基于“因加而发”理论探讨中医药调控免疫炎症微血管损伤在肺炎恢复期“瘥后防复”中的作用  

Role of Traditional Chinese Medicine in Regulating Immune Inflammation and Microvascular Damage in Preventing Recurrence of Pneumonia During Recovery Based on Combination of Pathogenic Factors

作　　者：彭鑫 徐浩田 梁磊 栾哲宇 王晗笑 杨坤[1] 封继宏[2] PENG Xin;XU Haotian;LIANG Lei;LUAN Zheyu;WANG Hanxiao;YANG Kun;FENG Jihong(Tianjin University of Traditional Chinese Medicine(TCM),Tianjin 301617,China;The Second Affiliated Hospital of Tianjin University of TCM,Tianjin 300250,China)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学第二附属医院,天津300250

出　　处：《中国实验方剂学杂志》2025年第9期249-258,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82174333);国家中医药管理局青年岐黄学者培养项目(国中医药人教函[2022]256号);天津中医药大学第二附属医院薪火相传领军人才项目(津中医二附政发〔2023〕50号)。

摘　　要：肺炎是全球范围内发病率和病死率较高的感染性疾病,其对机体的损害不局限于急性期。“因加而发”理论强调体内故邪停聚、新邪引动,新故合邪致病生,是对肺炎恢复期疾病发病内涵的高度概括。肺炎恢复期机体存在免疫稳态破坏、持续低度炎症和微血管损伤等病理改变,将持续影响身体机能,影响患者身体健康及生活质量,增加二次感染的风险。中医学认为肺炎乃因虚致病,恢复期以“气虚血瘀”为核心病机特点,此时机体正气未充、余邪未尽,易感外邪,使肺炎瘥后复发。“瘥后防复”作为中医学“治未病”理念的重要一环,强调在疾病恢复期仍需进行善后调摄,从而预防疾病复发。该文从“因加而发”发病观出发,针对疾病“气虚血瘀”的病机特点,探讨中医药调控免疫炎症微血管损伤在肺炎恢复期“瘥后防复”中的作用与内涵,以期为肺炎恢复期的有效防治拓展新思路。Pneumonia is an infectious disease with high morbidity and mortality worldwide,and its damage to the body is not limited to the acute phase.The theory of combination of pathogenic factors emphasizes that the combination of new pathogens and residual pathogens in the body leads to the occurrence of diseases,which generalizes the causes of recurrence during pneumonia recovery.During the recovery stage of pneumonia,pathological changes such as disturbance of immune homeostasis,persistent low-grade inflammation,and microvascular damage continue to affect the body function,impair the health and quality of life of patients,and increase the risk of secondary infection.According to the theory of traditional Chinese medicine(TCM),pneumonia is caused by deficiency,and Qi deficiency and blood stasis is the core pathogenesis in the recovery stage.At this time,the body is not full of healthy qi and still has residual pathogens,and thus it is susceptible to external pathogenic factors that lead to disease recurrence.As an important part of the TCM philosophy of treating disease before its onset,prevention of recurrence after recovery emphasizes the need for aftercare in the recovery stage to prevent disease recurrence.Based on the pathogenesis theory of combination of pathogenic factors and the pathogenesis of Qi deficiency and blood stasis,this paper discusses the effect and connotation of TCM in regulating immune inflammation and microvascular damage in preventing recurrence of pneumonia during the recovery stage,aiming to develop new ideas for effective prevention and treatment of pneumonia at this stage.

关 键 词：因加而发 免疫炎症微血管损伤 肺炎恢复期 瘥后防复 理论探讨 

分 类 号：R259[医药卫生—中西医结合] R563.1[医药卫生—中医内科学] R856.2[医药卫生—中医学]