寒温统一论治急性胰腺炎

Treatment of acute pancreatitis based on the integrative theory of typhoid fever,miscellaneous diseases and epidemic febrile diseases

急性胰腺炎并发症多、花费巨大、重症病死率高。合并肺、肾、心多器官功能障碍,局部并发积液坏死感染和后期恢复是疾病进展的关键节点和环节。中医药治疗急性胰腺炎得到国内公认。早期,基于中医“热病”理论形成了急性胰腺炎热病观的证候期分类。近年研究表明单纯依赖“热病”理论过度苦寒通下可能加重病情。笔者结合急性胰腺炎病理生理过程的临床实际,在张再良教授提出的热病四分法临床诊疗格局基础上提出了寒温统一论治急性胰腺炎的方法。该方法可覆盖急性胰腺炎疾病全程,关注早期器官损伤的治疗和局部并发症与疾病恢复期的管理,强调整体性视角、个性化治疗策略、对疾病演变的跟踪以及恢复期的关注,是急性胰腺炎创新诊疗的临床新路径及中医药在危急重症治疗应用中的典范。

Acute pancreatitis(AP),characterized by complex complications,substantial treatment expenses,and elevated mortality rates in severe instances involving multi-organ dysfunction and post-recovery challenges,has traditionally been addressed through Traditional Chinese Medicine(TCM)based on the“Hot Disease”theory.Recent research,however,indicates potential adverse effects from over-relying on this approach with bitter and cold purgative herbals.Evolving from this,a novel methodology,conceptualized by Professor ZHANG Zailiang,integrates the theory of typhoid fever,miscellaneous diseases and epidemic febrile diseases.This paradigm shift encompasses the entire AP spectrum,emphasizing early interventions for organ damage,proactive complication management,and meticulous postrecovery care.It proposes a comprehensive,tailored strategy for monitoring disease evolution and convalescence,signaling a significant advancement in the AP treatment paradigm,particularly in the context of TCM’s role in critical care.