从“急性虚证”理论探析急危重症辨治

Analysis of Syndrome Differentiation and Treatment of Emergency and Severe Diseases from Theory of“Acute Deficiency Syndrome”

“急性虚证”理论是基于急危重症所具有的特殊正气虚损状态及其发生发展过程提出的涵盖病因病机、治则治法的当代中医理论,对各种急危重症救治具有重要指导意义。脓毒症以正虚邪盛为基本病机,以补虚、扶正、固本为主要治则,早期扶正、祛邪兼顾补虚,可阻止病情进行性恶化;急性脑卒中基本病机是气血、阴精亏虚,在此基础上病理产物积聚,遇诱发因素而突然发病,治疗当扶正祛邪、标本兼顾,尤其重视及早应用扶助元气药;重症急性胰腺炎以正脱邪陷、气阴两虚为主要病机,治疗以补气养阴为基本治则,应用参麦注射液可调节免疫、保护器官功能,改善预后。“急性虚证”理论强调重视正气,“早期扶正、积极扶正”对急危重症救治具有重要临床价值。

The theory of“acute deficiency syndrome”is a contemporary theory in traditional Chinese medicine that covers the etiology,pathogenesis,therapeutic principles and methods based on the special state of healthy qi deficiency and its occurrence and development process in emergency and severe diseases.It has important guiding significance for the treatment of various emergency and severe diseases.The basic pathogenesis of sepsis is deficient healthy qi and excessive pathogenic factors,and the main therapeutic principle is to supplement deficiency,reinforce healthy qi to restore the normal function.Reinforcing healthy qi,expelling pathogenic factors,as well as supplementing deficiency in the early stage can prevent the progressive deterioration of sepsis.The basic pathogenesis of acute stroke is deficiency of qi and blood,yin and essence,on this basis,the accumulation of pathological products and sudden onset in case of predisposing factors.In the treatment,we should reinforce healthy qi and expel pathogenic factors,simultaneously treat both symptoms and root cause,especially pay attention to the application of Chinese medicinals for supplementing primordial qi.The main pathogenesis of severe and acute pancreatitis is healthy qi collapse and pathogenic factors invasion,deficiency of qi and yin.The basic therapeutic principle is to tonify qi and nourish yin.The application of Shenmai Injection(参麦注射液)can regulate immunity,protect organ function and improve prognosis.The theory of“acute deficiency syndrome”emphasizes the importance of healthy qi.Reinforcing healthy qi actively in the early stage has important clinical value for the treatment of emergency and severe diseases.