刘伟胜教授治疗重症肺系疾病学术思想与临床经验的整理研究
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摘要
背景
急性肺损伤(acute lung injury,ALI)/急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是在严重感染、休克、创伤及烧伤等非心源性疾病过程中,肺毛细血管内皮细胞和肺泡上皮细胞损伤造成弥漫性肺间质及肺泡水肿,导致的急性低氧性呼吸功能不全或衰竭。在ALI/ARDS的各种病因中,脓毒症是ALI/ARDS发病的首要原因,占所有原因的37%以上。研究表明,脓毒症所致ALI/ARDS的病死率明显高于非脓毒症所致ALI/ARDS。虽然目前机械通气治疗及部分药物治疗ALI/ARDS取得了一定的效果,但ALI/ARDS的治疗当中还是存在着死亡率高、易发生机械通气并发症等问题,尚需进一步研究。
导师刘伟胜教授为长期从事医疗、教学、科研情况,在中西医结合治疗呼吸、肿瘤方面有其独到见解,在运用通里攻下、补益扶正等法治疗呼吸系统危重症方面积累了丰富经验,结合三年跟师体会,总结了刘伟胜教授在呼吸系统重症及肿瘤的学术思想及临床经验。
通过复习文献发现目前关于脓毒症致ALI/ARDS的中医临床证候研究仍非常缺乏,而且多为实验研究,提示中医药治疗ALI/ARDS可能有其优势,但临床研究极少,多数是停留在对发病极期病理变化的观察和干预对相关机制因素的影响,未能反映治疗对预后(如病死率、致残率、28天生存率等)的影响。首先对脓毒症致ALI/ARDS的中医证候要素进行研究,总结其中医证候特点,对于寻找切入点进行中医药疗法干预该病,最终形成中医诊疗方案具有重要的意义。
在总结脓毒症致ALI/ARDS的中医证候规律基础上结合刘伟胜教授治疗急性呼吸衰竭经验,以益气通腑泻热法治疗脓毒症致ALI患者,拟通过临床随机对照研究以证实其疗效,并对其疗效机制进行初步观察。
目的
1、总结刘伟胜教授在重症肺系疾病的学术思想及诊治经验,为临床中西辨治提供学习和经验。
2、对脓毒症致ALI/ARDS患者的中医证候要素进行调查,总结其证候要素的构成特点,为脓毒症致ALI的中医干预治疗提供证候学研究依据。
3、评价益气通腑泻热法治疗脓毒症致ALI的临床疗效,并观察该法对脓毒症致ALI患者全身炎症反应、相关炎症因子、凝血功能的影响。
1、通过文献研究,总结脓毒症致ALI/ARDS患者常见的中医证候要素。采用临床横断面调查研究方法,共纳入脓毒症致ALI/ARDS患者69例,其中51例为非ARDS患者,18为ARDS患者；40例为严重脓毒症患者,29例为脓毒症性MODS患者。在纳入时对中医基本证候要素进行调查,包括基本虚证类中的气虚证、血虚证、阴虚证、阳虚证,基本实证类中的痰证、火热证、血瘀证、水停证。同时调查APACHE Ⅱ评分。对脓毒症致ALI/ARDS不同分层组的中医证候要素构成进行统计分析,同时对中医基本证候要素、APACHE Ⅱ评分进行相关性研究。
2、采用前瞻性随机对照临床研究方法,共纳入脓毒症致ALI患者51例,应用简单随机数字表法进行随机分组,其中试验组26例,对照组25例。试验组、对照组的西医治疗均按照2008年国际脓毒症指南进行,试验组则在西医治疗的基础上加用益气通腑泻热法进行干预,比较两组患者的临床疗效。以住院期间病死率、28天生存率作为主要疗效指标；以呼吸功能、炎症指标水平、凝血功能及APACHE Ⅱ评分作为次要疗效评价指标；同时观察患者的ICU住院天数及总住院天数。
结果
1、对69例脓毒症致ALI/ARDS患者的中医证候要素进行调查,结果发现以虚实夹杂证多见,占81.2%,单纯实证的占18.8%,无1例为单纯的虚证。在虚证的基本证候要素中,气虚证出现频率最高达100%,其后依次为阳虚证(39.1%)、阴虚证(26.1%)、血虚证(11.6%)。在实证的基本证候要素中,痰证的出现频率最高,占92.8%,其后依次为火热证(85.5%)、血瘀证(58.0%)、水停证(13.0%)。ALI患者与ARDS患者的中医基本证候要素构成无明显差异。而与严重脓毒症患者相比,脓毒症性MODS患者的阳虚证明显增多,经统计学分析差异有显著性意义(P<0.05)。对不同证候要素的APACHE Ⅱ评分进行比较分析,结果发现,出现阳虚证的脓毒症患者的APACHE Ⅱ评分高于未出现阳虚证的脓毒症患者。
2、在前瞻性随机对照研究部分,共51例脓毒症致ALI患者纳入临床研究,应用简单随机数字表法进行随机分组,其中试验组26例,对照组25例。试验组3例患者及对照组2例患者在5天内死亡,资料收集不齐,均予以剔除,两组病例的脱落率经统计学分析差异无显著性意义。最终进入统计分析的受试者共46例,其中试验组23例,对照组23例。研究结果未能证实益气通腑泻热法可改善脓毒症致ALI患者的28天生存率、减少病死率及住院天数。但与对照组相比,益气通腑泻热法治疗有助于改善脓毒症致ALI患者的APACHE Ⅱ评分。在呼吸功能方面,试验组通气第2天pH值、Sa02等呼吸相关指标较对照组有明显改善。在炎症反应方面,益气通腑泻热法有助于降低患者血清CRP浓度、降钙素原浓度,可能起到一定的减轻全身炎症反应的作用。但在调节TNF-a、IL-6、IL-10方面,试验组与对照组相比并无明显差异。在凝血功能方面,目前观察的凝血功能相关指标PT及APTT得到一定改善,证实益气通腑泻热法在改善脓毒症致ALI患者凝血功能方面有一定优势。试验组24小时血乳酸较对照组明显改善,提示益气通腑泻热法治疗脓毒症致ALI患者可能有助于改善微循环。
