高原肺水肿发病机制及防治研究进展

Research Progress of Pathogenesis and Prevention and Treatment of High Altitude Pulmonary Edema

高原环境(低压低氧、寒冷、强紫外线、干燥、风沙大等)引起的肺动脉压过度增高、肺泡-毛细血管膜通透性异常、肺血容量增加、肺部炎症反应等因素致使血浆、蛋白和红细胞漏出/渗出至肺间质或肺泡,从而导致高原肺水肿(high altitude pulmonary edema,HAPE)的发生。中西医治疗HAPE各有优势,可取得一定的疗效。中医药治疗HAPE存在的不足是:中医对HAPE的防治作用机制尚未完全明确,需要进一步的动物实验研究和验证;中医治疗HAPE的临床数据相对较少,需要更多高质量的临床研究来验证其疗效。因此,今后应加强对中医理论和经典组方的深入研究,开展更多的动物实验和临床研究,收集更多证据支持中医防治HAPE的有效性,同时也要加强与西医的协同合作,充分利用两者的优势,进一步提高临床疗效。

High altitude environment(such as low pressure and low oxygen,cold,strong ultraviolet,dryness,wind and sand,etc.)cau⁃ses excessive increase in pulmonary artery pressure,alveola⁃capillary membrane permeability abnormalities,increased pulmonary blood volume,pulmonary inflammation reaction and other factors,resulting in leakage/leakage of plasma,protein and red blood cells into the lung interstitium or alveoli.This results in high altitude pulmonary edema(HAPE).Chinese and Western medicine have their own ad⁃vantages in the treatment of HAPE,and can achieve certain curative effects,but there are also some shortcomings:the mechanism of pre⁃vention and treatment of HAPE by TCM is not completely clear,and further animal experimental research and verification are needed.There are relatively few clinical data on TCM treatment of HAPE,and more high⁃quality clinical studies are needed to verify the efficacy of TCM.Therefore,in the future,it is necessary to strengthen the in⁃depth study of TCM theory and classic prescriptions,carry out more animal experiments and clinical studies,and collect more evidence to support the effectiveness of TCM prevention and treatment of HAPE.At the same time,it is needed to strengthen the cooperation with Western medicine,make full use of the advantages of both,and further improve the clinical efficacy.