世界中医药
世界中醫藥
세계중의약
WORLD CHINESE MEDICINE
2014年
3期
291-295
,共5页
脓毒症%肝损伤%中医药
膿毒癥%肝損傷%中醫藥
농독증%간손상%중의약
Sepsis%Liver injury%Traditional Chinese Medicine
脓毒症是严重感染或创伤后常见的并发症,可造成多器官功能障碍,肝损伤是脓毒症常见的并发症,并且在脓毒症向多器官功能障碍的发展过程中作为一个非常重要的环节。脓毒症相关肝损伤的发病率较高,对脓毒症的预后具有特异性的预警作用,可以作为独立的危险因素。脓毒症相关肝损伤的发病机制,主要是炎性因子释放导致的肝细胞功能障碍,包括肝细胞的坏死和凋亡、再生障碍、微循环障碍、能量代谢障碍等。肝脏Kupffer细胞在肝细胞损害和肝功能障碍中具有重要的调控作用,肝星形细胞也参与了这一过程。脓毒症合并肝损伤主要表现为血清转氨酶和碱性磷酸酶的升高以及轻至中度高胆红素血症。脓毒症相关肝损伤属于中医学理论中热毒症的范畴,属于急黄。 Kupffer细胞在发病机制中的重要作用,应该属于三焦的范畴,因此,清利三焦应该作为本病的重要治法。
膿毒癥是嚴重感染或創傷後常見的併髮癥,可造成多器官功能障礙,肝損傷是膿毒癥常見的併髮癥,併且在膿毒癥嚮多器官功能障礙的髮展過程中作為一箇非常重要的環節。膿毒癥相關肝損傷的髮病率較高,對膿毒癥的預後具有特異性的預警作用,可以作為獨立的危險因素。膿毒癥相關肝損傷的髮病機製,主要是炎性因子釋放導緻的肝細胞功能障礙,包括肝細胞的壞死和凋亡、再生障礙、微循環障礙、能量代謝障礙等。肝髒Kupffer細胞在肝細胞損害和肝功能障礙中具有重要的調控作用,肝星形細胞也參與瞭這一過程。膿毒癥閤併肝損傷主要錶現為血清轉氨酶和堿性燐痠酶的升高以及輕至中度高膽紅素血癥。膿毒癥相關肝損傷屬于中醫學理論中熱毒癥的範疇,屬于急黃。 Kupffer細胞在髮病機製中的重要作用,應該屬于三焦的範疇,因此,清利三焦應該作為本病的重要治法。
농독증시엄중감염혹창상후상견적병발증,가조성다기관공능장애,간손상시농독증상견적병발증,병차재농독증향다기관공능장애적발전과정중작위일개비상중요적배절。농독증상관간손상적발병솔교고,대농독증적예후구유특이성적예경작용,가이작위독립적위험인소。농독증상관간손상적발병궤제,주요시염성인자석방도치적간세포공능장애,포괄간세포적배사화조망、재생장애、미순배장애、능량대사장애등。간장Kupffer세포재간세포손해화간공능장애중구유중요적조공작용,간성형세포야삼여료저일과정。농독증합병간손상주요표현위혈청전안매화감성린산매적승고이급경지중도고담홍소혈증。농독증상관간손상속우중의학이론중열독증적범주,속우급황。 Kupffer세포재발병궤제중적중요작용,응해속우삼초적범주,인차,청리삼초응해작위본병적중요치법。
Sepsis is a common complications after serious infection or trauma ,sepsis can cause multiple organ dysfunction.Liver injury is a common complication of sepsis ,and play a very important link in the process of the development of multiple organ dysfunction.Sepsis related liver injury have higher incidence ,is a characteristic early warning indicators for the prognosis of sepsis ,can be used as an inde-pendent risk factor.In the pathogenesis of sepsis related liver damage is mainly caused by inflammatory cytokines released hepatocellular dysfunction,including liver cell necrosis and apoptosis,regeneration barrier,microcirculation,energy metabolic disorders,etc.Liver Kupffer cells plays an important regulatory role in the liver cell injury and liver dysfunction ,hepatic stellate cells also involved in this process.Sepsis combined liver injury mainly show elevated serum aminotransferase and alkaline phosphatase ,and mild to moderate high blood bilirubin.Sepsis related liver injury belongs to the category of disease of toxic heat in TCM theory ,belong to the emergency and vio-lation of jaundice.Important role in the pathogenesis of Kupffer cells , belongs to the category of the sanjiao ( triple energizer ) disease.Therefore,clear the sanjiao(triple energizer)should be as an important treatment of the disease .