从《不居集》"外损致虚"辨治脓毒症探析OA

Based on the theory of"deficiency resulted from external injury"in Bu Ju Ji,this paper holds that the onset of sepsis is manifested either as"excessive pathogenic factor directly attacking the interior"or"repeated contraction of external pathogenic factors consuming qi and blood",both of which take external injury as the cause and eventually lead to consumptive disease.It is a dynamic process in which the body transforms from excessive pathogen in the acute stage to vital qi deficiency in the chronic critical illness stage.Its core pathogenesis lies in predominant toxin and declined vital qi,as well as stagnated toxin obstructing collaterals,presenting a critical state of intermingled deficiency and excess.With the gradual exhaustion of vital qi and worsening immunosuppression,the disease becomes protracted and ultimately results in depletion of zang fu viscera.Therapeutically,balance should be maintained between consolidating the interior and relieving external pathogens.According to the abun-dance or decline of primordial qi and the severity of external pathogens,the resolving and supporting method is ad-opted for severe external pathogen with mild vital qi deficiency to clear static toxin and dredge collaterals;the toni-fying and supporting method is applied for severe deficiency with mild external pathogen to eliminate residual pathogens completely and prevent recurrent infection.Meanwhile,it is essential to protect middle qi,nourish yin and strengthen yang,and correct immune disturbance.