结论
1、刘伟胜教授临证注重辨证与辨病相结合,提倡中西互参,学术思想主要体现在擅于肺肠同治、重视调养胃气、强调补益扶正、重症中西互补、规范用药法则等五个方面。
2、脓毒症致ALI患者的中医证候以虚实夹杂证多见,以气虚、痰证、火热、血瘀为主要症候特点,在临床干预治疗中,泻实与补虚需要兼顾。在脓毒症性MODS阶段,阳虚证的发生有升高趋势,提示需注意固护阳气。
3、益气通腑泻热法可能有助于减轻脓毒症致ALI患者全身炎症反应、改善凝血功能及微循环,可能有助于脓毒症致ALI患者短期内呼吸功能及总体病情的改善,有一定的临床疗效,值得进一步研究。
Background
ALI (acute lung injury)/ARDS(acute respiratory distress syndrome) is non-cardiogenic, acute hypoxic respiratory failure causing by injury of both endothelial and epithelial cells, with subsequent aveolar flooding, which usually develops in response to amajor insult such as sepsis, shock, trauma, and burn, etc. Sepsis is the most frequent risk factor for the development of ALI/ARDS (as high as37%and even more). Sepsis-induced ALI has been reported to have a higher case fatality rate than other causes of ALI. Despite recent therapeutic advances, ALI/ARDS is still associated with high mortality rates.
Professor Liu Weisheng has been engaged in medical care, medical teaching and medical research for for decades, accumulating rich experiences in treatments for critical pulmonary disease and tumour both in traditional Chinese medicine and Westren medicine. The present study summerize Academic ideas of Professor Liu Weisheng about critical pulmonary disease and tumour. Literature research of Sepsis-induced ALI/ARDS shows that few studies are about TCM syndromes. Studies about TCM treatments for Sepsis-induced ALI/ARDS show that TCM treatments may be beneficial. But most of them are Animal experimental studies focusing on pathological changes and regulation of pathogenesis factors. There is a lack of study about effect of TCM treatments on pathogenesis such as mortality, disability and28-day survival rate, etc. The present study summerizes TCM syndromes of sepsis-induced ALI patients. Based on Professor Liu Weisheng's experiences on treating acute respiratory failure, carrying a prospective randomized controlled trial on Yiqi Tongfu Xiere Therapy treating Sepsis-induced ALI patients to observe the effects and the possible pathogenesis.
Object ives
1.To summarizes Professor Liu Weisheng's academic ideas and treatment experiences on critical pulmonary diseases.
2. To investigate the common elements of TCM syndromes of sepsis-induced ALI patients, summarize the characteristics of TCM syndromes of sepsis-induced ALI patients.
