基于“治未病”理论探讨卒中相关性肺炎的防治

Discussion on Prevention and Treatment of Stroke-Associated Pneumonia Based on the Theory of “Preventing Disease”

摘要: 卒中相关性肺炎是脑卒中患者发病7日内并发的肺部感染，是临床最常见的并发症之一。“治未病”思想为中医学的重要组成部分，包含未病先防、既病防变、病后防复3个方面，与卒中相关性肺炎的三级预防有异曲同工之妙。预防为主、防治结合是控制卒中相关性肺炎发生与发展的根本原则。SAP未病先防即扶助正气，早期识别吞咽功能障碍、防止误吸等；既病防变即确诊SAP阶段，尽早进行中医辨证用药，西医选用敏感抗生素、采用特殊护理等治疗措施，以防病情加重和转移；病后防复即SAP缓解阶段，调摄以防复发。在SAP的防治中应用该思想，对于脑卒中恢复、预防肺炎发生、提高患者生活质量、防止病情复发具有重要的临床意义。

Abstract: Stroke-associated pneumonia is one of the most common complications of pulmonary infection after stroke. The idea of “preventing disease” is an important part of traditional Chinese medicine, which includes three aspects: preventing disease before disease, preventing disease from changing, and preventing recovery after disease. It is similar to the prevention of stroke-associated pneumonia. Prevention first and combination of prevention and treatment are the fundamental principles for controlling the occurrence and development of stroke-associated pneumonia. Prevention of SAP before disease helps righteousness, early identification of swallowing dysfunction, prevention of aspiration, etc. In the stage of SAP diagnosis, TCM dialectics should be carried out as soon as possible, and antibiotics and special nursing should be used in Western medicine to prevent aggravation and transfer. Preventing recurrence after the disease is SAP remission stage, adjusting to prevent recurrence. The application of this thought in the prevention and treatment of SAP is of great clinical significance for the recovery of stroke, the prevention of pneumonia, the improvement of patients’ lives, and the prevention of recurrence of the disease.