从“肺玄府-气液-络脉”理论分期辨治脓毒症急性肺损伤探析

Analyzing the Staging and Treatment of Acute Lung Injury in Sepsis Based on the Theory of"Fei XuanfuQi Ye-Luo Mai"

笔者认为脓毒症急性肺损伤的病机演变与“肺玄府-气液-络脉”理论关系密切,宜分期辨治,早期宜清肺调玄、活血化饮、通利肺络,以阻断病情进展;炎性渗出期当泻肺调玄、活血利水、行气通络;肺水肿期需宣肺通玄、祛瘀逐饮、益气通络;肺实变期应益肺开玄、祛瘀化痰、补虚通络。提倡早期干预,中西医结合综合治疗,尽早阻断病情恶性循环,降低死亡率,为中医药防治脓毒症急性肺损伤提供新的思路。

The authors explore the close relationship between the pathogenesis of this disease and the theory of“Fei Xuanfu-Qi Ye-Luo Mai”.A staging and treatment approach is proposed,suggesting that in the early stage,emphasis should be placed on clearing the lung and regulating the Xuanfu level,promoting blood circulation and resolving fluid retention,and unblocking the lung collaterals to prevent disease progression.During the stage of inflammatory exudation,the focus should be on purging the lungs and regulating the Xuanfu level,promoting blood circulation and ventilating lung qi for diuresis,and activating qi-flowing and dredging collaterals.In the stage of pulmonary edema,it is necessary to ventilating lung qi and unblocking Xuanfu,dispelling stasis and expelling fluid retention,and strengthen qi while unblocking the collaterals.During the stage of lung consolidation,the strategy should be to benefiting lung and broadening Xuanfu,eliminating stasis and removing phlegm,and tonifying and unblocking collaterals.Early intervention is advocated and comprehensive treatment combining traditional Chinese medicine and western medicine is recommended to block the progression of the disease,reduce the mortality rate,thus providing new perspectives for the prevention and treatment of acute lung injury in sepsis using traditional Chinese medicine.