基于卫气营血辨证探讨脓毒症并发DIC早期识别与预防

Discussion on early recognition and prevention of sepsis complicated with DIC based on "Wei Qi Ying Xue" syndrome differentiation

脓毒症并发弥散性血管内凝血(DIC)的特征主要表现为全身凝血的激活,以及内皮功能障碍引起的纤溶相对抑制,从而引起多器官功能衰竭,病死率高。然而临床上对于脓毒症并发DIC尚无特效疗法,诊断亦因无法及时监测凝血功能变化具有相对滞后的缺点。中医学具有辨证论治、未病先防、既病防变的特点,研究发现卫气营血辨证的传变过程与脓毒症患者由轻到重的病情发展联系密切。因此,本文拟在中医卫气营血辨证理论的指导下,通过采集中医四诊信息及实验室相关指标,早期识别脓毒症并发DIC所处阶段,从肝论治脓毒症,以期为脓毒症提供新的治疗方向,从而改善患者预后。

Sepsis complicated with disseminated intravascular coagulation(DIC) is characterized by systemic coagulation activation and relative inhibition of fibrinolysis due to endothelial dysfunction, leading to multiple organ failure.It has high mortality. However, there is still no specific treatment for sepsis complicated with DIC in clinic, and the diagnosis is relatively delayed because it is unable to monitor the changes of coagulation function in time.Traditional Chinese medicine has the characteristics of syndrome differentiation and treatment, prevention before disease, and prevention of disease change. It is found that the transmission process of Wei Qi Ying Xue syndrome differentiation is closely related to the development of sepsis from mild to severe. Therefore, it′s planned to identify the stage of sepsis complicated with DIC early and treat sepsis based on the theory of liver under the guidance of the theory of Wei Qi Ying Xue syndrome differentiation by collecting the information of the four diagnosis of traditional Chinese medicine and relevant indicators in the laboratory, in order to provide a new treatment direction for sepsis and improve the prognosis of patients.