the basis and clinical research on acupuncture analgesia are reviewed.

In recent years, significant progress has been achieved in both basic and clinical research within the field of traditional medicine, garnering increasing attention worldwide. To further promote a high-quality and international development of traditional medicine, the editorial board of Acupuncture and Herbal Medicine provided a collection of the “Top 50 High-impact Researches of Traditional Medicine” published in 2021 through objective indicators and a strict selection process. The findings of the selected articles have a significant academic influence and possess considerable academic value both nationally and internationally. The selected articles cover a wide range of topics, including clinical research, acupuncture, pharmacology, chemistry, biosynthesis, medicinal plant resources, and new formulation and drug delivery system research on traditional medicine. Therefore, this article outlines the selection process of the top 50 high-impact research articles, analyzes their research characteristics, and provides a brief summary of their new findings and perspectives in the field of traditional medicine.

Objective:This work aimed to report the first complete mitochondrial genome (mitogenome) of Rheum palmatum, summarize the features of Caryophyllales mitogenomes, and to reveal the potential of utilizing the mitogenomes of R. palmatum and other Caryophyllales species for inferring phylogenetic relationships and species identification.

Methods: Both Illumina short reads and PacBio HiFi reads were utilized to obtain a complete mitogenome of R. palmatum. A variety of bioinformatics tools were employed to characterize the R. palmatum mitogenome, compare the reported mitogenomes in Caryophyllales and conduct phylogenetic analysis.

Results: The mitogenome of R. palmatum was assembled into a single master circle of 302,993 bp, encoding 35 known protein-coding genes, 18 transfer RNA genes, and three ribosome RNA genes. A total of 249 long repeats and 49 simple sequence repeats were identified in this mitogenome. The sizes of mitogenomes in Caryophyllales varied from 253 kb to 11.3 Mb. Among them, 23 mitogenomes were circular molecules, one was linear, and one consisted of relaxed circles, linear molecules, and supercoiled DNA. Out of the total mitogenomes, 11 were single-chromosome structure, whereas the remaining 14 were multi-chromosomal organizations. The phylogenetic analysis is consistent with both the Engler system (1964) and the Angiosperm Phylogeny Group III system.

Conclusions: We obtained the first mitogenome of R. palmatum, which consists of a master circle. Mitogenomes in Caryophyllales have variable genome sizes and structures even within the same species. Circular molecules are still the dominant pattern in Caryophyllales. Single-chromosome mitogenomes account for nearly a half of all the mitogenomes in Caryophyllales, in contrast to previous studies. It is feasible to utilize mitochondrial genomes for inferring phylogenetic relationships and conducting species identification.

Objective: Celastrol is a pentacyclic triterpenoid extracted from the traditional Chinese medicinal herb, Tripterygium wilfordii. This study aims to provide a scientific basis for the rational development and use of celastrol in breast cancer.
Method: A quantitative chemical biology approach was used to investigate the protein targets and molecular mechanisms of celastrol in breast cancer cells.
Results: Low-concentration celastrol exerted an anti-tumor effect by directly binding to hydroxysteroid dehydrogenase-like 2 (HSDL2) and inhibiting its expression. Moreover, the expression of the pro-apoptotic protein, Bcl-2-associated X (BaX), increased, the level of the anti-apoptotic protein, B-cell lymphoma-2 (Bcl-2), decreased, and the rate of apoptosis increased. After the transfection of cells with si-HSDL2, the apoptosis rate was similar to that observed after the administration of celastrol. However, apoptosis was reversed by the overexpression of HSDL2. Furthermore, our mass spectrometry (MS) data indicated a relationship between HSDL2 and the mitogen-activated protein kinase (MAPK) signaling pathway. We also found that the expression of HSDL2 was directly related to the degree of extracellular signal-regulated kinase (ERK) phosphorylation.
Conclusion: Celastrol may promote apoptosis by suppressing the HSDL2/MAPK/ERK signaling pathway.

Malignant tumor has become a major threat affecting human health, and is one of the main causes of human death. Recent studies have shown that many traditional Chinese medicines (TCM) have good anti-tumor activity, which may improve the therapeutic effect of routine treatment and quality of life with lower toxicity. However, the efficacy of TCM alone for the treatment of tumors is limited. Metal ions are essential substances for maintaining normal physiological activities. This article summarized the multiple mechanisms in which metal ions are involved in the prevention and treatment of tumors in TCM.

Traditional medicine has garnered significant global recognition, with an estimated 80% of the global population using it. Therefore, it is essential to fully understand the integration of traditional medicines into current healthcare systems. This review aims to provide a comprehensive overview of the standard process to modernize traditional medicine scientifically in the context of modern biomedicine, further termed here as “scientization”. Specifically, we aim to summarize the advancements made in understanding the efficacy, effectiveness, and underlying mechanisms of herbal medicine. We also examined the transition from experience- to evidence-based medicine during acupuncture. Furthermore, we explore the development of universal safety and quality control standards. Finally, we discuss international trade and export markets for Chinese medical products. The development and integration of traditional medicine have allowed it to further improve human health, resulting in a more comprehensive health solution for the global population.

Volatile oil (VO) is the main chemical component of common plants in Chrysanthemum genus, and it possesses several beneficial pharmacological properties, including bacteriostatic, antioxidant, anti-tumor, anti-inflammatory, antipyretic, analgesic, anti-osteoporotic, antihypertensive, sedative, and hypnotic effects. To date, research on the effective components of Chrysanthemum extract has mainly focused on flavonoids, whereas limited data are available on the chemical constituents and underlying mechanisms of action of the VO components. In this review, the pharmacological activities and mechanisms of VO are comprehensively reviewed with the aim of providing a foundation for further development for medicinal, aromatherapy, and diet therapy applications.

Sepsis is a life-threatening inflammatory syndrome with high morbidity and mortality rates. However, options for sepsis are still limited to general treatment in intensive care units (ICUs), and effective therapies that improve sepsis survival are required. Immune disturbances play a vital role in the pathology of sepsis and are associated with protracted inflammation, susceptibility to infections, and death. Therefore, many investigators have focused on the potential benefits of immunomodulation therapy for sepsis. Electroacupuncture (EA) has been practiced in clinics for many years and has shown advantages in treating infectious diseases. Over the last few decades, our understanding of the efficacy and mechanisms of EA in sepsis has undergone considerable developments. We searched the literature regarding “CNKI, Wan Fang Data, VIP Database, PubMed, and Ingenta Connect” from 2010 to 2023, using the keywords “sepsis” “septic” and “electroacupuncture” and 336 sources were searched. Finally, we included 82 studies that targeted the immune system to determine EA's anti-inflammatory and immunomodulatory effects on sepsis. In this review, we found that EA has clinical benefits in relieving septic inflammation, improving immune function, and attenuating related multi-organ injury through several mechanisms, such as activation of the cholinergic anti-inflammatory pathway (CAP), vagal-adrenal axis, inhibition of the nuclear factor Kappa-B (NF-κB) signaling pathway, signal transducers and activators of transcription (STAT) signaling pathway, and improvement of immune cell function. Therefore, EA may be a promising complementary therapy for sepsis treatment. We also expect these data will contribute to further studies on EA in sepsis.