3. To observe the effects of Yiqi Tongfu Xiere Therapy on Sepsis-induced Acute Lung Injury patients.
Methods
1. Summarized the common elements of TCM syndromes of sepsis and ALI/ARDS patients through literature. Subsequently using clinical cross-sectional survey research methods and69patients enrolled with sepsis-induced ALI. Among69cases,51cases were non-ARDS patients,18cases were ARDS patients;40cases were severe sepsis cases and29cases were septic MODS patients. To incorporate the basic TCM syndrome when investigating factors, including the basic deficiency:qi deficiency, blood deficiency, yin deficiency, yang deficiency, the basic excess class:phlegm, fiery, blood stasis, fluid-retention. Carried out statistical analysis of different groups, carried out correlation study on the basic elements of the TCM Syndrome and APACHE Ⅱ score.
2. Using prospective randomized controlled clinical research methods, a total of51sepsis-induced ALI patients enrolled. Appling simple randomized method to divide into random groups,26cases in trial group and25cases in control group. Experimental group and Western treatment control group treated in accordance with international guidelines of sepsis, while the experimental group was treated with Yiqi Tongfu Xiere therapy at the same time, and compared the clinical efficacy of the two groups. Taking The hospital survival rate,28-day survival rate as the primary endpoint, taking respiratory function, cytokine levels, coagulation function and APACHE Ⅱ score as a secondary efficacy evaluation.
Results
1. Carried out investigation on the TCM syndromes of the69cases of sepsis-induced ALI/ARDS patients, the results found out that the pattern of deficiency-excess complex was the most common, accounting for81.2%,18.8%of pure excess, no patient was showed to be simple deficiency. In the basic elements of deficiency syndrome, qi deficiency was the most frequent (100%), followed by Yang Deficiency (39.1%), Yin deficiency syndrome (26.1%), blood deficiency (11.6%). In the basic elements of excess syndrome, the highest frequency of occurrence was phlegm (92.8%), followed by fiery (85.5%), blood stasis (58.0%), fluid-retention (13.0%). There is no significant difference in the constituent of the basic TCM syndromes between non-ARDS and ARDS patients. As compared with sever sepsis patients, yang deficiency syndrome increased in septic MODS patients which was statistically significant (P<0.05). APACHE Ⅱ score of elements of different syndromes were compared, results showed that the APACHE Ⅱ score was higher with patients which occurred yang deficiency than patients who had not occurred Yang Deficiency (P<0.05).
2. From the prospective randomized controlled study,3patients of the trial group and2patients of the control group died within5days, data collection was incomplete, and to be removed, the loss rate of two groups was not statistically significant. A total of46cases eventually entered statistical analysis, of which23cases as experimental group,23cases as control group. The results failed to confirm that Yiqi Tongfu Xiere Therapy help to improve the mortality,28-day survival rate and length of hospitalization of sepsis-induced ALI patients. Compared with the control group, Significant improvement was detected in APACHE Ⅱ score, partial respiratory parameters (pH、SaO2on the second day of ventilation) in the trail group. In the inflammatory response, the study observed that Yiqi Tongfu Xiere Therapy help reduce the concentrations of serum CRP which may play a certain role to reduce systemic inflammatory response. However, compared with the control group, the trial group in the regulation of TNF-a, IL-6and IL-10has not showed a greater advantage. In the coagulation function, the study observed that Yiqi Tongfu Xiere Therapy help improve the coagulation function parameters of PT and APTT, which may play a certain role to improve coagulation function. The study observed that Yiqi Tongfu Xiere Therapy help reduce the concentrations of serum lactate, which may play a certain role to improve microcirculation
Conclusions
1. Professor Liu Weisheng pays much attention to the combination of syndrome differentiation and disease differentiation, advocates the intergration of chinese and western medicine, and his academic thought mainly embodies in intergral treatment of Pulmonary and the Large Intestine, conditioning the Stomach Qi, Supplementing qi and Strengthening the Body, intergration of chinese and western medicine to Chinese and western and rational drug using such five aspects.
2. Sepsis-induced ALI patients are found to be categorized as a pattern of deficiency-excess complex. In clinical intervention, giving consideration to both "deficiency" and "reducing excess" is necessary. At the stage of MODS in sepsis, the incidence of Yang deficiency tended to increase and so attention should be paid to "support the Yang" treatment.
3. Yiqi Tongfu Xiere therapy may play a certain role to reduce systemic inflammatory response, improve coagulation function, microcirculation and short-term respiratory function and overall condition.
