[1]余 欢,蔡 萌,王孟清,等.从“风痰瘀虚”辨析儿童难治性肺炎支原体肺炎细胞因子风暴[J].陕西中医,2025,46(1):80-83,87.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.017]
 YU Huan,CAI Meng,WANG Mengqing,et al.Analysis of the cytokine storm of refractory mycoplasma pneumoniae pneumonia in children from the perspective of “Wind-phlegm and stasis-deficiency”[J].,2025,46(1):80-83,87.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.017]
点击复制

从“风痰瘀虚”辨析儿童难治性肺炎支原体肺炎细胞因子风暴
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年1期
页码:
80-83,87
栏目:
学术探讨
出版日期:
2025-01-05

文章信息/Info

Title:
Analysis of the cytokine storm of refractory mycoplasma pneumoniae pneumonia in children from the perspective of “Wind-phlegm and stasis-deficiency”
作者:
余 欢1蔡 萌2王孟清1帅云飞1
(1.湖南中医药大学第一附属医院 湖南中医药大学中医学国内一流建设学科,湖南 长沙 410007; 2.南方医科大学珠江医院儿科中心,广东 广州 510280)
Author(s):
YU HuanCAI MengWANG MengqingSHUAI Yunfei
(The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)
关键词:
难治性肺炎支原体肺炎 肺炎支原体感染 细胞因子风暴 儿童 辨证论治
Keywords:
Refractory mycoplasma pneumoniae pneumonia Mycoplasma pneumoniae infection Cytokine Storm Children Syndrome differentiation
分类号:
R 563.12
DOI:
DOI:10.3969/j.issn.1000-7369.2025.01.017
文献标志码:
A
摘要:
难治性肺炎支原体肺炎(RMPP)常由肺炎支原体肺炎进展而来,儿童发病率逐年升高,临床上迁延不愈容易并发多器官损伤。中医药辨治该病有一定优势,重归经典,与本病病理变化结合,提出细胞因子风暴是导致肺系重症症候群的主要原因,其特点与风温之邪致病相类,痰瘀为病进之主因,虚象显现于疾病始末。现以“风痰瘀虚”为总纲,阐述儿童RMPP细胞因子风暴之治则治法,当分三期:细胞因子风暴前驱期,宣泻结合以平温热; 风暴爆发期,化瘀逐痰以通肺络; 细胞因子风暴缓解期,健脾益肺以养气阴,当灵活遣用方药,并结合中医外治之法以进一步提升疗效。
Abstract:
Refractory mycoplasma pneumoniae pneumonia(RMPP)often arises from misdiagnoses or inadequate treatments of mycoplasma pneumoniae pneumonia(MPP).The incidence rate among children is escalating annually,and if left untreated,it can lead to multi-organ damage.Traditional Chinese medicine offers potential benefits in treating this disease by revisiting classical methods and aligning them with the pathological changes observed in the disease.It suggests that a cytokine storm is the primary cause of severe pulmonary syndrome.This storm shares similarities with the pathogenesis induced by the evils of Wind-warmth and phlegm-stasis,with Deficiency manifesting at both the onset and conclusion of the disease.Based on the overarching framework of “Wind-phlegm and stasis-deficiency”,the treatment for pediatric RMPP cytokine storm is divided into three phases:the prodromal stage,which requires catharsis to clear heat and dampness; the outbreak stage,during which stasis resolving and phlegm expelling should be used to unblock the lung collaterals; and the remission phase,during which strengthening the spleen and lungs to nourish qi and yin is emphasized.Prescription drugs are judiciously used in conjunction with external traditional Chinese medicine techniques to improve clinical outcomes.

参考文献/References:

