基于三焦膜腠理论探讨脓毒症胃肠障碍发病机制

The Pathogenesis of Gastrointestinal Dysfunction in Sepsis Based on Theory of Membranous Sanjiao

脓毒症是当前严重危害人类生命健康的重大疾病之一,其病死率居高不下。而胃肠道是脓毒症最早累及的靶器官之一,其功能障碍可进一步加快脓毒症进程,最终导致全身器官衰竭直至死亡。西医多采用液体复苏、保护胃黏膜、免疫调节、营养支持、改善菌群等手段治疗,但预后并不理想。中医多从脾胃角度论治该病,而深究其本质病机,则是邪伏三焦膜腠、气化失职,渐伤于脾胃肠腑,并弥漫三焦五脏、导致恶性循环的连续病理过程。因此,文章基于三焦膜腠理论,探讨脓毒症胃肠障碍的发病机制,以期为中医治疗脓毒症胃肠障碍提供理论依据。

Sepsis is one of the major diseases that seriously jeopardize human life and health,and its mortality rate remains high.The gastrointestinal tract is one of the earliest target organs involved in sepsis,and its dysfunction can further accelerate the process of sepsis,ultimately leading to systemic organ failure until death.Western medicine uses fluid resuscitation,protection of gastric mucosa,immunomodulation,nutritional support,improvement of bacterial flora and other means of treatment,but the prognosis is not ideal.Traditional Chinese medicine treats the disease from the perspective of the spleen and stomach,but when look deeply into its underlying pathology,it is a continuous pathological process in which the evils are in the sanjiao membrane and coupling,the qi and chemistry fail to perform their duties,and gradually injure the spleen,stomach,and intestines,and permeate the sanjiao and five viscera,leading to a vicious cycle.Therefore,based on the theory of membranous sanjiao,the article discussed the pathogenesis of gastrointestinal injury in sepsis,with a view to providing theoretical basis for the treatment of gastrointestinal injury in sepsis in traditional Chinese medicine.