脓毒症动物模型与中西医临床病证特点的综合对比分析  

Comprehensive Comparative Analysis of Sepsis Animal Models and Characteristics of Clinical Syndromes in Integrated Traditional Chinese and Western Medicine

作　　者：李珊[1] 李超[2] 武亦文 薛静雯 陈晴晴 梁腾霄[1,2] LI Shan;LI Chao;WU Yiwen;XUE Jingwen;CHEN Qingqing;LIANG Tengxiao(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Sun Simiao Hospital,Beijing University of Chinese Medicine,Tongchuan 727031,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学孙思邈医院,陕西铜川727031

出　　处：《中国实验方剂学杂志》2024年第20期212-218,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局第五批全国临床优秀人才研修项目(国中医药人教函[2022]1号);2024年度市级中医医院中医药科研能力提升项目(SZY-NLTL-2024-003);北京中医药大学2024年度新教师启动基金项目(2024-BUCMXJKY-056,2024-BUCMXJKY-057)。

摘　　要：该文以脓毒症的中医辨证论治和西医临床特征为基点,广泛搜集并深入剖析了国内外关于脓毒症动物模型的最新研究成果;严格参照脓毒症中医证型诊断标准,对各类动物模型的临床表现、病理变化及生物标志物表达等多维度指标进行了细致的评估,反映模型对人类脓毒症中医证型的模拟程度。研究结果显示,升结肠支架植入模型的赋值分析结果显示为中西医较高吻合度,证型上更加符合腑气不通证诊断标准;腹腔外脓毒症模型的赋值分析结果显示为中医较高吻合度,证型上更加符合急性虚证诊断标准,强调了脓毒症正气亏虚的核心病机。这些发现不仅丰富了脓毒症动物模型的多样性,也凸显了中西医结合研究的必要性和潜力。现有脓毒症动物模型构建多侧重于西医病理机制,较少直接融入中医辨证要素,提示在未来的研究设计中,应积极探索将中医证候分类及干预原则融入模型建立过程,如通过调整模型诱发因素、观察更多中医特有症状及体征等,以期建立更贴近临床实际、兼顾中西医视角的脓毒症模型。This study,anchored in the traditional Chinese medicine(TCM)syndrome differentiation and treatment principles alongside the clinical characteristics of sepsis in Western medicine,extensively gathers and meticulously dissects the latest research findings on sepsis animal models from both Chinese and international sources.Adhering strictly to TCM syndrome diagnostic criteria for sepsis,the study conducts a thorough evaluation of various animal models across multiple dimensions,including clinical manifestations,pathological changes,and biomarker expressions,so as to reflect the degree of resemblance these models have to human sepsis TCM syndromes.The results reveal that the colon stent implantation model exhibits a higher degree of congruence with both TCM and Western medicine standards,particularly aligning with the diagnosis of the"Fu-Qi obstruction syndrome".Conversely,the extraperitoneal sepsis model shows a higher degree of congruence with TCM,fitting more closely with the diagnosis of"acute deficiency syndrome"and emphasizing the core pathogenesis of Qi deficiency in sepsis.These findings not only augment the diversity of sepsis animal models but also highlight the necessity and potential of integrated TCM and western medicine research.Current sepsis animal models predominantly focus on western pathophysiological mechanisms,with limited direct incorporation of TCM syndrome differentiation elements.This underscores the need,in future study designs,to actively explore integrating TCM syndrome classification and intervention principles into model development.This could be achieved by manipulating model-inducing factors and observing more TCM-specific symptoms and signs among other strategies,so as to establish sepsis models that more closely resemble clinical reality and incorporate both TCM and western medical perspectives.

关 键 词：脓毒症 动物模型 中西医临床病证 

分 类 号：R631[医药卫生—外科学] R-332[医药卫生—临床医学] R284.2R285R289R287R22R2-031R33R24