[1] 穆世茵,邹映雪,郭永盛,等.儿童难治性肺炎支原体肺炎的危险因素及其预测效能[J].山东医药,2024,64(23):11-15.
[2] 张新星,顾文婧,陈正荣,等.2011-2015年苏州地区儿童难治性肺炎支原体肺炎流行病学分析[J].儿科药学杂志,2019,25(8):7-10.
[3] 杨勇,崔巍,王利东,等.小儿难治性肺炎支原体肺炎高危因素分析[J].陕西医学杂志,2010,39(11):1498-1500.
[4] 吴春兴,焦广,郭杰.国内细胞因子风暴研究的趋势及热点探讨[J].西安文理学院学报(自然科学版),2024,27(3):56-64.
[5] CHANNAPPANAVAR R,PERLMAN S.Pathogenic human coronavirus infections:Causes and consequences of cytokine storm and immunopathology[J].Semin Immunopathol,2017,39(5):529-539.
[6] 甄建华,于河,谷晓红.细胞因子风暴中医辨证要点解析[J].北京中医药大学学报,2023,46(6):763-769.
[7] 戴林欣,谢静.儿童难治性肺炎支原体肺炎常见临床问题的中医对策[J].南京中医药大学学报,2023,39(8):720-727.
[8] 许鑫松,袁琛,李刚.儿童难治性肺炎支原体肺炎早期识别指标的研究[J].中国现代医生,2024,62(17):13-16.
[9] 刘月梅,张磊,赵二要,等.小儿难治性肺炎支原体肺炎临床特征及免疫机制研究[J].中国中西医结合儿科学,2021,13(1):21-24.
[10] PODDIGHE D.Extra-pulmonary diseases related to Mycoplasma pneumoniae in children:Recent insights into the pathogenesis[J].Curr Opin Rheumatol,2018,30(4):380-387.
[11] 李艳娇,李焕敏,孙丹,等.基于网络药理学和分子对接技术探究柴胡-葛根治疗肺炎支原体肺炎引起发热的作用机制[J].云南中医学院学报,2020,43(6):69-78.
[12] OSTERHOUT J A,KAPOOR V,EICHHORN S W,et al.A preoptic neuronal population controls fever and appetite during sickness[J].Nature,2022,606(7916):937-944.
[13] MARGETIE S.Inlfammation and haemostasis[J].Biochem Med,2012,22(1):49-62.
[14] TAKAHASHI I,ISHIHARA M,OISHI T,et al.Common carotid arteritis and polymyalgia with mycoplasma pneumoniae infection[J].J Infect Chemother,2019,25(4):281-284.
[15] 李智强,黄剑明,周畅军,等.重症肺炎患者肠道菌群变化及其与免疫功能的关系[J].山东医药,2023,63(11):15-18.
[16] 薛庆辉,安玉凤.难治性肺炎支原体肺炎患儿外周血PCT、DD及IL-17水平的检测意义[J].保健医学研究与实践,2022,19(7):59-62.
[17] 刘恩顺,孙增涛,苏景深,等.ARDS“肺肠同病”的病理特征与通腑泻肺中药作用机制的实验研究[J].世界中医药,2014,9(4):415-417,421.
[18] 吕义良,王晓,张葆青.祛湿开窍法治疗难治性肺炎支原体肺炎医案1则[J].中国民间疗法,2024,32(5):89-92.
[19] 张祺嘉钰,孙毅,张恩户,等.清瘟败毒饮治疗感染性疾病的实验及其临床研究[J].海峡药学,2015,27(5):99-100.
[20] 曲晓红.千金苇茎汤加减方治疗小儿肺炎支原体肺炎(痰热闭肺证)的疗效及对血清因子的影响[J].中华养生保健,2024,42(1):30-33.
[21] 刘静,史艳平,赵珍珍,等.清肺疏络饮对肺炎支原体肺炎小鼠治疗机制研究[J].陕西中医,2023,44(3):290-293.
[22] 刘永生,王金菊,张辉果.沙参麦冬汤加减对阴虚肺热证肺炎支原体肺炎恢复期患者免疫炎症反应的影响[J].中国实验方剂学杂志,2020,26(21):149-154.
[23] 杨爱君,崔红,姚燕青.小儿难治性肺炎支原体肺炎的中西医结合诊治进展[J].中国医刊,2014,49(12):24-27.
[24] 樊晶晶,谢静.穴位贴敷辅助治疗小儿肺炎支原体肺炎有效性及安全性的Meta分析[J].中医临床研究,2024,16(15):56-62.
[25] 李艳玲,宋涛,隋勇,等.中西医结合治疗小儿难治性肺炎支原体肺炎的安全性观察[J].世界中西医结合杂志,2016,11(1):77-79.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(82174437); 湖南省自然科学基金资助项目(2020JJ4478); 湖南省卫生健康委员会科研计划项目(20200289); 湖南中医药大学中医儿科学湖南省“双一流”学科建设项目(4912-0005001010)
更新日期/Last Update: 2025-01-09