"恶血"与"微血栓":论"恶血归肝"理论与脓毒症凝血功能紊乱的相关性OA

Sepsis-induced coagulopathy(SIC)is one of the critical factors contributing to the high mortality of sepsis;it is essentially characterized by the formation of systemic microthrombi mediated by immune and inflammatory processes.Currently,anticoagulant therapy faces numerous clinical challenges and has limited efficacy.The theory of"pathogenic blood returning to liver"originates from Li Dongyuan's Inventions in Medicine and emphasizes the close connection between pathogenic blood and the liver.This theory shares certain similarities with the formation of"microthrombi"in sepsis,which lead to coagulation dysfunction,in terms of their occurrence,development,and pathophysiological progression.This article systematically reviews the theory of"pathogenic blood returning to liver"and explores its intrinsic pathological connection with"microthrombi".Based on this,the core pathogenesis of SIC is characterized by"the mutual entanglement of toxins and blood stasis,the internal generation of pathogenic blood,hepatic damage,and disruption of hepatic regulatory functions".The core therapeutic principles of"clearing pathogenic blood,soothing the liver,and eliminating toxins and blood stasis"provide a theoretical framework and new perspectives for the treatment of SIC.