摘要
脓毒症是急诊及ICU常见的急危重症之一,容易并发毛细血管渗漏综合征(CLS),累及全身多脏器,出现以全身进行性水肿、低血压,低蛋白血症、低氧血症、少尿等为主要临床表现的一种综合征。然现代医学在其治疗上仍无特异性手段,大都是对症支持的综合治疗,并且在液体管理、改善毛细血管通透性、呼吸机机械通气、连续性肾脏替代疗法、调节免疫抑制等疗效方面参差不齐。随着中医药研究水平的不断提高,在治疗脓毒症方面中医药发挥了其独特的优势,本文通过温习中医大量文献,以“痰饮”为切入点,从“虚、饮、瘀”三个证候要素,并且结合现代药理研究角度系统阐述脓毒症并发毛细血管渗漏综合征的病因病机及治疗方法,希冀为临床治疗该病提供新的思路及方向。
Sepsis is one of the most common acute and severe cases in emergency department and ICU.It is easy to be complicated with capillary leak syndrome(CLS),involving multiple organs of the whole body.The main clinical manifestations of sepsis are systemic progressive edema,hypotension,hypoproteinemia,hypoxemia and oliguria.However,modern medicine still has no specific means in its treatment.Most of them are symptomatic and supportive comprehensive treatment,and the curative effects are uneven in liquid management,improvement of capillary permeability,mechanical ventilation of ventilator,continuous renal replacement therapy and regulation of immunosuppression.With the continuous improvement of the research level of traditional Chinese medicine,traditional Chinese medicine has played its unique advantages in the treatment of sepsis.In this paper,through reviewing a large number of TCM literature,taking“phlegm and fluid”as the breakthrough point,from the“deficiency,drink,blood stasis”three syndrome elements,and combined with modern pharmacological research angle,the etiology,pathogenesis and treatment of sepsis complicated with capillary leakage syndrome are systematically expounded in order to provide new ideas and direction for clinical treatment of the disease.
作者
林柏柏
沈梦雯
钱义明
赵雷
连佳明
陈嘉琪
孙旗
褚梦瑶
钱风华
LIN Baibai;SHEN Mengwen;QIAN Yiming;ZHAO Lei;LIAN Jiaming;CHEN Jiaqi;SUN Qi;CHU Mengyao;QIAN Fenghua(Shanghai University of Traditional Chinese Medicine,Shanghai 200080,China)
出处
《陕西中医》
2021年第2期222-224,238,共4页
Shaanxi Journal of Traditional Chinese Medicine
基金
上海市卫生健康委员会卫生行业临床研究专项(201940205)
上海市卫生健康委员会、上海市中医药管理局中医专项培育项目(04.YY021.16)
上海中医药大学附属岳阳中西医结合医院青年基金资助项目(2019YYQ07)。
关键词
脓毒症
毛细血管渗漏综合征
痰饮
病因病机
辨证施治
温药
活血化瘀
Sepsis
Capillary leakage syndrome
Phlegm and fluid
Etiology and pathogenesis
Syndrome differentiation and treatment
Warm herbs
Activate blood and resolve stasis
