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2015社区获得性肺炎中西医综合治疗指南(2015年上海市基层版)发布

2016-07-15 MedSci MedSci原创

为了进一步完善上海市基层社区中西医综合治疗社区获得性肺炎的诊疗规范,促进中西医综合治疗社区获得性肺炎诊疗水平的提高,上海市中西医结合学会急救专业委员会组织有关专家,在总结近年来上海市各级医院中西医综合治疗社区获得性肺炎经验的基础上,编制了《社区获得性肺炎中西医综合治疗指南》( 2015 年上海市基层版) 。 本指南适用于上海市各社区卫生服务中心或乡镇卫生院的中医全科医师,旨在为上海市基层

为了进一步完善上海市基层社区中西医综合治疗社区获得性肺炎的诊疗规范,促进中西医综合治疗社区获得性肺炎诊疗水平的提高,上海市中西医结合学会急救专业委员会组织有关专家,在总结近年来上海市各级医院中西医综合治疗社区获得性肺炎经验的基础上,编制了《社区获得性肺炎中西医综合治疗指南》( 2015 年上海市基层版) 。
 
本指南适用于上海市各社区卫生服务中心或乡镇卫生院的中医全科医师,旨在为上海市基层社区中西医综合治疗社区获得性肺炎工作提供指导性意见,规范相关的的诊疗工作。
 
社区获得性肺炎( community acquired pneumonia,CAP) 是指在医院外罹患的感染性肺实质( 含肺泡壁,即广义上的肺间质) 炎症,包括具有明确潜伏期的病原体感染而在入院后于潜伏期内发病的肺炎。社区获得性肺炎的病因繁多,以感染最为常见,如细菌、病毒及支原体、真菌、衣原体、立克次体等病原体均可引起。
 
病因病机
 
根据临床表现,社区获得性肺炎可归属于中医学“风温肺热病”范畴,其主要病因病机为感受外邪、肺失宣肃,以及正气内虚、脏腑功能失调、病理产物积聚。
 
①风热或风寒之邪侵犯机体,首先犯肺,引起肺的宣发肃降功能下降,出现咽痛、咳嗽、咯痰等症状。
 
②肺本有伏热,外邪入侵,正气与之相搏,热毒充斥于体内,导致出现高热、口干、口渴等症,甚者出现神昏、出血等危候。
 
③年老体弱或久病宿疾等引起机体正气虚损,脏腑功能失调,导致痰、湿、瘀等病理产物积聚。
 
④痰浊内生,复感外邪,上干于肺,肺气上逆,出现咳嗽、咯白色稀痰等; 痰与热邪搏结,痰热壅盛,出现发热、咯黄稠痰等证候。
 
⑤痰热伤阴耗气,日久出现气阴两虚之证,症见咳嗽、痰少、汗出、口干等。本病初期,病邪轻浅,病位在肺卫,表现为风热闭肺证; 外邪袭肺,肺失清肃,或正气虚损,脏腑功能失调,痰湿内生,表现为痰浊阻肺证。本病中期,外邪传里,或内有蕴热,邪正相争,肺气壅滞,出现痰热壅肺证; 痰热伤阴耗气,日久出现气阴两虚之证。本病晚期,病情难以控制,疾病进一步传变,逆传心 包,或 邪 陷 正 脱,表现为神昏谵语、喘 脱、厥 脱等症。


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    2016-09-18 1e10c84am36(暂无匿称)

    不错哦继续关注

    0

  5. 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createdAvatar=http://q.qlogo.cn/qqapp/1103841572/7A67BB0C918BB93015189EDF204227A1/100, createdBy=384d1918843, createdName=qq03f03582, createdTime=Sat Jul 16 15:13:00 CST 2016, time=2016-07-16, status=1, ipAttribution=)]
    2016-09-04 ylzr123

    赞!好文章,拜读,值得深入学习!

    0

  6. 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  7. 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  8. 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createdAvatar=http://q.qlogo.cn/qqapp/1103841572/7A67BB0C918BB93015189EDF204227A1/100, createdBy=384d1918843, createdName=qq03f03582, createdTime=Sat Jul 16 15:13:00 CST 2016, time=2016-07-16, status=1, ipAttribution=)]
    2016-07-16 qq03f03582

    非常感谢

    0

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