ICU危重病人非心源性心肌损伤中医辨证分型分布研究的综述报告

ICU危重病人非心源性心肌损伤中医辨证分型分布研究的综述报告ICU(IntensiveCareUnit)isaspecializedmedicaldepartmentthatprovidesextensivecareforseverelyillpatients.Amongthevariousdiseasesthatcausecriticalillness,non-cardiogenicmyocardialinjury(NCMI)isalife-threateningdisorderthatcanleadtoseveralcomplicationsandhighmortalityrate.Thisconditioncanbecausedbyvariousfactors,includingsepsis,trauma,drugtoxicity,andothers.TraditionalChineseMedicine(TCM)hasbeenusedtotreatcriticalillness,includingNCMI,forseveralcenturies.OneoftheessentialaspectsofTCMtreatmentistoclassifythepatientsbasedonthesyndromedifferentiation.Inthisarticle,wereviewtheexistingliteraturerelatedtotheTCMdifferentiationofsyndromesinICUpatientswithNCMI.Thereviewwilldiscusstheprevalenceofeachsyndrome,therelatedsymptoms,andthetreatmentapproachesrelatedtoeachcategory.PrevalenceofSyndromeDifferentiationInthemajorityofstudies,themostcommonTCMsyndromedifferentiationforICUpatientswithNCMIisthe'qiandyindeficiencysyndrome.'Thistypeofsyndromeiscommoninpatientswhohaveundergoneseverephysicalandemotionalstressandhaveahistoryofchronicdiseases.Thesepatientsusuallyexhibitsymptomssuchasdrymouth,thirst,fatigue,andpalpitations.The'qistagnationandbloodstasissyndrome'isthesecondmostcommonsyndromeobservedinICUpatientswithNCMI.Patientswiththissyndromeusuallyhavesymptomssuchaschestdiscomfort,coldlimbs,andcyanosis.The'phlegmandbloodstasissyndrome'islesscommonamongICUpatientswithNCMI,butitisstillasignificantdifferentiationobservedinsomepatients.Patientswiththissyndromeusuallyhavesymptomssuchaschesttightness,coughing,andagreasytonguecoating.RelatedSymptomsThe'qiandyindeficiencysyndrome'ischaracterizedbysymptomssuchasfatigue,shortnessofbreath,weaknessofthelimbs,drymouth,andthirst.Thesesymptomsareoftenrelatedtotheexhaustionofthevitalqiandthedepletionofthebodyfluids.Patientswiththissyndromeusuallyhaveapaletonguewiththinwhitecoating.The'qistagnationandbloodstasissyndrome'ischaracterizedbysymptomssuchaschestpain,shortnessofbreath,coldlimbs,andcyanosis.Thesesymptomsarerelatedtothestagnationofqiandtheaccumulationofbloodinthechestarea.Patientswiththissyndromeusuallyhaveadarktonguewithapurplishcolororbruisesonthetongue.The'phlegmandbloodstasissyndrome'ischaracterizedbysymptomssuchaschesttightness,coughing,andagreasytonguecoating.Thesesymptomsarerelatedtotheaccumulationofphlegmandbloodstasisinthechestarea.Patientswiththissyndromeusuallyhaveagreasytonguecoatingandaswollentongue.TreatmentApproachesThetreatmentapproachesforeachTCMsyndromedifferentiationvarydependingontheunderlyingpathology.The'qiandyindeficiencysyndrome'isusuallytreatedbyreplenishingthebodyfluidsandnourishingthevitalqi.Thetreatmentofteninvolvestheuseoftonifyingherbs,suchasRenShen(RadixGinseng)andHuangQi(RadixAstragali).Acupunctureandmoxibustionarealsoeffectiveintreatingthissyndrome.The'qistagnationandbloodstasissyndrome'istreatedbypromotingthecirculationofqiandresolvingbloodstasis.Thetreatmentofteninvolvestheuseofblood-activatingherbs,suchasDanShen(RadixSalviaemiltiorrhizae)andChuanXiong(RhizomaLigusticiChuanxiong).Acupunctureandcuppingtherapyarealsoeffectiveintreatingthissyndrome.The'phlegmandbloodstasissyndrome'istreatedbyresolvingphlegmandpromotingthecirculationofblood.Thetreatmentofteninvolvestheuseofphlegm-resolvingherbs,suchasBaiJieZi(SemenSinapisalbae)andZhiShi(FructusAurantiiimmaturus).Acupunctureandmoxibustionarealsoeffectiveintreatingthissyndrome.ConclusionInconclusion,ICUpatientswithNCMIcanbeclassifiedintodifferentTCMsyndromedifferentiations,andeachdifferentiationhasitssymptomatologyandtreatmentapproaches.The'qiandyindeficiencysyndrome'isthemostcommondifferentiationobservedinICUpatientswithNCMI,whilethe'qistagnationandbloodstasissyndrome'andthe'phlegmandbloodstasissyndrome'arelesscommonbutstillsignificant.TheTCMtreatmentapproachesforeachsyndromedifferentiationdifferdependingontheunderlyingpathology.Acupuncture,moxi