铜绿假单胞菌感染所致肺炎炎症“瀑布效应”的发生机理与扶正解毒化瘀方的治疗

The mechanism of 'Cascade Reaction'for pneumonia Inflammation due to pseudomonas aeruginosa infection and the treatment of the prescription of FuzhengJieduHuayu

铜绿假单胞菌是引起医院内感染常见的条件致病菌之一,具有检出率高、耐药性强、致死率高等特点。多重耐药铜绿假单胞菌感染所致的肺炎治疗难度大、预后差、病死率高,已成为临床医学抗感染领域最棘手的问题之一,亟待解决。铜绿假单胞菌致病的核心机制之一在于脂多糖通过Toll样受体4信号转导通路激发炎症"瀑布效应",可导致脓毒症,甚至脓毒性休克。肺炎属于中医风温肺热病的范畴,"正气亏虚、热邪炽盛,毒瘀互结"的病机贯穿在风温肺热病的始终。我院热病课题组发现扶正解毒化瘀方切合这一病机,并对铜绿假单胞菌感染所致的肺炎疗效确切。其机制可能与该治法方药抑制铜绿假单胞菌感染所致的炎症损伤、促进炎症损伤的修复、延缓或抑制甚至可能逆转铜绿假单胞菌的耐药、与抗生素协同抑菌等有关。

Pseudomonas aeruginosa is one of the most common resistant pathogen of nosocomial infection,which has the characteristics of high detection rate, great resistance and high lethality. The pneumonia caused by multiple drug-resistant Pseudomonas aeruginosa infection is hard to treat, with poor prognosis and high mortality, it has become one of the thorniest problems in the field of clinical medical anti infection, which needs to be solved urgently. One of the core pathogenic mechanism of Pseudomonas aeruginosa is that lipopolysaccharide activates TLR4 signal pathway and triggers inflammatory cascade reaction as ＂waterfall effect＂,which can lead to sepsis and even septic shock. Pneumonia belongs to the wind warm and pulmonary heat disease in TCM. Deficiency of vital qi, toxicity-blood stasis syndrome is throughout this disease. The prescription of Fuzheng Jiedu Huayu which came from a long period of clinical practice from the research group of fever in our hospital, is fit to the syndrome mentioned above and has significant effect in treating pneumonia caused by Pseudomonas aeruginosa. The mechanism may be related to inhibiting the inflammatory injury caused by Pseudomonas aeruginosa infection, promoting the recovery of inflammatory injury,delaying or inhibiting or even reversing the resistance of Pseudomonas aeruginosa,and synergistic bacteriostasis with antibiotics.