OBJECTIVE:To evaluate the add-on effect of Qinbei Qingfei Yiqi (QBQFYQ) granules for ventilator-associated pneumonia (VAP) in non-infectious critical ly ill patients.METHODS:In this randomized controlled trial,80 non-infectious critically ill patients undergoing mechanical ventilation in the intensive care unit (ICU)were randomly divided into two groups:those receiving QBQFYQ granules plus usual treatment (ex-perimental group,n ＝ 50) and those receiving only the usual treatment (control group,n ＝ 30).Themain outcome measures were VAP rate,time of VAPoccurrence,duration of mechanical ventilation,and length of ICU stay.Interleukin-6 (IL-6),C-reac-tive protein (CRP),and T-lymphocyte (CD4+,CD8+,and CD4+/CD8+ ratio) serum levels were also evaluated before and after treatment.RESULTS:Compared with the control group treatment,QBQFYQ administration significantly reduced the duration of mechanical ventilation [(9.58± 3.14) vs (12.52 ± 4.33) days] and length of ICU stay [(14.57 ± 3.72) vs (17.82 ± 5.24) days] and delayed VAP occurrence [(4.31 ± 0.86) vs (2.43 ± 0.27)days].Additionally,CRP and IL-6 serum levels and CD4+/CD8+ ratio were significantly lower in the experimental group (P ＜ 0.05) than in the control group.However,there were no significant differences in hospital mortality rate (30.0％ vs 33.3％) and adverse events (4.0％ vs 6.7％).CONCLUSION:QBQFYQ delays the time of VAP occurrence and shortens the duration of mechanical ventilation in non-infectious critically ill patients,possibly through anti-inflammatory and immunomodulatory mechanisms.