急性肺损伤(acute lung injury,ALI)/急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是在严重感染、休克、创伤及烧伤等非心源性疾病过程中,肺毛细血管内皮细胞和肺泡上皮细胞损伤造成弥漫性肺间质及肺泡水肿,导致的急性低氧性呼吸功能不全或衰竭。在ALI/ARDS的各种病因中,脓毒症是ALI/ARDS发病的首要原因,占所有原因的37%以上。研究表明,脓毒症所致ALI/ARDS的病死率明显高于非脓毒症所致ALI/ARDS。虽然目前机械通气治疗及部分药物治疗ALI/ARDS取得了一定的效果,但ALI/ARDS的治疗当中还是存在着死亡率高、易发生机械通气并发症等问题,尚需进一步研究。
导师刘伟胜教授为长期从事医疗、教学、科研情况,在中西医结合治疗呼吸、肿瘤方面有其独到见解,在运用通里攻下、补益扶正等法治疗呼吸系统危重症方面积累了丰富经验,结合三年跟师体会,总结了刘伟胜教授在呼吸系统重症及肿瘤的学术思想及临床经验。
通过复习文献发现目前关于脓毒症致ALI/ARDS的中医临床证候研究仍非常缺乏,而且多为实验研究,提示中医药治疗ALI/ARDS可能有其优势,但临床研究极少,多数是停留在对发病极期病理变化的观察和干预对相关机制因素的影响,未能反映治疗对预后(如病死率、致残率、28天生存率等)的影响。首先对脓毒症致ALI/ARDS的中医证候要素进行研究,总结其中医证候特点,对于寻找切入点进行中医药疗法干预该病,最终形成中医诊疗方案具有重要的意义。
在总结脓毒症致ALI/ARDS的中医证候规律基础上结合刘伟胜教授治疗急性呼吸衰竭经验,以益气通腑泻热法治疗脓毒症致ALI患者,拟通过临床随机对照研究以证实其疗效,并对其疗效机制进行初步观察。
目的
1、总结刘伟胜教授在重症肺系疾病的学术思想及诊治经验,为临床中西辨治提供学习和经验。
2、对脓毒症致ALI/ARDS患者的中医证候要素进行调查,总结其证候要素的构成特点,为脓毒症致ALI的中医干预治疗提供证候学研究依据。
3、评价益气通腑泻热法治疗脓毒症致ALI的临床疗效,并观察该法对脓毒症致ALI患者全身炎症反应、相关炎症因子、凝血功能的影响。
1、通过文献研究,总结脓毒症致ALI/ARDS患者常见的中医证候要素。采用临床横断面调查研究方法,共纳入脓毒症致ALI/ARDS患者69例,其中51例为非ARDS患者,18为ARDS患者；40例为严重脓毒症患者,29例为脓毒症性MODS患者。在纳入时对中医基本证候要素进行调查,包括基本虚证类中的气虚证、血虚证、阴虚证、阳虚证,基本实证类中的痰证、火热证、血瘀证、水停证。同时调查APACHE Ⅱ评分。对脓毒症致ALI/ARDS不同分层组的中医证候要素构成进行统计分析,同时对中医基本证候要素、APACHE Ⅱ评分进行相关性研究。
2、采用前瞻性随机对照临床研究方法,共纳入脓毒症致ALI患者51例,应用简单随机数字表法进行随机分组,其中试验组26例,对照组25例。试验组、对照组的西医治疗均按照2008年国际脓毒症指南进行,试验组则在西医治疗的基础上加用益气通腑泻热法进行干预,比较两组患者的临床疗效。以住院期间病死率、28天生存率作为主要疗效指标；以呼吸功能、炎症指标水平、凝血功能及APACHE Ⅱ评分作为次要疗效评价指标；同时观察患者的ICU住院天数及总住院天数。
结果
1、对69例脓毒症致ALI/ARDS患者的中医证候要素进行调查,结果发现以虚实夹杂证多见,占81.2%,单纯实证的占18.8%,无1例为单纯的虚证。在虚证的基本证候要素中,气虚证出现频率最高达100%,其后依次为阳虚证(39.1%)、阴虚证(26.1%)、血虚证(11.6%)。在实证的基本证候要素中,痰证的出现频率最高,占92.8%,其后依次为火热证(85.5%)、血瘀证(58.0%)、水停证(13.0%)。ALI患者与ARDS患者的中医基本证候要素构成无明显差异。而与严重脓毒症患者相比,脓毒症性MODS患者的阳虚证明显增多,经统计学分析差异有显著性意义(P<0.05)。对不同证候要素的APACHE Ⅱ评分进行比较分析,结果发现,出现阳虚证的脓毒症患者的APACHE Ⅱ评分高于未出现阳虚证的脓毒症患者。
2、在前瞻性随机对照研究部分,共51例脓毒症致ALI患者纳入临床研究,应用简单随机数字表法进行随机分组,其中试验组26例,对照组25例。试验组3例患者及对照组2例患者在5天内死亡,资料收集不齐,均予以剔除,两组病例的脱落率经统计学分析差异无显著性意义。最终进入统计分析的受试者共46例,其中试验组23例,对照组23例。研究结果未能证实益气通腑泻热法可改善脓毒症致ALI患者的28天生存率、减少病死率及住院天数。但与对照组相比,益气通腑泻热法治疗有助于改善脓毒症致ALI患者的APACHE Ⅱ评分。在呼吸功能方面,试验组通气第2天pH值、Sa02等呼吸相关指标较对照组有明显改善。在炎症反应方面,益气通腑泻热法有助于降低患者血清CRP浓度、降钙素原浓度,可能起到一定的减轻全身炎症反应的作用。但在调节TNF-a、IL-6、IL-10方面,试验组与对照组相比并无明显差异。在凝血功能方面,目前观察的凝血功能相关指标PT及APTT得到一定改善,证实益气通腑泻热法在改善脓毒症致ALI患者凝血功能方面有一定优势。试验组24小时血乳酸较对照组明显改善,提示益气通腑泻热法治疗脓毒症致ALI患者可能有助于改善微循环。
结论
