细胞因子风暴中医辨证要点解析  

The key of traditional Chinese medicine syndrome differentiation of cytokine storm

作　　者：甄建华 于河 谷晓红 ZHEN Jianhua;YU He;GU Xiaohong(School of Life Sciences,Beijing University of Chinese Medicine,Beijing 100029,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学生命科学学院,北京100029 [2]北京中医药大学中医学院

出　　处：《北京中医药大学学报》2023年第6期763-769,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82004249);国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-D-202203)。

摘　　要：细胞因子风暴是机体对外界刺激产生的免疫过激反应,主要表现为细胞因子-白细胞正反馈环路的风暴式增高,并由此导致高炎性状态下的组织损伤与器官功能障碍。通过分析细胞因子风暴相关疾病的生物学病因、组织病理、病程进展及临床表现等信息,对细胞因子风暴进行辨证解析,认为其由外因、不内外因等多元病因启动,伴发毒、痰、瘀、虚等病理因素,涉及温热、湿热两类温病,临床传变符合卫气营血辨证,正邪交争可有顺证、逆证之分,病位多责肺、心、脾、胃。临证辨治细胞因子风暴相关疾病时,应注重辨识上述信息,判别细胞因子风暴发生的风险,并采用适当治法截断其进程、扭转其态势、预防其发生、改善其预后。Cytokine storm,which is an overreaction of the immune system to external stimulation,is characterized by a rapid increase in cytokine levels and leucocyte counts due to a positive feedback loop,and results in tissue damage and organ dysfunction with a highly inflammatory state.By analyzing the pathogeny,histopathology,disease progression,and clinical manifestation of diseases related to cytokine storm,this article summarizes key information from traditional Chinese medicine for syndrome differentiation.The etiologies of cytokine storm include external causes and causes that are neither internal nor external,and pathologies such as toxin,phlegm,blood stasis,and deficiency are also observed during cytokine storm.The spectrum of diseases covers warm-heat and damp-heat diseases,which could be differentiated using Weifen-Qifen-Yingfen-Xuefen theory;in addition,the fight between vital qi and pathogenic qi can be divided into syndromes with good prognosis and syndromes with unfavorable prognosis.The most commonly injured organs are the lung,heart,spleen,and stomach.However,during the treatment of diseases related to cytokine storm,attention should be paid to the above information to estimate the risk of a cytokine storm occurring,and to adopt appropriate treatment method to prevent its occurrence and improve prognosis.

关 键 词：细胞因子风暴 中医辨证要点 病因 病理 病性 病期 病势 病位 

分 类 号：R228[医药卫生—中医基础理论]