【摘要】内毒素性肺损伤为临床上常见危急病症，中医学根据其临床表现将其归为“喘脱”、“暴喘”、“温病”等范畴，其多因外邪犯肺、肺失宣降、痰热阻肺、致肺通调水道功能失司所致。现代研究发现中药治疗内毒素性肺损伤具有一定优势，主要从抑制内毒素诱发的细胞因子或炎性因子的释放、改善微循环和血液流变性、调节免疫功能等方面发挥作用。笔者通过回顾近20年国内外文献，从内毒素性肺损伤产生的机制及中药复方治疗的现状，进行文献分析和总结，为中药应用于内毒素所致肺损伤的防治应用提供一定药理学依据。
【关键词】中药复方；内毒素性肺损伤；研究进展
【中图分类号】R2856【文献标志码】 A【文章编号】1007-8517（2017）04-0064-08
Progress in the Treatment of Lung Injury Induced by Endotoxin-Using Traditional Chinese MedicineWEN TaoqunWANG XueWANG FengXU FengSANG WentaoZENG Nan*
College of Pharmacy，Chengdu University of Traditional Chinese Medicine， Education Key Laboratory of Standardization of
ChineseHerbal Medicine， Key Laboratory of Systematic Research， Development and Utilization of Chinese Medicine
Resources in Sichuan Province-Key Laboratory Breeding Base Co-founded by
Sichuan Province and MOST，Chengdu 611137，ChinaAbstract：Endotoxin-induced lung injury is a common clinical critical illness，it is classified as “asthma off”，“storm surge”，“febrile disease” and other areas according to their clinical performance in the Traditional Chinese Medicine，Which usually caused by exogenous pathogen invading lung， leading the impairment of dispersing and descending function of the lung，ang then phlegm heat in lung， causing the function of lung dredging and regulating water passage lost. Modern studies have found that the traditional Chinese medicine has some advantages in treatment of endotoxin-induced lung injury， Such as inhibiting the release of cytokines or inflammatory factors induced by endotoxin， improvement of microcirculation and hemorheology and adjusting the immune function， etal.The author reviews the literatures of nearly 20 years， the arising mechanisms and traditional Chinese medicine treatment on endotoxin-induced lung injury was analyzed and summered， which provide a pharmacological basis for using Chinese medicine to treatment of lung injury induced by endotoxin.
Keywords：Traditional Chinese Compound Prescription； Endotoxin-Induced Lung Injury；The Advance
內毒素是革兰阴性细菌细胞壁外膜组成成分，主要为脂多糖（Lipopolysaccharides，LPS），是细菌致病的主要物质，能诱发多种危急重病症。内毒素性肺损伤属于许多疾病的并发症，临床表现有弥漫性肺血管内皮细胞及肺泡损伤、肺组织水肿及肺不张等病理特征，细胞水平上表现有中性粒细胞、单核细胞等炎性细胞的浸润和募集表现；分子水平上表现为多种炎性因子或介质的过度释放，促炎抗炎反应失衡。传统中医学中对内毒素性肺损伤无相关记载，但依据该病症的临床表现，将其归属于中医学中“温病”、“喘脱”、“暴喘”等范畴，主因感染外邪（如六淫、外伤、邪毒、病气）等，邪毒伤肺所致。目前研究发现，中药复方在防治内毒素性肺损伤方面具有一定的优势，临床与实验研究报道日益增多。中药复方主要通过清热解毒、通腑泻下、活血化瘀、补益回阳救逆等功效发挥对内毒素性肺损伤的治疗作用，现总结如下。
1内毒素性肺损伤的主要病理生理机制
多种因素可导致肺损伤，但绝大多数是由内毒素引起，LPS能引起直接或间接损伤，后者主要包括炎症反应失衡、促凝/抗凝系统失衡、氧化/抗氧化失衡、细胞凋亡等，致使炎性介质释放失控，毛细血管通透性增加，中性粒细胞浸润并聚集在损伤部位，引发一系列症状。