1、刘伟胜教授临证注重辨证与辨病相结合,提倡中西互参,学术思想主要体现在擅于肺肠同治、重视调养胃气、强调补益扶正、重症中西互补、规范用药法则等五个方面。
2、脓毒症致ALI患者的中医证候以虚实夹杂证多见,以气虚、痰证、火热、血瘀为主要症候特点,在临床干预治疗中,泻实与补虚需要兼顾。在脓毒症性MODS阶段,阳虚证的发生有升高趋势,提示需注意固护阳气。
3、益气通腑泻热法可能有助于减轻脓毒症致ALI患者全身炎症反应、改善凝血功能及微循环,可能有助于脓毒症致ALI患者短期内呼吸功能及总体病情的改善,有一定的临床疗效,值得进一步研究。
Background
ALI (acute lung injury)/ARDS(acute respiratory distress syndrome) is non-cardiogenic, acute hypoxic respiratory failure causing by injury of both endothelial and epithelial cells, with subsequent aveolar flooding, which usually develops in response to amajor insult such as sepsis, shock, trauma, and burn, etc. Sepsis is the most frequent risk factor for the development of ALI/ARDS (as high as37%and even more). Sepsis-induced ALI has been reported to have a higher case fatality rate than other causes of ALI. Despite recent therapeutic advances, ALI/ARDS is still associated with high mortality rates.
Professor Liu Weisheng has been engaged in medical care, medical teaching and medical research for for decades, accumulating rich experiences in treatments for critical pulmonary disease and tumour both in traditional Chinese medicine and Westren medicine. The present study summerize Academic ideas of Professor Liu Weisheng about critical pulmonary disease and tumour. Literature research of Sepsis-induced ALI/ARDS shows that few studies are about TCM syndromes. Studies about TCM treatments for Sepsis-induced ALI/ARDS show that TCM treatments may be beneficial. But most of them are Animal experimental studies focusing on pathological changes and regulation of pathogenesis factors. There is a lack of study about effect of TCM treatments on pathogenesis such as mortality, disability and28-day survival rate, etc. The present study summerizes TCM syndromes of sepsis-induced ALI patients. Based on Professor Liu Weisheng's experiences on treating acute respiratory failure, carrying a prospective randomized controlled trial on Yiqi Tongfu Xiere Therapy treating Sepsis-induced ALI patients to observe the effects and the possible pathogenesis.
Object ives
1.To summarizes Professor Liu Weisheng's academic ideas and treatment experiences on critical pulmonary diseases.
2. To investigate the common elements of TCM syndromes of sepsis-induced ALI patients, summarize the characteristics of TCM syndromes of sepsis-induced ALI patients.
