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1.河南中医药大学,郑州 450000
2.河南中医药大学 第一附属医院,郑州 450003
Published:05 September 2023,
Published Online:27 September 2022,
Received:21 May 2022,
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沙俊生,张楠,孙维义等.大承气汤在脓毒症治疗中的相关研究进展[J].中国实验方剂学杂志,2023,29(17):274-282.
SHA Junsheng,ZHANG Nan,SUN Weiyi,et al.Da Chengqitang in Treatment of Sepsis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(17):274-282.
沙俊生,张楠,孙维义等.大承气汤在脓毒症治疗中的相关研究进展[J].中国实验方剂学杂志,2023,29(17):274-282. DOI: 10.13422/j.cnki.syfjx.202202222.
SHA Junsheng,ZHANG Nan,SUN Weiyi,et al.Da Chengqitang in Treatment of Sepsis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(17):274-282. DOI: 10.13422/j.cnki.syfjx.202202222.
脓毒症是由感染等诱因发展而来的系统性炎症反应综合征,全球每年罹患人数冲破千万;其病理生理机制繁杂,常伴内毒素移位与胃肠道功能紊乱、炎性因子激活与免疫失调、凝血紊乱、多脏器功能受损等诸多机体失衡,且包含全身炎症反应、细胞凋亡、细胞氧化应激损伤等细胞受损机制;其诊治难度大、预后差,是沉重的医疗负担。中医与西医对脓毒症的诊治都进行了长足的探索。由于抗生素耐药与激素滥用问题凸显及高昂的医疗费用传递给医患双方的压力,使得西医在脓毒症诊治方面价值有限。祖国医学将脓毒症这一病证归于“温病”“伤寒”范畴。大承气汤为《伤寒论》中应对阳明腑实证的经典方剂,现代医学证实其具有在增进胃肠动力、调节肠道微生态基础上进一步发挥抗氧化应激、降低炎症水平、延缓细胞凋亡等功效。鉴于以往理论基础及大量用药经验,医家提出用大承气汤复方联合西药在注重“整体观”的基础上对脓毒症开展“菌毒并举,标本兼治”等新的治疗理念,现已将该组方广泛应用于临床。该文就与大承气汤相关经典研究、最新发现及其在脓毒症治疗中的确切表现为着手点进行综述,以期进一步明确该组方辅助治疗脓毒症的机制、优势,并发掘其潜在功效,为今后其在临床上的推广提供更及时、更充分、更科学的理论支撑。
Sepsis is a systemic inflammatory syndrome induced by infection and other factors, with the number of patients worldwide exceeding 10 million each year. The pathophysiological mechanism is of this disease complex. Sepsis is often accompanied by endotoxin translocation, gastrointestinal dysfunction, inflammatory cytokine activation, immune dysregulation, coagulation disorder, multiple organ function impairment and many other body imbalances, as well as systemic inflammation, apoptosis, oxidative stress injury and other cell damage mechanisms. This disease causes a heavy medical burden due to the difficult diagnosis and treatment and the poor prognosis. Great progress has been achieved in the diagnosis and treatment of sepsis with traditional Chinese medicine (TCM) and western medicine. The value of western medicine in the diagnosis and treatment of sepsis is limited due to antibiotic resistance, hormone abuse, and high medical costs. Sepsis is classified as a warm disease or typhoid fever in TCM. Da Chengqitang is a classical formula in the
Treatise on Typhoid Fever
to deal with the excess syndrome of Yang brightness Fu-organ. Modern medicine has proved that Da Chengqitang has the effect of inhibiting oxidative stress, reducing inflammation, and delaying apoptosis by improving gastrointestinal dynamics and regulating intestinal microecology. On the basis of the previous theoretical basis and the rich experience in the medication, medical practitioners have proposed a new therapeutic concept of using Da Chengqitang in combination with western drugs from a holistic view involving both bacteria and toxicity for treating both the symptoms and the root cause, which has a wide range of application. The article reviews the classical research and latest findings of Da Chengqitang in the treatment of sepsis, with a view to clarifying the mechanism and advantages of this formula in the adjuvant treatment of sepsis, exploring its potential efficacy, and providing timely, adequate, and scientific theoretical support for the promotion of this formula in the clinical practice.
大承气汤脓毒症研究进展中西医联合炎症氧化应激凋亡
Da Chengqitangsepsisresearch progressintegrated Chinese and western medicineinflammationoxidative stressapoptosis
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