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社区获得性肺炎分期分级中医防治策略及实践

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社区获得性肺炎(CAP)为老年人常见呼吸系统感染性疾病,中医、中西医结合治疗具有疗效优势.根据CAP临床特点,提出CAP感染期、恢复期的分期概念,结合感染期轻症、中症、重症的疾病严重程度提出了分期分级的防治目标和策略.轻中症肺炎以提高治愈率、重症肺炎以降低病死率、恢复期以降低新发上下呼吸道感染事件为主要目标.中医防治策略:轻症肺炎治以疏散外邪,宣降肺气,祛湿化痰或清肺化痰;中症肺炎治以清肺解毒、燥湿化痰,佐以补肺健脾或益气养阴;重症肺炎根据邪实、正虚(脱)的主次,祛邪与扶正有所侧重;恢复期治以扶正为主、佐以祛邪.并开展了相关临床研究进行实践验证,结果说明分期分级的防治策略对提升CAP的诊疗水平具有重要指导价值.
Strategies and Practice of Traditional Chinese Medicine for Prevention and Treatment of Community-Acquired Pneumonia Based on Stages and Severity
Community-acquired pneumonia(CAP)is a common respiratory infectious disease in the elderly,and traditional Chinese medicine(TCM)and integrated TCM and western medicine showed effectiveness.According to the clinical characteristics of CAP,the staging concepts of CAP infection and recovery are proposed,and the pre-vention and treatment goals and strategies of staging and grading are put forward in combination with the disease seve-rity of mild,moderate and severe infections.The main objectives are to increase the cure rate of mild and moderate pneumonia,to reduce the case fatality rate of severe pneumonia,and to reduce the incidence of new upper and lower respiratory tract infections during the recovery period,respectively.TCM prevention and treatment strategies:for mild pneumonia,treatments should scatter and dissipate external pathogens,diffuse and descend lung qi,dispel dampness and dissolve phlegm,or clear lung and dissolve phlegm;for moderate pneumonia,treatments should clear lungs and resolve toxins,dry dampness and dissolve phlegm,and supplementing with tonifying lungs and strengthen spleen,or benefit qi and nourish yin;for severe pneumonia,the treatment of dispelling pathogen and supporting healthy qi should be emphasised according to the primary and secondary levels of excess pathogen and deficiency healthy qi;and for the recovery period,treatments should mainly support healthy qi,and supplement with dispelling pathogen.Relevant clinical studies have been conducted for practical verification,and the results showed that inte-grated TCM and Western medicine treatment can improve the cure rate of mild to moderate pneumonia,decrease the case fatality rate of severe pneumonia,and reduce the re-hospitalisation of pneumonia during the recovery period,indicating that the staged and graded prevention and treatment strategy has important guiding value for improving the diagnosis and treatment of CAP.

community-acquired pneumoniaprevention and treatment strategiesstaged prevention and treatmentgraded prevention and treatment

李建生、王明航

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河南中医药大学呼吸疾病中医药防治省部共建协同创新中心/河南省中医药防治呼吸病重点实验室,河南省郑州市郑东新区金水东路156号,450046

河南中医药大学第一附属医院

社区获得性肺炎 防治策略 分期论治 分级论治

中医药传承与创新"百千万"人才工程岐黄工程首席科学家项目国家中医药传承创新团队项目

国中医药人教字[2021]7号ZYYCXTD-C-202206

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(16)
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