3. To observe the effects of Yiqi Tongfu Xiere Therapy on Sepsis-induced Acute Lung Injury patients.
Methods
1. Summarized the common elements of TCM syndromes of sepsis and ALI/ARDS patients through literature. Subsequently using clinical cross-sectional survey research methods and69patients enrolled with sepsis-induced ALI. Among69cases,51cases were non-ARDS patients,18cases were ARDS patients;40cases were severe sepsis cases and29cases were septic MODS patients. To incorporate the basic TCM syndrome when investigating factors, including the basic deficiency:qi deficiency, blood deficiency, yin deficiency, yang deficiency, the basic excess class:phlegm, fiery, blood stasis, fluid-retention. Carried out statistical analysis of different groups, carried out correlation study on the basic elements of the TCM Syndrome and APACHE Ⅱ score.
2. Using prospective randomized controlled clinical research methods, a total of51sepsis-induced ALI patients enrolled. Appling simple randomized method to divide into random groups,26cases in trial group and25cases in control group. Experimental group and Western treatment control group treated in accordance with international guidelines of sepsis, while the experimental group was treated with Yiqi Tongfu Xiere therapy at the same time, and compared the clinical efficacy of the two groups. Taking The hospital survival rate,28-day survival rate as the primary endpoint, taking respiratory function, cytokine levels, coagulation function and APACHE Ⅱ score as a secondary efficacy evaluation.
Results
1. Carried out investigation on the TCM syndromes of the69cases of sepsis-induced ALI/ARDS patients, the results found out that the pattern of deficiency-excess complex was the most common, accounting for81.2%,18.8%of pure excess, no patient was showed to be simple deficiency. In the basic elements of deficiency syndrome, qi deficiency was the most frequent (100%), followed by Yang Deficiency (39.1%), Yin deficiency syndrome (26.1%), blood deficiency (11.6%). In the basic elements of excess syndrome, the highest frequency of occurrence was phlegm (92.8%), followed by fiery (85.5%), blood stasis (58.0%), fluid-retention (13.0%). There is no significant difference in the constituent of the basic TCM syndromes between non-ARDS and ARDS patients. As compared with sever sepsis patients, yang deficiency syndrome increased in septic MODS patients which was statistically significant (P<0.05). APACHE Ⅱ score of elements of different syndromes were compared, results showed that the APACHE Ⅱ score was higher with patients which occurred yang deficiency than patients who had not occurred Yang Deficiency (P<0.05).
2. From the prospective randomized controlled study,3patients of the trial group and2patients of the control group died within5days, data collection was incomplete, and to be removed, the loss rate of two groups was not statistically significant. A total of46cases eventually entered statistical analysis, of which23cases as experimental group,23cases as control group. The results failed to confirm that Yiqi Tongfu Xiere Therapy help to improve the mortality,28-day survival rate and length of hospitalization of sepsis-induced ALI patients. Compared with the control group, Significant improvement was detected in APACHE Ⅱ score, partial respiratory parameters (pH、SaO2on the second day of ventilation) in the trail group. In the inflammatory response, the study observed that Yiqi Tongfu Xiere Therapy help reduce the concentrations of serum CRP which may play a certain role to reduce systemic inflammatory response. However, compared with the control group, the trial group in the regulation of TNF-a, IL-6and IL-10has not showed a greater advantage. In the coagulation function, the study observed that Yiqi Tongfu Xiere Therapy help improve the coagulation function parameters of PT and APTT, which may play a certain role to improve coagulation function. The study observed that Yiqi Tongfu Xiere Therapy help reduce the concentrations of serum lactate, which may play a certain role to improve microcirculation
Conclusions
1. Professor Liu Weisheng pays much attention to the combination of syndrome differentiation and disease differentiation, advocates the intergration of chinese and western medicine, and his academic thought mainly embodies in intergral treatment of Pulmonary and the Large Intestine, conditioning the Stomach Qi, Supplementing qi and Strengthening the Body, intergration of chinese and western medicine to Chinese and western and rational drug using such five aspects.
2. Sepsis-induced ALI patients are found to be categorized as a pattern of deficiency-excess complex. In clinical intervention, giving consideration to both "deficiency" and "reducing excess" is necessary. At the stage of MODS in sepsis, the incidence of Yang deficiency tended to increase and so attention should be paid to "support the Yang" treatment.
3. Yiqi Tongfu Xiere therapy may play a certain role to reduce systemic inflammatory response, improve coagulation function, microcirculation and short-term respiratory function and overall condition.
引文
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