姜良铎教授从状态论治急性呼吸窘迫综合征

Prof. Jiang Liangduo’s treatment of acute respiratory distress syndrome from “state”

急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)是非心源性的各种内外致病因素导致的急性临床综合征,以进行性呼吸困难、顽固性低氧血症为临床表现,疾病发展至后期甚至并发严重呼吸衰竭。"从状态论治"是姜良铎教授在临床诊治过程中最为突出的学术思想,姜良铎教授认为:在从状态论治的思想指导下诊治ARDS应掌握以下三方面内容:把握外邪犯肺、气不摄津、气不流津、成湿成痰是ARDS的核心病机特点,因此补气宣肺,分清泄浊贯穿始终;根据患者就诊时的状态辨别ARDS病因、病位、病性和邪盛正衰的变化即当前病机,应用清热、化痰、活血等方法对症治疗;潜在病机即ARDS继续演变,发展为热入心包、阴竭阳脱等危候,则需醒神开窍、回阳救逆。从状态论治对ARDS有更准确、全面的认识,从而更有把握地进行诊治。

Acute respiratory distress syndrome(ARDS) is an acute clinical syndrome caused by various internal and external pathogenic factors. Its clinical manifestations are progressive dyspnea and intractable hypoxemia, and severe respiratory failure may occur in the late stages of the disease. Treatment from "state" is one of Professor Jiang Liangduo’s most prominent academic thoughts. Professor Jiang believes, in the thought of treatment from "state", these three aspects should be mastered : evils invade the lung, and lung impairment causes Qi not to move body fluid, causing the formation of dampness and phlegm, which are its core pathogenesis. Therefore, tonifying Qi and diffusing the lung, clearing away turbid discharge run through the whole treatment;The patient’s state at the time helps to identify the etiology, location, nature of ARDS and strength between the body’s anti-pathogenic factors and pathogenic factors, which is the current pathogenesis. Methods of clearing away heat, resolving phlegm and promoting blood circulation can be used for symptomatic treatment. The underlying pathogenesis, namely ARDS, continues to evolve into the condition of heat entering the pericardium, Yin exhausting and Yang collapse. Then it is necessary to awaken the mind and resuscitate, restore Yang and the adversity. Only by mastering the above contents can we have a more accurate and comprehensive understanding of ARDS and be more confident in diagnosis and treatment.