[TCM understanding and therapeutic strategies for respiratory drug-resistant bacterial infections]

Currently, respiratory drug-resistant bacterial infections are a major global public health challenge due to their protracted course of disease and suboptimal treatment outcomes. In the face of slow progress in the development of new antibiotics, TCM offers novel perspectives for preventing and treating such infections by leveraging its unique advantages in holistic regulation and syndrome differentiation. This paper, for the first time, systematically constructed a TCM composite pathogenesis model centered on the core concept of bacteria-toxin-stasis-deficiency. It elucidated the dynamic evolution pattern characterized by deficiency in nature and excess in superficiality and proposed a stage-specific and syndrome-specific diagnostic and therapeutic framework, along with a prevention and treatment strategy of advancing intervention to intercept and reverse disease progression. From a TCM perspective, these infections can be categorized under conditions such as wind-warmth, lung abscess, cough, or latent pathogen. The key pathogenesis involves "internal deficiency of lung Qi leading to lingering pathogenic factors", resulting in the mutual binding of phlegm, stasis, and toxins in the lungs. Based on the dynamic interplay between healthy Qi and pathogenic factors, the clinical presentation can be divided into two phases: pathogen excess with healthy Qi impairment and healthy Qi deficiency with lingering pathogen. These phases encompass core syndrome types including healthy Qi deficiency with lingering pathogen, latent pathogen in pleurodiaphragmatic interspace, phlegm-stasis-toxin binding, and dual deficiency of Qi and Yin. Therapeutically, modified classical formulas such as Maxing Shigan Decoction, Zhuye Shigao Decoction, Dayuanyin, Qianjin Weijing Decoction, and Shashen Maidong Decoction are employed to embody the principle of reinforcing healthy Qi and eliminating pathogen. Clinical practice demonstrates that adhering to an integrated traditional Chinese and western medicine model guided by the principles of integrating pathogenesis with pathology and medicinal properties with pharmacology can effectively improve patient prognosis, reduce recurrence rates, and enhance quality of life. This approach provides a new paradigm of integrated traditional Chinese and western medicine for addressing the global crisis of antimicrobial resistance.