韩云教授宣肺调肠方治疗脓毒症急性呼吸窘迫综合征临证经验
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摘要
脓毒症是严重创伤、休克、感染等重症患者常见并发症,其病死率高,是重症医学领域研究的重点和难点问题之一。严重脓毒症患者可出现多脏器功能衰竭,其中急性呼吸窘迫综合征(Acute respiratory distress syndrome,ARDS)是脓毒症呼吸系统最为严重的并发症,而且通常较其他器官功能衰竭更早出现。脓毒症ARDS属中医"暴喘"范畴,多属本虚标实之证。韩云教授作为全国名老中医学术思想继承人、中国中医科学院中青年名中医,在治疗脓毒症所致呼吸系统并发症方面积累了丰富的临床经验。宣肺调肠方即是韩云教授结合多年临床经验在经方基础上化裁自拟而成,用以治疗脓毒症ARDS、中医辨证属气虚痰热腑实者,多年来广泛应用于临床,疗效颇丰。文章旨在简要阐述并分析宣肺调肠方的临证运用经验。
Sepsis is the common complication of severe trauma,shock and infection,with high mortality rate. It is the one of the key and difficult issues in research of intensive care medicine,the patient with severe sepsis commonly has multi-organ failure,in which,acute respiratory disease syndrome( ARDS) is the most severe complication in the respiratory system of sepsis and occurs the earliest than the failure of other organs. Sepsis ARDS is in the category of baoxiao,which is deficiency of the root cause and excess of the symptom. Prof. Han Yun,the inheritor of the academic thought of national famous physician of Chinese medicine,the famous young TCM physician of China Academy of Chinese Medical Sciences.Xuanfei tiaochang formul( for dispersing lung qi and regulating intestine functions) is the self-prepared the formula on the base of the accumulation of the clinical experiences of Prof. Han for sepsis ARDS that is differentiated as qi deficiency and phlegm heat. The satisfactory effects have been achieved by the wide application in clinical practice. In the paper,the clinical application of such formula was introduced.
Sepsis is the common complication of severe trauma,shock and infection,with high mortality rate. It is the one of the key and difficult issues in research of intensive care medicine,the patient with severe sepsis commonly has multi-organ failure,in which,acute respiratory disease syndrome( ARDS) is the most severe complication in the respiratory system of sepsis and occurs the earliest than the failure of other organs. Sepsis ARDS is in the category of baoxiao,which is deficiency of the root cause and excess of the symptom. Prof. Han Yun,the inheritor of the academic thought of national famous physician of Chinese medicine,the famous young TCM physician of China Academy of Chinese Medical Sciences.Xuanfei tiaochang formul( for dispersing lung qi and regulating intestine functions) is the self-prepared the formula on the base of the accumulation of the clinical experiences of Prof. Han for sepsis ARDS that is differentiated as qi deficiency and phlegm heat. The satisfactory effects have been achieved by the wide application in clinical practice. In the paper,the clinical application of such formula was introduced.
引文
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[2]Prescott HC,Angus DC. Postsepsis Morbidity[J]. Jama,2018,319(1):91.
[3]Reinhart K,Daniels R,Kissoon N,et al. Recognizing Sepsis as a Global Health Priority-A WHO Resolution[J]. N Eng J Med,2017,377(5):414-417.
[4]ProudfootAG,McAuleyDF,GriffithsMJ,et al. Human models of acute lung injury[J]. Dis Mod Mechan,2011,4(2):145-153.
[5]Qiao L,Liu Z. Analysis of the risk factors of acute respiratory distress syndrome of Berlin new definition in patients with sepsis in emergency department[J]. Chinese Critical Care Medicine,2015,27(7):558
[6]吕根法,王志国,石宏伟,等.中草药括抗内毒素作用机制的研究进展[J].河南科技大学学报:医学版,2010,28(3):230-232.
[7]韩云,赖芳,林燕钊,等.刘伟胜教授中药通里攻下法治疗急性呼吸衰竭经验[J].辽宁中医药大学学报,2010,12(2):7-8.
[8]朱文翔,刘原君,程发峰,等.承气汤类方与“肺肠同治”应用探讨[J].中医药导报,2015,21(1):6-9.
[9]韩春生.“肺与大肠相表里”理论在急性肺部感染治疗中的应用研究[D].北京:北京中医药大学,2002.
[10]徐彩超,刘新桥,刘恩顺,等.“肺与大肠相表里”理论指导治疗ALI/ARDS的临床疗效报告[J].天津中医药大学学报,2011,30(3):141.