Pathogenesis and Treatment Strategy of

Xinyi XU; Yuyang LAN; Xinyue WANG; Ying GAO; Ziqi SHAN; Xiaokun YANG; Lu XIAO

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Pathogenesis and Treatment Strategy of "Macrocirculation-Microcirculation" Uncoupling in Sepsis：from the Perspective of "Deep Heat，Deep Syncope"

VernacularTitle:从“热深厥深”探讨脓毒症“大循环-微循环”失耦联的发病机制和辨治思路
Author: Xinyi XU ¹ ; Yuyang LAN ¹ ; Xinyue WANG ² ; Ying GAO ¹ ; Ziqi SHAN ¹ ; Xiaokun YANG ¹ ; Lu XIAO ¹
Author Information

1. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine，Tianjin，300381
2. Tianjin University of Traditional Chinese Medicine
Publication Type:Journal Article
Keywords: sepsis; deeper heat， deep syncope; macrocirculation; microcirculation; uncoupling
From: Journal of Traditional Chinese Medicine 2026;67(13):1403-1408
CountryChina
Language:Chinese
Abstract: By reviewing modern research and integrating clinical practice， this paper interprets the correlation between "deep heat， deep syncope" and the "macrocirculation-microcirculation" uncoupling in sepsis， alongside its clinical applications in sepsis prevention and treatment. It is considered that "deep heat" corresponds to peripheral vasodilation and the hypermetabolic state at the macrocirculation level， whereas "deep syncope" manifests as hypoperfusion and impaired oxygen utilization at the microcirculation level. These two states interact detrimentally， forming the core contradiction of macrocirculation-microcirculation uncoupling in sepsis. Based on the traditional Chinese medicine （TCM） connotations of "deep heat， deep syncope" and modern medical research， this paper elucidates the systemic pathological evolution of sepsis from the inflammatory cascade to impaired oxygen utilization. Accordingly， the following therapeutic principles are proposed. In the early stage， it is suggested to clear heat and drain fire to vent the constrained yang. In the progressive stage， the focus is put on unblocking the lower jiao （焦） and expelling stasis to dredge the vessels and collaterals. In the recovery stage， the method of regulating and harmonizing yin and yang can be used to smooth the flow of qi and blood.