基于“四证四法”辨治脓毒症心肌病的研究进展  

Research progress in the syndrome differentiation and treatment of sepsis-induced cardiomyopathy by the theories of ’four patterns and four methods’

作　　者：杨飞宇 郭力恒 张敏州 何健卓 YANG Fei-yu;GUO Li-heng;ZHANG Min-zhou;HE Jian-zhuo(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Post-doctoral Workstation of Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]广州中医药大学第二附属医院,广州510120 [2]上海中医药大学博士后工作站,上海201203 [3]广州中医药大学第二附属医院重症医学科,广州510120

出　　处：《中华中医药杂志》2022年第8期4263-4268,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82074216);广州市科技局市联合资助项目(No.202102010242)。

摘　　要：脓毒症病死率在全球高居不下,常诱发非感染器官发生功能障碍,心肌损伤是脓毒症最严重的并发症之一,其病理机制复杂,尚无特异性疗法。中医药属“厥脱”“热毒”“喘证”等病证范畴。中医药在脓毒症治疗中发挥重要作用,脓毒症心肌病目前尚缺乏系统的中医辨证论治及理法方药整理小结。文章基于热毒证及清热解毒法、血瘀证及活血化瘀法、腑气不通证及通里攻下法及急性虚证及扶正固脱法的“四证四法”辨治思路,整理经典文献、现代中医专家认识、基础及临床实验证据,对中医药治疗脓毒症心肌病的辨证、中药汤剂及中药注射剂的研究进展进行阐述。The mortality rate of sepsis remains high in the global,and it often induces dysfunction of noninfected organs.Myocardial dysfunction is one of the most serious complications of sepsis.Its pathological mechanism is complex and there is no specific therapy.It also belongs to ’Jue-Tuo’ ’toxic heat’ ’asthma’,and other disease syndrome categories of traditional Chinese medicine(TCM).TCM plays an important role in the treatment of sepsis.At present,there is still a lack of systematic TCM syndrome differentiation and principal-method-recipe medicines for septic cardiomyopathy.Based on the ’four patterns and four methods’:’clearing heat and removing toxicity method’ for ’toxic heat syndrome’;’activating blood and removing blood stasis method’ for ’blood stasis syndrome’;’purgation method’ for ’Fu qi obstruction syndrome’;’strengthening body resistance method’ for ’acute deficiency syndrome’,by sorting out the classic literature,consensus of modern TCM experts,basic and clinical experimental evidence,this article will describe the research progress of syndrome differentiation,Chinese herbal decoction,Chinese medicine injection in the treatment of sepsis-induced cardiomyopathy.

关 键 词：脓毒症心肌病 四证四法 中药注射液 本虚标实 清热解毒 活血化瘀 通里攻下 扶正固脱 

分 类 号：R278[医药卫生—中医学]