从顽痰伏络论治耐药铜绿假单胞菌所致肺部感染OA

Pulmonary infection caused by drug-resistant Pseudomonas aeruginosa frequently occurs in older patients and in those with chronic airway diseases,recurrent hospitalizations,or repeated prior exposure to antimicrobial agents.It is characterized by difficulty in eradicating the pathogen,a protracted clinical course,recurrent acute exacerbations,and persistent respiratory symptoms even after infection control.Based on the traditional Chinese medicine(TCM)theories concerning phlegm,latent pathogens,and collateral diseases,this paper proposes a therapeutic approach for pulmonary infection induced by drug-resistant Pseudomonas aeruginosa from the perspective of stubborn phlegm lurking in lung collaterals.Deficiency of the body's vital resistance is considered as the pathogenic basis,whereas lung invasion by heat toxin and body fluid consumption with subsequent phlegm formation constitute the initial pathogenic process.As phlegm turbidity persists,it gradually develops into stubborn phlegm,which interacts with heat toxin and blood stasis and becomes deeply lodged in the pulmonary collaterals.This result in the persistence of pathogenic factors and their reactivation under triggering conditions.Thus,the pathogenesis is characterized by the coexistence of vital resistance deficiency and pathogenic excess,the intermingling of heat toxin and phlegm turbidity,and the progressive aggravation of stubborn phlegm retention,latent pathogenic factors in the collaterals,and phlegm-blood stasis binding.Treatment should strengthen the body's vital resistance,eliminate pathogenic factors,resolve phlegm,unblock the collaterals,and follow stage-based management.The acute exacerbation and protracted and recurrent stages are treated with modified Fuzheng Jiedu Huayu Formula as the basic prescription.During acute exacerbations,emphasis is placed on clearing heat and detoxifying,resolving phlegm and discharging pus,with concurrent support for the body's vital resistance.During the protracted or recurrent stage,treatment focuses on clearing heat,resolving phlegm,softening hardness,unblocking the collaterals,and eliminating residual toxins.During recovery,Jiexing Junzi Granules are used to replenish qi and nourish yin,regulate and tonify the spleen and lung,and resolve residual phlegm.This therapeutic framework provides a reference for the TCM management of pulmonary infection caused by drug-resistant Pseudomonas aeruginosa.