Treating sepsis induced intestinal injury from "Chang-Bi" based on the integration of theory of Chinese medicine and Western medicine
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摘要: 脓毒症胃肠损伤是脓毒症最常见的并发症,亦是导致多器官功能障碍综合征的初始环节。积极改善患者胃肠道功能对提高脓毒症救治成功率意义重大。目前,行业内对本病进行了大量深入研究并取得了显著成绩,但由于该病发病机制复杂且未完全明确,常常难以取得令人满意的临床疗效。谢胜教授从医30余载,带领团队致力于中医病机在疾病预测、预防及治疗方面的研究,提出救治急危重症的“中西医病机融通”理论观点,并基于该理论观点从“肠痹”论治脓毒症胃肠损伤,获得良效。Abstract: Septic-induced intestinal injury is a complication avoided by sepsis, and it is also the initial link of multiple organ dysfunction syndrome. Improving the intestinal mortality of patients is of great significance in improving the success rate of sepsis treatment. However, because of the complexity of the pathogenesis of the disease is not completely clear, the clinical efficacy is not satisfactory, and even some patients have further deteriorated. Professor XIE Sheng has more than 30 years of medical experience. He leads our team, which is dedicated to exploring and researching TCM pathogenesis in disease prediction, prevention, and treatment. He has proposed a theoretical viewpoint of "integration of TCM and Western medicine pathogenesis" in the treatment of acute and critical cases. Treating sepsis-induced intestinal injury from" Chang-Bi" based on the integration of Chinese and Western medicine theory obtains good results.
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[1] Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J]. Lancet, 2020, 395(10219): 200-211. doi: 10.1016/S0140-6736(19)32989-7
[2] Garcia-Rodriguez JF, Marino-Callejo A. The factors associated with the trend in incidence of Bacteraemia and associated mortality over 30 years[J]. BMC Infect Dis, 2023, 23(1): 69. doi: 10.1186/s12879-023-08018-0
[3] Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations[J]. Am J Respir Crit Care Med, 2016, 193(3): 259-272. doi: 10.1164/rccm.201504-0781OC
[4] Königsrainer I, Türck MH, Eisner F, et al. The gut is not only the target but a source of inflammatory mediators inhibiting gastrointestinal motility during sepsis[J]. Cell Physiol Biochem, 2011, 28(4): 753-760. doi: 10.1159/000335769
[5] 邱实, 秦秉玉. ICU脓毒症病人肠道功能与院内30 d死亡的关系[J]. 青岛大学学报(医学版), 2023, 59(2): 226-231. doi: 10.11712/jms.2096-5532.2023.59.064
[6] Chang H, Li S, Li Y, et al. Effect of sedation with dexmedetomidine or propofol on gastrointestinal motility in lipopolysaccharide-induced endotoxemic mice[J]. BMC Anesthesiol, 2020, 20(1): 227. doi: 10.1186/s12871-020-01146-z
[7] Klingensmith NJ, Coopersmith CM. The Gut as the Motor of Multiple Organ Dysfunction in Critical Illness[J]. Crit Care Clin, 2016, 32(2): 203-212. doi: 10.1016/j.ccc.2015.11.004
[8] Cao Q, Liu Y, Wu Y, et al. Profilin 2 promotes growth, metastasis, and angiogenesis of small cell lung cancer through cancer-derived exosomes[J]. Aging(Albany NY), 2020, 12(24): 25981-25999.
[9] 谢胜, 刘园园, 张丽敏, 等. 从"五痹"切入探讨危急重症的中西医病机融通与组方思路[J]. 广西科学, 2022, 29(6): 1021-1025.
[10] 张登本. 对《黄帝内经》所论之"痹病"及其意义的探讨[J]. 中医药通报, 2020, 19(5): 1-3.
[11] 王妍曦, 桑希生. 基于《黄帝内经》对"痹"内涵及痹病分类的认识[J]. 中国中医基础医学杂志, 2021, 27(6): 916-917, 1010.
[12] 张雨婷, 范骏. 免疫紊乱: 与肠道相关的脓毒症病理机制[J]. 南昌大学学报(医学版), 2023, 63(4): 85-89.
[13] 施荣, 王倩, 熊旭东. 炎调方治疗脓毒症致急性胃肠损伤的可行性探讨[J]. 医学争鸣, 2018, 9(4): 48-51.
[14] 汪海东, 冯强, 楼旭丹, 等. 中医学"火"的现代理解概说[J]. 中医杂志, 2016, 57(23): 2052-2056.
[15] 胡英山, 王晶晶, 高红梅. 脓毒症相关肠道功能障碍发病机制的研究进展[J]. 天津医药, 2023, 51(3): 333-336.
[16] 上海市中西医结合学会急救专业委员会, 上海市中西医结合学会重症医学专业委员会, 上海市医师协会急诊科医师分会, 等. 脓毒症急性胃肠功能障碍中西医结合临床专家共识[J]. 中华危重病急救医学, 2022, 34(2): 113-120. doi: 10.3760/cma.j.cn121430-20211216-01880
[17] 李仪琳, 姬航宇, 张润顺, 等. 基于脾胃气化内涵探讨中医药对肠黏膜屏障的保护作用[J]. 中国中西医结合消化杂志, 2023, 31(10): 816-820. doi: 10.3969/j.issn.1671-038X.2023.10.17
[18] 范骏. 肠道黏膜免疫[J]. 国际免疫学杂志, 2006, 29(2): 111-115.
[19] 张安琪, 万瑾毅, 姚海强. 基于"脾主为卫"探讨肠道黏膜免疫在痰湿体质调体干预中的作用机制及临床应用[J]. 北京中医药大学学报, 2023, 46(2): 159-163.
[20] Nedeva C. lnflammation and cell death of the innate and adaptive immune system during sepsis[J]. Biomolecules, 2021, 11(7): 1011.
[21] 孙慧慧, 罗嗣雄, 刘永芳, 等. 基于"脾为之卫"理论探讨肠道黏膜免疫与类风湿关节炎的中医机制[J]. 中医学报, 2021, 36(3): 506-510.
[22] 郭文茜, 王琦, 郭刚, 等. 基于人体肠道菌群探讨"脾为后天之本"[J]. 中华中医药杂志, 2021, 36(9): 5165-5168.
[23] 温永天, 王凤云, 唐旭东, 等. 从肠道菌群探讨"内伤脾胃, 百病由生"的科学内涵[J]. 中华中医药杂志, 2022, 37(8): 4334-4337.
[24] 黄琦, 万强, 刘言薇, 等. 基于"阴火"理论试析动脉粥样硬化炎症机制的中医内涵[J]. 世界科学技术-中医药现代化, 2020, 22(8): 2942-2947.
[25] 潘峻桦, 张晓冉, 孙丽莎, 等. 基于"阴火"理论探讨肠道菌群失调与绝经后骨质疏松的关系[J]. 内蒙古中医药, 2023, 42(10): 131-133.
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