从“不通则痛”探讨急性胰腺炎中西医病机认识
TCM and Western medicine understandings of pathogenesis of acute pancreatitis based on "obstruction causes pain"
- 现代中医临床 2022年29卷第6期 页码：20-25
- 作者机构：
四川大学华西医院 成都 610000
- 作者简介：
林娟，女，在读硕士生
#夏庆，男，硕士，主任医师，博士生导师，E-mail: xiaqing@medmail.com.cn
- 基金信息：国家自然科学基金项目(82104598)
DOI：10.3969/j.issn.2095-6606.2022.06.005
中图分类号： R256.33纸质出版日期：2022-11-30，
收稿日期：2022-04-01，
- 稿件说明：
移动端阅览
林娟, 韩晨霞, 姜坤, 等. 从“不通则痛”探讨急性胰腺炎中西医病机认识[J]. 现代中医临床, 2022,29(6):20-25.
LIN Juan, HAN Chenxia, JIANG Kun, et al. TCM and Western medicine understandings of pathogenesis of acute pancreatitis based on "obstruction causes pain"[J]. Modern Chinese Clinical Medicine, 2022,29(6):20-25.
林娟, 韩晨霞, 姜坤, 等. 从“不通则痛”探讨急性胰腺炎中西医病机认识[J]. 现代中医临床, 2022,29(6):20-25. DOI： 10.3969/j.issn.2095-6606.2022.06.005.
LIN Juan, HAN Chenxia, JIANG Kun, et al. TCM and Western medicine understandings of pathogenesis of acute pancreatitis based on "obstruction causes pain"[J]. Modern Chinese Clinical Medicine, 2022,29(6):20-25. DOI： 10.3969/j.issn.2095-6606.2022.06.005.
摘要
剧烈上腹部疼痛作为急性胰腺炎(acute pancreatitis
AP)的诊断标准之一，与患者的临床结局指标和主观体验密切相关。越来越多的临床和基础研究证实，疼痛作为AP损伤早期事件，可能参与疾病发展。传递疼痛的外周神经在局部促进炎症因子的合成与释放，进而通过介导神经源性炎症加重胰腺损伤，与中医“不通则痛，痛则不通”以及AP “邪郁-热盛-气闭”的病机演变规律不谋而合，从疼痛角度阐述神经系统参与AP发生发展的相关机制、梳理中医病机理论内涵，并总结临床相关治疗证据加以佐证。
Abstract
Severe upper abdominal pain
as one of the diagnosis criterions of acute pancreatitis (AP)
is closely related to the clinical outcomes and subjective feelings of patients. Elevated evidence of clinical and basic studies indicated that pain
as an early event
may relate to the development and severity of AP. Pancreatic nerve transmits sensory information and enhances the synthesis and release of local inflammatory cytokines
a process called neurogenic inflammation
which may aggravate the damage to the pancreas. This process is coincided with the pathogenesis of "pathogen constraint-excessive heat-qi block" in AP and the "obstruction causes pain" theory in TCM. The authors illustrated the role of neural mechanism in AP
also the TCM pathogenesis of the disease and related clinical evidence.
关键词
急性胰腺炎不通则痛中西医病机
Keywords
acute pancreatitisobstruction causes painintegrated traditional Chinese and western medicinepathogenesis
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