中国药物警戒 ›› 2026, Vol. 23 ›› Issue (7): 721-726.
DOI: 10.19803/j.1672-8629.20250563

• 专家论坛 • 上一篇    下一篇

脓毒症中药药对研究

王璐1, 白颖璐1,2, 张玉雯1, 徐霄龙1,2,3, 刘清泉1,2,3,*   

  1. 1首都医科大学附属北京中医医院急诊危重症诊疗中心,北京 100010;
    2北京市中医药研究所,北京 100010;
    3北京中医药大学中医学院,北京 102488
  • 收稿日期:2025-08-14 出版日期:2026-07-15 发布日期:2026-07-16
  • 通讯作者: *刘清泉,男,主任医师,教授·博导,中西医结合急诊与危重症。E-mail: liuqingquan2003@126.com
  • 作者简介:王璐,女,博士,中医学。
  • 基金资助:
    国家中医药多学科交叉创新团队项目（ZYYCXTD-D-202201）; 国家中医药管理局高水平中医药重点学科建设项目（ZYYZDXK-2023001）; 国家自然科学基金资助项目（82474428）

Drug pairs of traditional Chinese medicine against sepsis

Wang Lu1, Bai Yinglu1,2, Zhang Yuwen1, Xu Xiaolong1,2,3, Liu Qingquan1,2,3,*   

  1. 1Emergency and Critical Care Centre, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China;
    2Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China;
    3College of Traditional Chinese Medicine, Beijing University of Traditional Chinese Medicine, Beijing 102488, China
  • Received:2025-08-14 Online:2026-07-15 Published:2026-07-16

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摘要： 目的 探讨“药证相应”理论指导下,大黄-瓜蒌、黄芪-当归、人参-麦冬3组药对分阶段干预脓毒症的方药功效、药理机制与临床价值,为中医治疗脓毒症提供参考。方法 对脓毒症病程中“热毒”“瘀毒”“正虚”期演变,早期选用清热解毒、通腑泄热的大黄-瓜蒌;进展期选用活血通络、扶助正气的黄芪-当归;晚期选用扶正固本、益气养阴的人参-麦冬,系统观察其临床疗效并整合药理研究。结果 大黄-瓜蒌、黄芪-当归、人参-麦冬3组药对可通过多靶点、多途径等方式有效抑制炎症、氧化应激、细胞凋亡,调节免疫及凝血功能,从而显著缓解患者发热、寒战、心慌、气促、意识障碍等临床症状,降低APACHE Ⅱ及SOFA评分,缩短住院时长,提高患者生存率。结论 基于“药证相应”理论的中药药对治疗,契合脓毒症“分层精准干预”的治疗需求,在不同病程阶段可多点截断脓毒症炎症-免疫-凝血-多器官功能障碍,为临床治疗提供参考。

关键词: 药证相应, 脓毒症, 大黄-瓜蒌, 黄芪-当归, 人参-麦冬, 药对, 药理作用, 临床应用

Abstract: Objective To explore the therapeutic efficacy, pharmacological mechanisms, and clinical value of three herbal pairs (Radix et Rhizoma Rhei-Fructus Trichosanthis Radix Astragali-Radix Angelicae Sinensis Radix et Rhizoma Ginseng-Radix Ophiopogonis) in the staged intervention of sepsis based on the “herbal-syndrome correspondence” theory in order to provide new therapeutic strategies for treating sepsis with TCM. Methods Given the evolution of heat toxicity through stasis toxicity to deficiency of positive qi in the course of sepsis, Rhubarb and Fructus Trichosanthis were selected in the early stage to clear heat, remove toxins and drain heat from organs. In the progressive stage, Astragali and Angelicae Sinensis were used to activate blood circulation and enhance vital qi. In the late stage, Ginseng and Ophiopogon japonicus were used to consolidate vital qi and strengthen the root of qi and nourish yin. Results The three herbal pairs, Radix et Rhizoma Rhei-Fructus Trichosanthis, Radix Astragali-Radix Angelicae Sinensis, Radix et Rhizoma Ginseng-Radix Ophiopogonis could effectively inhibit inflammation, oxidative stress, apoptosis, and regulate immunity and coagulation through multi-targets and multi-channels, which might significantly alleviate the clinical symptoms of fever, chills, panic, shortness of breath, and impaired consciousness of patients, reduce the APACHEⅡand SOFA scores, and shorten hospital stay, and improve the survival of patients. Conclusion The paired herbal therapy based on the theory of “herbal-syndrome correspondence” can meet demands of sepsis treatment for “layered precision intervention” by inhibiting sepsis-induced inflammation, immune dysregulation, coagulation disorders, and multiple organ dysfunction at multiple points indifferent stages of the disease, offering a safe and effective approach.

Key words: Medicinal Evidence Correspondence, Sepsis, Radix et Rhizoma Rhei-Fructus Trichosanthis, Radix Astragali-Radix Angelicae Sinensis, Radix et Rhizoma Ginseng-Radix Ophiopogonis, Drug Pair, Pharmacological Effect, Clinical Application

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