脓毒症心肌损害的研究进展及中医药治疗初探  

Research progress of sepsis-induced myocardial damage and the treatment with traditional Chinese medicine

作　　者：张蕾[1] 黄烨[1] 杨志旭[1] 耿涛[2] Zhang Lei;Huang Ye;Yang Zhixu;Geng Tao(Department of Emergency,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Department of Psychosomatic Medicine,Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Bejing 100053,China)

机构地区：[1]中国中医科学院西苑医院急诊科,北京100091 [2]中国中医科学院广安门医院心身医学科,北京100053

出　　处：《中国中西医结合急救杂志》2023年第2期226-229,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：中国中医科学院西苑医院苗圃课题(2019XYMP-16);中国中医科学院科技创新工程重大攻关项目(CI2021A02905);中国中医科学院科技创新工程重大攻关项目(CI2021A02908)。

摘　　要：脓毒症是一种严重危及生命的器质性功能障碍疾病,其发生发展过程中身体对感染的反应是造成组织损伤和器官功能衰竭的重要原因.脓毒症诱导的心功能障碍(SIMD)是脓毒症的常见并发症,约 50%的脓毒症患者会出现心肌功能障碍的表现.心功能受损程度对于脓毒症至关重要,因为它是疾病治疗方法选择及预后的重要评价指标.古代医籍多将SIMD归属于"温热病"的范畴,后世医家对该病病因病机和治则治法提出了诸多理论,临证中取得了良好的临床效果.随着医学的发展,中医药在SIMD治疗中越来越发挥重要作用.现从心肌肾上腺素能反应、能量代谢、收缩功能改变等方面阐述SIMD的发病机制,并对SIMD中西医治疗进行初步探讨,以期为SIMD的治疗提供参考.Sepsis is a serious life-threatening organic dysfunction disease.The body's response to infection during its occurrence and development is an important cause of tissue damage and organ failure.Sepsis-induced myocardial damage(SIMD)is a common complication of sepsis,about 50%of septic patients have myocardial dysfunction.The degree of cardiac function impairment is crucial for sepsis because it is an important indicator for the choice of treatment and prognosis of the disease.The ancient medical records mostly attributed the disease to the category of"febrile disease".Later doctors put forward many theories on the etiology,pathogenesis,and treatment of the disease,and achieved good clinical results in clinical practice.Traditional Chinese medicine plays an increasingly important role in the treatment of SIMD.The article describes the pathogenesis of SIMD from cardiomyocyte-adrenergic response,energy metabolism,and changes in systolic function,and also discusses the Chinese and Western medicine treatment of SIMD to provide a reference for the treatment of SIMD.

关 键 词：脓毒症 脓毒症心肌损害 液体复苏 温热病 综述 

分 类 号：R459.7[医药卫生—急诊医学]