从"气失其治、津血同辙"探讨急性呼吸窘迫综合征的治疗OA
Discussion on the Treatment of Acute Respiratory Distress Syndrome from the Theory of"Qi Loses Its Regulatory Function,Fluids and Blood Follow the Same Path"
认为急性呼吸窘迫综合征(ARDS)以气机失常为首乱之因,气病为先,津血病变随后而生,病位在肺、病本在气、病变在津血,病机与"气失其治、津血同辙"契合.据此将本病分为三期,早期气机壅逆,津血受阻,极期气脱阳衰,津血失统,恢复期气耗津伤,余邪羁留,分别治以宣肺开闭化痰蠲饮、益气固脱利水化瘀、益气生津兼清余滞,予葶苈大枣泻肺汤合宣白承气汤或射干麻黄汤加减、真武汤合参蛤散加减、沙参麦冬汤合补肺汤.同时,从"气失其治、津血同辙"探讨俯卧位通气(PPV)的治疗机理,认为PPV通过复大气运转、解气血水滞结,实现"气至血所"之效,可为ARDS中西医结合诊疗提供思路.
Acute respiratory distress syndrome(ARDS)is believed to primarily result from a disorder of the qi movement,with qi dysfunction occurring first,followed by changes in fluids and blood.The disease is located in the lungs,with its root in qi and pathological changes in fluids and blood,aligning with the theory of"qi loses its regulatory function,fluids and blood follow the same path".Accordingly,ARDS is divided into three stages,the early stage with qi congestion,counterflow,fluids and blood obstruction,severe stage with qi collapse,yang depletion,fluids and blood out of control),and recovery stage with qi consumption and fluids damage,residual pathogen retention.For the corresponding treatments,in the early stage,the focus is on diffusing the lung qi,opening the block,dissol-ving phlegm,and eliminating fluid retention,using Tingli Dazao Xiefei Decoction(葶苈大枣泻肺汤)and Xuanbai Chengqi Decoction(宣白承气汤)/Shegan Mahuang Decoction(射干麻黄汤)with modifications.In the severe stage,the priority is to reinforce qi,stabilize collapse,and promote diuresis and blood circulation,with modified Zhenwu Decoc-tion(真武汤)and Shenge Powder(参蛤散).During recovery stage,the emphasis shifts to replenishing qi and body fluids while clearing residual pathogens,with Shashen Maidong Decoction(沙参麦冬汤)and Bufei Decoction(补肺汤).At the same time,from the perspective of"qi loses its regulatory function,fluids and blood follow the same path",the mechanism of prone position ventilation(PPV)is explored.It is believed that the effect of"qi reaching the blood"via PPV by restoring the qi movement and unblocking qi,blood and water retention,which offers insights for the diagnosis and treatment of ARDS with integrated traditional Chinese and western medicine.
翁慧;陈波;陈腾飞;叶成坚;郑文贺
福建中医药大学附属第二人民医院,福建省福州市鼓楼区五四路282号,350003福建中医药大学附属第二人民医院,福建省福州市鼓楼区五四路282号,350003福建中医药大学附属第二人民医院,福建省福州市鼓楼区五四路282号,350003福建中医药大学附属第二人民医院,福建省福州市鼓楼区五四路282号,350003福建中医药大学附属第二人民医院,福建省福州市鼓楼区五四路282号,350003
急性呼吸窘迫综合征气血津液俯卧位通气
acute respiratory distress syndromeqibloodbody fluidsprone position ventilation
《中医杂志》 2026 (7)
792-797,6
福建省科技计划(2024Y9479)福建省卫生健康委员会福建省西学中高级人才研修项目(闽卫中医函[2023]1063号)
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