膿毒癥是宿主對(duì)感染所致的危及生命的多器官功能障礙，發(fā)病機(jī)制涉及炎癥反應(yīng)、血管內(nèi)皮、凝血、免疫、微循環(huán)等多位點(diǎn)、多系統(tǒng)的異常和相互作用。四妙勇安湯（ Simiao Yongan Decoction， SMYAD）是治療熱毒熾盛之脫疽的經(jīng)典名方，SMYAD 加減化裁具有抗炎、抗氧化、抗凝、免疫調(diào)節(jié)等藥理作用，可改善膿毒癥發(fā)生發(fā)展過(guò)程中的多系統(tǒng)紊亂和多臟器功能障礙，對(duì)膿毒癥有良好的治療效果。通過(guò)系統(tǒng)綜述膿毒癥的發(fā)病機(jī)制、 SMYAD 加減化裁治療膿毒癥的研究進(jìn)展、后續(xù)應(yīng)用開(kāi)發(fā)所面臨的科學(xué)問(wèn)題，為經(jīng)典名方加減化裁在膿毒癥等危重癥治療領(lǐng)域的應(yīng)用開(kāi)發(fā)提供重要理論依據(jù)。

Sepsis is a life-threatening multi-organ dysfunction caused by the host's response to the infection, and the pathogenesis involves the abnormalities and interactions of inflammatory response, vascular endothelium, coagulation, immunity, and microcirculation. Simiao Yongan Decoction (四妙勇安湯, SMYAD), a classic formula for treating digital gangrene caused by intense heat-toxicity, has been modified to exhibit various pharmacological effects such as anti-inflammatory, antioxidant, anticoagulant, and immunomodulatory activities. These modifications can ameliorate the dysfunction of multiple systems and organs during the development of sepsis, demonstrating a promising therapeutic effect. This paper systematically reviews the pathogenesis of sepsis, the research progress of modified SMYAD in treatment of sepsis, and the scientific problems faced by the subsequent application development, with a view to providing an important theoretical basis for application and development of the modified classic formula in treatment of sepsis and other critical illnesses.

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國(guó)家自然科學(xué)基金資助項(xiàng)目(81703773);江蘇省自然科學(xué)基金資助項(xiàng)目(BK20170560);江蘇省中醫(yī)藥科技發(fā)展計(jì)劃(MS2023173)