中医凉血破瘀养血法治疗脓毒症相关肝损伤思路探讨  

Discussion the Method of“Cooling blood,Removing Blood Stasis and Nourishing Blood”in TCM for Treating Sepsis-associated Liver Dysfunction

作　　者：周桢 王倩[1] 方荣[1] Zhou Zhen;Wang Qian;Fang Rong(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《中国中医急症》2023年第9期1560-1563,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82074156)。

摘　　要：脓毒症相关肝损伤(SALD)是脓毒症常见的高病死率并发症,中医对此研究较少。笔者基于叶天士温病卫气营血辨证理论,提出SALD属于“血分证,热入血分”辨证范畴,以血热耗血为病机特征,以瘀血为关键病理因素,以此指导中医治疗SALD应在泄热凉血之余,配合破瘀养血,以期恢复肝之生理功能,及时“截断”血分证进一步发展。文章将结合文献查阅及前期临证研究探讨SALD中医病因病机,分析并论证以“凉血破瘀养血法”治疗SALD的中医思路,细化脓毒症相关器官功能障碍的中医内涵,提供中医药治疗SALD的新思路。Sepsis-associated liver dysfunction(SALD)is a common complication in sepsis with high mortality,which still lacks researches in TCM.We propose that SALD belongs to heat entering blood aspect pattern based on the method of“syndrome differentiation of Weifen,Qifen,Yingfen,Xuefen”in warm diseases created by Ye Tianshi,and its characteristic TCM pathogenesis is blood heat while its key TCM etiology is blood stasis,which guide us to treat SALD using the method of removing blood stasis and nourishing blood besides the method of dissipating heat and cooling blood to recover biological function of liver in TCM and block process of blood-aspect pattern.This article will discuss TCM etiology and pathogenesis of SALD and the method of using“cooling blood,removing blood stasis and nourishing blood”to treat SALD though literature and our previous studies,and aims to detail TCM content on sepsis-induced organ dysfunction and provide brand new thinking on treatment for SALD in TCM.

关 键 词：脓毒症相关肝损伤 温病卫气营血辨证 血分证 凉血破瘀养血法 

分 类 号：R242[医药卫生—中医临床基础]