从“瘀毒阻络”和“正气不足”角度探讨脓毒症急性呼吸窘迫综合征的中医病机

Discussion on the TCM pathogenesis of acute respiratory distress syndrome of sepsis syndrome from"blood stasis with toxin blocking collaterals"and"deficient healthy qi"

急性呼吸窘迫综合征(ARDS)为脓毒症常见并发症,属于中医“喘证”“暴喘”“喘脱”范畴,病位主要在肺。正气不足、瘀毒阻络是脓毒症主要病因病机。瘀毒邪气侵袭肺脏,热毒煎灼血中津液,血液黏稠运行不畅,致瘀毒互结于肺。又急性虚证、热毒伤气、热毒灼津,津液虚少无以化气,致正气亏虚不能司呼吸、固津液及行血,致痰饮水湿瘀血阻肺。瘀毒阻肺、肺气不足、痰饮水湿瘀血致肺气闭塞发为本病。由此认为,瘀毒阻络、正气不足是脓毒症ARDS的中医病机。

Acute respiratory distress syndrome is one of the common complications of sepsis syndrome,belonging to the"Chuan syndrome","Baochuan",and"Chuantuo"in the TCM field,and the disease is mainly located in the lung.The main etiology and pathogenesis of sepsis syndrome is deficient healthy qi and blood stasis with toxin blocking collaterals.Blood stasis and toxin invade the lung,causing heat and toxin to burn the body fluid in the blood.Blood viscosity and poor circulation lead to the accumulation of blood stasis and toxin in the lung.Acute deficiency syndrome,heat toxin damaging qi,heat toxin burning body fluid deficiency with little ability to dissipate qi,resulting in deficiency of healthy qi,inability to regulate breathing,inability to consolidate body fluid,inability to promote blood circulation,causing phlegm,dampness,and blood stasis blocking the lung.This disease is characterized by blood stasis with toxin blocking collaterals,deficient lung qi,and obstruction of lung qi caused by phlegm,water,dampness,and blood stasis.Therefore,blood stasis with toxin blocking collaterals,as well as deficient healthy qi are TCM pathogenesis of ARDS with sepsis syndrome.