姜良铎教授从状态辨治阿片类药物中毒合并脓毒症患者1例

A case of septic patient with opioid intoxication treated by Professor Jiang Liangduo through state differentiation and treatment

北京中医药大学东直门医院于2018年12月9日收治1例脓毒症患者。该患者为长期服用毒品者,即阿片类药物中毒者,患者近6个月来无明显诱因出现胸闷喘憋、汗出,不欲饮食,未予重视及诊治;近10 d来,胸闷喘憋、纳差加重,伴呼吸困难、周身乏力、头晕恶心,以“胸闷喘憋6个月,加重10 d”入院,诊断为阿片类药物中毒后脓毒症。入院4 h后患者出现心搏骤停,给予胸外按压、除颤、血管活性药物等措施后抢救成功。后姜良铎教授结合患者当前症状和体征,给予抗感染、化痰平喘、改善脑循环、清热解毒、回阳救逆、豁痰开窍治疗,并基于中医状态学说辨证论治,给予中药进行治疗。经治疗患者症状改善,取得一定的临床疗效,这为今后此类患者的救治提供了经验。

On December 9,2018,Dongzhimen Hospital of Beijing University of Chinese Medicine treated a patient with sepsis.The patient was a chronic drug user,namely,an opioid poisoning patient.In the past six months,the patient had experienced chest tightness,wheezing,sweating,and loss of appetite with no inducement,and these symptoms were not taken seriously and treated;in the past 10 days,the chest tightness,wheezing and poor appetite have aggravated,accompanied by dyspnea,general fatigue,dizziness and nausea.The patient was admitted to hospital with"chest tightness and wheezing for six months,aggravated for 10 days"and was diagnosed with post-opioid sepsis.Four hours after admission,the patient went into cardiac arrest and was successfully resuscitated after chest compressions,defibrillation and vasoactive drugs.Afterwards,Professor Jiang Liangduo,considering the patient's current symptoms and signs,treated the patient with anti-infection,resolving sputum and relieving asthma,enhancing cerebral circulation,heat-clearing and detoxicating,reviving the yang for resuscitation,eliminating phlegm for resuscitation,and given the patient Chinese herbal medicine based on the state theory of Chinese medicine.The treatment relieved the patient's symptoms and obtained certain clinical efficacy,which provided treatment experience for such patients in the future.