从"痰热"与"氧化应激-炎症反应"的相关性探析急性肺损伤/呼吸窘迫综合征的中医辨治OA

Acute lung injury/acute respiratory distress syndrome(ALI/ARDS)is a critical respiratory condition with high mortality,caused by multifactorial etiologies.Its pathogenesis remains complex and incompletely elucidated.Current evidence indicates that the synergistic interaction between oxidative stress and inflammatory responses plays a pivotal role in disease progression.The activation and release of reactive oxygen species(ROS)and inflammatory mediators contribute to disrupting alveolar-capillary endothelial barrier integrity,thereby exacerbating lung tissue damage.From the perspective of traditional Chinese medicine(TCM),phlegm-heat is recognized as a core pathological factor in ALI/ARDS.Phlegm-turbidity,viewed as the pathological manifestation of ROS,arises from disordered water metabolism,while heat-toxin,corresponding to inflammatory factors,serves as a key effector substance aggravating the inflammatory cascade.Based on the TCM theory of phlegm-heat,this paper proposes that ALI/ARDS progression is characterized by confluence of internal and external dampness,accumulation and steaming of phlegm-heat,and interaction of blood stasis and toxin.The core treatment principle of fortifying the spleen and nourishing the primordial essence is consistently applied throughout the course.Preventive strategies emphasize strengthening the spleen to consolidate the root and benefiting the lungs to reinforce the exterior,utilizing the Fuzheng Biwen formula.In the early stage of the disease course,the focus is on clearing heat and ventilating the lung,activating the spleen to resolve turbidity.Xuanfei Huazhuo formula is selected for treatment.During middle to late stages,emphasis shifts to clearing the ying level,resolving blood stasis,cooling the blood,and detoxifying,using the Qingfei Tongluo Formula.This approach aims to provide novel theoretical insights and methodological guidance for the clinical prevention and treatment of ALI/ARDS.