呼吸系统耐药菌感染的中医认识与治疗策略OA
TCM understanding and therapeutic strategies for respiratory drug-resistant bacterial infections
呼吸系统耐药菌感染病程迁延、疗效欠佳,是当前全球公共卫生的重大挑战.面对新型抗生素研发滞缓的现状,中医药凭借整体调节与辨证论治的独特优势,为此类感染的防治提供了新思路.该文首次系统构建以菌-毒-瘀-虚为核心病机的中医复合模型,阐明其"本虚标实"的动态演变规律,并提出"分期-分证"的诊疗框架与"防治前移,截断扭转"的防治策略.在中医学范畴内,此类感染可归于"风温""肺痈""咳嗽"或"伏邪"等,病机关键在于"肺气内虚,邪气留恋",以致痰、瘀、毒互结于肺.根据正邪消长,临床可分为"邪盛正损"与"正虚邪恋"2 期,涵盖正虚邪恋、邪伏膜原、痰瘀毒结、气阴两伤等核心证型.治疗上,分别以麻杏石甘汤、竹叶石膏汤、达原饮、千金苇茎汤、沙参麦冬汤等经方加减,以体现"扶正祛邪"之则.临床实践表明,遵循"病机结合病理,药性结合药理"的中西医结合模式,能有效改善患者预后,减少复发并提高生存质量,为应对全球抗生素耐药性危机提供了中西医协同的新范式.
Currently,respiratory drug-resistant bacterial infections are a major global public health challenge due to their protracted course of disease and suboptimal treatment outcomes.In the face of slow progress in the development of new antibiotics,TCM offers novel perspectives for preventing and treating such infections by leveraging its unique advantages in holistic regulation and syndrome differentiation.This paper,for the first time,systematically constructed a TCM composite pathogenesis model centered on the core concept of bacteria-toxin-stasis-deficiency.It elucidated the dynamic evolution pattern characterized by deficiency in nature and excess in superficiality and proposed a stage-specific and syndrome-specific diagnostic and therapeutic framework,along with a prevention and treatment strategy of advancing intervention to intercept and reverse disease progression.From a TCM perspective,these infections can be categorized under conditions such as wind-warmth,lung abscess,cough,or latent pathogen.The key pathogenesis involves"internal deficiency of lung Qi leading to lingering pathogenic factors",resulting in the mutual binding of phlegm,stasis,and toxins in the lungs.Based on the dynamic interplay between healthy Qi and pathogenic factors,the clinical presentation can be divided into two phases:pathogen excess with healthy Qi impairment and healthy Qi deficiency with lingering pathogen.These phases encompass core syndrome types including healthy Qi deficiency with lingering pathogen,latent pathogen in pleurodiaphragmatic interspace,phlegm-stasis-toxin binding,and dual deficiency of Qi and Yin.Therapeutically,modified classical formulas such as Maxing Shigan Decoction,Zhuye Shigao Decoction,Dayuanyin,Qianjin Weijing Decoction,and Shashen Maidong Decoction are employed to embody the principle of reinforcing healthy Qi and eliminating pathogen.Clinical practice demonstrates that adhering to an integrated traditional Chinese and western medicine model guided by the principles of integrating pathogenesis with pathology and medicinal properties with pharmacology can effectively improve patient prognosis,reduce recurrence rates,and enhance quality of life.This approach provides a new paradigm of integrated traditional Chinese and western medicine for addressing the global crisis of antimicrobial resistance.
刘永辉;林韩东;张丽明;黄语嫣;林江;邓亚胜;韦俊全;臧明月;张荣昶;陈秋;兰太进;庞业展
广西中医药大学,广西 南宁 530200防城港市中医医院,广西 防城港 538000防城港市中医医院,广西 防城港 538000防城港市中医医院,广西 防城港 538000广西中医药大学,广西 南宁 530200防城港市中医医院,广西 防城港 538000防城港市中医医院,广西 防城港 538000防城港市中医医院,广西 防城港 538000防城港市中医医院,广西 防城港 538000成都中医药大学附属医院,四川 成都 610075成都中医药大学 养生康复学院,四川 成都 610075防城港市中医医院,广西 防城港 538000
呼吸系统耐药菌感染中医药伏邪痰瘀毒结扶正祛邪菌-毒-瘀-虚模型
respiratory drug-resistant bacterial infectionTCMlatent pathogenphlegm-stasis-toxin bindingreinforcing healthy Qi and eliminating pathogenbacteria-toxin-stasis-deficiency model
《中国中药杂志》 2026 (11)
3105-3116,12
四大慢病重大专项(2023ZD0509400)国家自然科学基金项目(82060825)全国高校黄大年式教师团队——中西医基础课程教师团队项目(教育部教师函[2022]2号)广西名中医林江传承工作室项目(桂中医药科教发[2021]6号)中医学广西一流学科项目(桂教科研[2022]1号)广西中医药创新团队项目(GZKJ2302)
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