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中医药研究与应用2025年第1卷第2期第41-45页,pISSN 3080-7670、eISSN 3080-7689 发布者:Quest Press 发布日期:2026/1/22
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中西结合论泻法在ICU中的应用


陈海侠

天津中医药大学附属武清中医院,天津,301700

摘要:泻法又称为泻下法、下法,是中医治病八法中的一种,拥有丰富的理论渊源,应用拥有泻下功用的中药,通过多种给药途径,达到疏通大便,使积滞排除,荡涤其实热,实现攻逐水饮之目的。急性脑血管病,中风,缘于阴阳失衡,脏腑之功能失调,气血现逆乱,上行于脑。肠-脑轴干预神经递质合成及分泌,影响大脑的内分泌、神经、免疫功能,使血压波动,促发脑血管病。予泻之通腹气,引邪出,降阳明,引气血下行,下潜亢阳,邪便不上扰神明。且急下存阴,减少其他变证。通过泻下调节凝血,使血小板疏散,稀释血液,改善大脑血流,促神经功能恢复,内毒素清除。通过“肠-胰轴”研究,肠道激素通过促进胰高血糖素的分泌,可以调节血糖,肠道中的酶,能加剧胰腺炎的进展,肠道的屏障功能受肠道微生态影响,菌群失调引起黏膜通透性增加,菌群易位,加速疾病进展。胰-肠关系在胰腺疾病发生、发展过程中,起着非常重要的作用。通过内、外及针灸综合治疗方法可有效控制病情。肺和大肠相互影响,肺燥热可以损伤大肠的津液,使大便干硬,通下促进排便,清除毒素,减少肠内炎症介质。炎症因子过度激活,导致肠屏障功能损伤,通透性增加,毒素通过淋巴系统进入肺、体循环,加速脏器损伤。经泻法清除致病菌群,维护肠壁功能,促进疾病恢复。在ICU急危重患者的医治中发挥着极其重要的作用,现将泻下法在ICU常见病中的应用做概述。

关健词:泻法;急性脑血管病;重症肺炎;重症急性胰腺炎
The application of integrated Chinese Westerntheory of laxativetherapy in Intensive Care Unit

Haixia Chen

Intensive Care Unit,Tianjin University of Traditional Chinese Medicine Affiliated Wuqing Hospital,Tianjin301700,China

Abstract:Catharsis,also know as the catharsis and descent,one of the eight diseases of TCM treatment.Drug use is flooded with ammonites,through a variety of approaches to achieve general guide shit in chuhe cleansed real hot,drink of attack by water.Acute cerebrovascular disease, stroke, is caused by the imbalance of yin and yang, the dysfunction of visceral organs, and the abnormal fluctuation of qi and blood, which ascends to the brain.Intervention on the gut-brain axis affects the synthesis and secretion of neurotransmitters, influencing the endocrine,nervous,and immune functions of the brain. This can lead to fluctuations in blood pressure and contribute to the development of cerebrovascular disease.This purgative is effective in relieving abdominal discomfort, expelling pathogenic factors, baancing the yin and yang energies, and acilitating the downward movement of qi and blood. By doing so, it subdues excessive energy and prevents it from disturbing the mind and spirit.And it is urgent to alleviate the retention of dampness and reduce the occurrence of other complications. By purging the bowels, blood coagulation is regulated, platelets are dispersed, bloodis diluted, cerebral blood flow is improved, neural function recoveryis promoted, and endotoxins are eliminated.Through the study of the gut-pancreas axis, gut hormones can regulate blood sugar levels by promoting the secretion of glucagon.Enzymes in the gut can exacerbate the progression of pancreatitis. The function of the gut barrier is influenced by the gut microbiome.An imbalanceof the microbial community leads to increasedmucosal permeability and the translocation ofmicroorganisms, which accelerates the progression of the disease.The relationship between the pancreas and theintestines plays a very important role in the occurrence and development of pancreatic diseases.Comprehensive treatment methods including internal, external, and acupuncture can effectively controlthe disease.The lungs and large intestine have a mutual influence on each other.The dryness and heat in the lungs can damage the fluid in the large intestine, leading to dry and hard stools.Activating the passageto promote bowel movements can help remove toxins and reduce the amount ofinflammatory mediators in the intestines.When inflammatory factors are overactivated, it can result in damage to the intestinal barrier function,increased permeability, and the entry of toxins through the lymphatic system into the pulmonary circulation and systemic circulation, acceleratingdamage to the organs. By using laxative methods to eliminate pathogenic microbial colonies,maintaining the function of the intestinal wall.and promoting recovery from the disease.It plays an important role in the treatment of severe patients with ICU.


Keywords : Purgation;Acute cerebrovascular disease;Severe pneumonia; Severe acute pancreatitis


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[3] 徐建昭,马岩石,王丹萍,等.基于微生物-肠-脑”轴的肠道菌群参与抑郁症相关研究进展[J].食品科学,2023,44(05):383-391.
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