浅析"急性虚证"概念的提出及对重症急性胰腺炎治疗的指导作用

The concept of"Jixing Xuzheng"and its guiding role in the treatment of severe acute pancreatitis

急性胰腺炎(AP)是消化系统常见急症,若进展为重症急性胰腺炎(SAP)则治疗难度大、治疗费用和病死率高."急性虚证"是指机体遭受各种致病因素打击时,人体正气被迅速消耗,邪气占据主导地位的一种病理状态.在脓毒症、新型冠状病毒感染(新冠病毒感染)等疾病的救治中,"急性虚证"理论均起到重要的指导作用.临床实践表明,SAP早期即可发生邪气壅盛、正气亏虚,"益气养阴"法对于SAP能起到很好的治疗作用.遂提出,"急性虚证"亦是SAP的重要病机,可发生于SAP早期,"扶正"应是SAP发生时的主要治则之一.临床治疗SAP时应中西医并重,相辅相成,以利于研究和探索针对SAP新的治疗方法.

Acute pancreatitis(AP)is a common emergency of the digestive system.If it progresses to severe acute pancreatitis(SAP),the treatment is difficult,costly,and the mortality is high."Jixing Xuzheng"refers to a pathological state in which the body is attacked by various pathogenic factors,resulting in the rapid consumption of the body's Zhengqi and the dominant Xieqi.In the treatment of sepsis,novel coronavirus pneumonia(COVID-19),and other diseases,the theory of"Jixing Xuzheng"plays an important role in guiding treatment.In clinical practice,the author found that SAP can have the accumulation of Xieqi and deficiency of Zhengqi in the early stage,and the method of"Yiqi Yangyin"can play a good role in treating SAP.Therefore,it is proposed that"Jixing Xuzheng"is also an important pathogenesis of SAP,which can occur in the early stage of SAP,and"Fuzheng"should be one of the main treatment principles of SAP.In the clinical treatment of SAP,combining traditional Chinese and Western medicine should be emphasized and complement each other,to facilitate the research and exploration of new treatment methods for SAP.