从肺脾肾和气血津液的关系探讨脓毒症急性肺损伤的中医证治  

Discussion on the Traditional Chinese Medicine Diagnosis and Treatment of Acute Pulmonary Injury in Sepsis from the Relationship between Lung, Spleen, Kidney, and Qi-Blood Fluid

作　　者：黄仁 唐俊玉 刘雨[1] 刘俊[1] 刘敏[1] 柏正平[1] HUANG Ren;TANG Junyu;LIU Yu;LIU Jun;LIU Min;BAI Zhengping(Hunan Academy of Traditional Chinese Medicine Affiliated Hospital,Changsha Hunan 410006,China)

机构地区：[1]湖南省中医药研究院附属医院,湖南长沙410006

出　　处：《中医药导报》2025年第1期199-203,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：肺、脾、肾与气血津液关系密切。脓毒症急性肺损伤(SALI)的病位在肺,其枢在脾,其根在肾,与胃、大肠、三焦密切相关;痰饮、瘀血、浊毒为其主要病理产物及致病因素,毒热是贯穿于SALI病程始终的致病因素。邪盛正亏,热毒袭扰,肺失宣降,肺气上逆为SALI发病的病理基础;气机逆乱,津停饮生,气滞血瘀,毒损肺络为SALI的关键病机;肺不主气,肾不纳气,胃不受纳,腑气不通为SALI病情转归的病理关键。治疗上宜根据不同的病机特点采取分期辨证之法,提倡早期干预,阻断病情恶性循环。The lungs,spleen,and kidneys are closely related to Qi-blood fluids.The location of sepsis-induced acute lung injury(SALI)is in the lungs,with its pivot in the spleen and its root in the kidneys,closely related to the stomach,large intestine,and triple burner.The phlegm retention,blood stasis,and turbid toxins are the main pathological products and pathogenic factors of SALI,while toxic heat is the pathogenic factor that runs through the course of SALI.The pathological basis of SALI is the imbalance of pathogenic factors,the invasion of heat and toxins,the loss of lung function,and the reversal of lung Qi.The key pathogenesis of SALI is the disorder of Qi flow,cessation of fluid intake,stagnation of Qi and blood stasis,and toxicity damage to the lung meridian.The pathological key to the progression of SALI is that the lungs do not control Qi,the kidneys do not receive Qi,the stomach does not receive Qi,and the organs and Qi are not connected.In terms of treatment,it is advisable to adopt a staged differentiation method based on different pathological characteristics,advocate early intervention,and block the vicious cycle of the disease.

关 键 词：脓毒症急性肺损伤 肺脾肾 气血津液 中医病机 

分 类 号：R249[医药卫生—中医临床基础]