Acute respiratory distress syndrome （ARDS） is believed to primarily result from a disorder of the

qi

movement， with

qi

dysfunction occurring first， followed by changes in fluids and blood. The disease is located in the lungs， with its root in

qi

and pathological changes in fluids and blood， aligning with the theory of "

qi

loses its regulatory function， fluids and blood follow the same path". Accordingly， ARDS is divided into three stages， the early stage with

qi

congestion， counterflow， fluids and bl

ood obstruction， severe stage with

qi

collapse，

yang

depletion， fluids and blood out of control）， and recovery stage with

qi

consumption and fluids damage， residual pathogen retention. For the corresponding treatments， in the early stage， the focus is on diffusing the lung

qi

， opening the block， dissol-ving phlegm， and eliminating fluid retention， using

Tingli Dazao Xiefei Decoction

（葶苈大枣泻肺汤） and

Xuanbai Chengqi Decoction

（宣白承气汤）

/ Shegan Mahuang

Decoction

（射干麻黄汤） with modifications. In the severe stage， the priority is to reinforce

qi

， stabilize collapse， and promote diuresis and blood circulation， with modified

Zhenwu Decoction

（真武汤） and

Shenge Powder

（参蛤散）. During recovery stage， the emphasis shifts to replenishing

qi

and body fluids while clearing residual pathogens， with

Shashen Maidong Decoction

（沙参麦冬汤） and

Bufei Decoction

（补肺汤）. At the same time， from the perspective of "

qi

loses its regulatory function， fluids and blood follow the same path"， the mechanism of prone position ventilation （PPV） is explored. It is believed that the effect of "

qi

reaching the blood" via PPV by restoring the

qi

movement and unblocking

qi

， blood and water retention， which offers insights for the diagnosis and treatment of ARDS with integrated traditional Chinese and western medicine.