中国中医科学院西苑医院,北京市海淀区西苑操场1号,100091
yangzhixu@sohu.com
收稿:2022-11-16,
修回:2022-12-12,
纸质出版:2023-06-02
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徐建兴,杨志旭.从伏邪温病辨治脓毒症经验[J].中医杂志,2023,64(11):1171-1174.
XU Jianxing,YANG Zhixu.Treating Sepsis from the Perspective of “Latent Pathogen in Warm Disease”[J].Journal of Traditional Chinese Medicine,2023,64(11):1171-1174.
徐建兴,杨志旭.从伏邪温病辨治脓毒症经验[J].中医杂志,2023,64(11):1171-1174. DOI: 10.13288/j.11-2166/r.2023.11.016.
XU Jianxing,YANG Zhixu.Treating Sepsis from the Perspective of “Latent Pathogen in Warm Disease”[J].Journal of Traditional Chinese Medicine,2023,64(11):1171-1174. DOI: 10.13288/j.11-2166/r.2023.11.016.
根据伏邪温病理论并结合治疗脓毒症的临床实践经验,认为“伏邪久藏”为诱发脓毒症之潜在病因;“邪热内伏,瘀毒阻络,内外合邪”是脓毒症的发病之机;余邪深伏,正虚邪恋,致脓毒症合并持续炎症-免疫抑制-高分解代谢综合征(PICS)等不良预后。治疗上以“清、透、养”为大法,运用“清法”清除体内毒邪,“透法”透邪散热、开达通路、清剿余邪,“养法”扶正祛邪外出、顾护脾肾和阴液,防止脓毒症向PICS转变。
According to the theory of latent pathogen in warm disease and the clinical practice experience in treating sepsis, it is believed that long-term accumulation of latent pathogen is the potential cause of sepsis. “Internal accumulation of pathogenic heat,stasis toxin blocking the collaterals, and combined internal and external pathogens” is the pathogenesis. Residual pathogen deeply buried and lingering pathogen due to healthy
qi
deficiency lead to persistent inflammation-immunosuppression-hypercatabolic syndrome (PICS) and other poor prognosis in sepsis. The main treatment method is to “clear, vent and nourish”. The clearing method is used to clear the pathogenic toxin in the body. The venting method can vent the pathogen and dissipate heat, open and unblock the pathway, and clear away residual pathogen. The nourishing method is to reinforce healthy
qi
and eliminate pathogen, care spleen-kidney and harmonize yin fluid, and prevent the transformation of sepsis into PICS.
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