从“虚劳”论治脓毒症并发持续炎症-免疫抑制-高分解代谢综合征

Treatment of Sepsis with Persistent Inflammation Immunosuppression Catabolism Syndrome from the Perspective of"Consumptive Disease"

本文以“虚劳”理论为基础并结合临床研究,分析脓毒症并发持续炎症-免疫抑制-高分解代谢综合征(PICS)的病因、病机及辨治,认为“营卫失调,正虚邪恋,瘀毒阻络”为脓毒症并发PICS的病机,治疗上以“扶正解毒通络”为总体治则,以补益为主并辅以清透,维持阴阳气血低水平平衡,同时开达通路清透余邪,消除体内痰瘀浊毒等积聚的病理产物,调节免疫代谢紊乱,以期预防反复感染,为中医辨治PICS拓展思路。

Based on the theory of"consumptive disease"and combined with clinical research,this paper analyses the etiology,pathogenesis and treatment of sepsis complicated by persistent inflammation immunosuppression catabolism syndrome(PICS),and concludes that the pathogenesis of sepsis complicated by PICS is“the imbalance of Ying and Wei,the deficiency of the positive and the attachment of the evil,and the obstruction of the channels by silt and toxin.”The treatment is based on tonifying and supplementing with clearing,maintaining a low level of balance between yin and yang,qi and blood,and at the same time opening up the channels to clear the remaining evil,eliminating the accumulation of phlegm,stagnation,toxicity and other pathological products in the body,regulating immune disorders and preventing recurrent infections.