中西医结合干预ICU获得性衰弱研究进展  

Progress in integrative intervention on intensive care unit acquired weakness

作　　者：张宏[1] 侯维维[1] 李韦韦 钟文[3] Zhang Hong;Hou Weiwei;Li Weiwei;Zhong Wen(Classic Traditional Chinese Medicine Ward,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China;Department of Endocrinology,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China;Department of Geriatrics,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China)

机构地区：[1]成都中医药大学附属医院经典病房,成都610072 [2]成都中医药大学附属医院内分泌科,成都610072 [3]成都中医药大学附属医院老年病科,成都610072

出　　处：《中国中西医结合急救杂志》2021年第6期751-754,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家自然科学基金(81804157);成都中医药大学杏林学者学科人才科研提升计划(QNXZ2019006);成都中医药大学附属医院海外合作项目(19HW05);成都中医药大学“杏林学者”学科人才科研提升计划青年教师创新专项。

摘　　要：重症监护病房(ICU)获得性衰弱(ICU-AW)是多种机制共同作用所致的负氮平衡、骨骼肌蛋白质以分解代谢为主的病理进程,对患者疾病康复、预后及死亡率有深远影响。其涉及的病理机制包括泛素蛋白酶体系统激活、自噬失调、线粒体功能障碍、细胞因子风暴等。目前的治疗措施以早期康复运动、营养支持、物理治疗等干预方式为主,但均存在一定的局限性,难以满足临床需求,亟待多学科学者关注该问题并深入研究。本文就骨骼肌生理病理、ICU-AW发生的病理机制及发生率等进行深入探讨,寻求干预治疗的潜在靶点,同时综述现有的可行干预方式,为临床及基础研究奠定基础;尤其是传统中医药在治疗衰弱性疾病方面有独到的见解和显著的疗效,综合运用汤剂、针灸、功法于临床实践对近期及远期预后均大有裨益。The intensive care unit(ICU)acquired weakness(ICU-AW)is a pathological process of negative nitrogen balance and catabolism of skeletal muscle protein,which is caused by multiple mechanisms and has a profound influence on rehabilitation,prognosis and mortality.The pathological mechanisms involved include activation of ubiquitin proteasome system,autophagy disorder,mitochondrial dysfunction,cytokine storm and so on.The current treatment measures mainly include early rehabilitation exercise,nutritional supplementation,physical therapy and other interventions,but all of them have certain limitations and are difficult to meet the clinical needs.Therefore,it is urgent for multidisciplinary scholars to pay attention to this problem and conduct in-depth research.In this paper,the pathological mechanism of ICU-AW was deeply discussed,the potential targets for intervention treatment were sought,and the existing feasible intervention methods were reviewed,laying a foundation for clinical and basic research.In particular,traditional Chinese medicine has unique insights and remarkable curative effects in the treatment of weakness diseases.The comprehensive use of decoction,acupuncture and moxibustion and gongfu in clinical practice is of great benefit to the short-term and long-term prognosis.

关 键 词：重症监护病房获得性衰弱 营养补充 肌电刺激 传统功法 中医药 肌肉萎缩 

分 类 号：R47[医药卫生—护理学]