首页|基于昼夜节律探索中西医结合辨治胃脘痛

基于昼夜节律探索中西医结合辨治胃脘痛

扫码查看
现代医学认为昼夜节律是指机体在生物钟的调控下,随外界昼夜的变化而形成的节律性机制.两千多年前以"天人合一"为核心的整体观念指导下的中医时间医学亦表明,人体五脏六腑的生理功能随着昼夜更迭而发生着规律性的变化,体现了人体的整体性与节律性.胃脘痛也称胃痛,以脘腹部发生疼痛为主要症状,是中医临床常见且多发的脾胃系病证之一,其发病与转归存在昼夜节律性.移行性复合运动是指清醒空腹状态下胃肠出现静息与收缩循环往复的周期性运动,该运动的夜间活动强度明显弱于白天.联系中医营卫理论,发现这与中医理论中卫气"夜伏昼出"的循行规律不谋而合.且进一步通过对相关研究分析,发现采用中医经典方加减联合常规西药三联疗法,构建中西医结合治疗胃脘痛理论的框架,在胃肠道昼夜节律理论的指导下,于辰、巳时用药,通过借助辰、巳时脾胃气血灌注的有利时机,协调气血阴阳,能够加速药物循经布散周身,更好地促进药物吸收.同时在夜间采取抑酸、保护胃黏膜等措施缓解疼痛,并辅以子午流注纳甲法取穴针刺、艾灸与按摩,更有利于胃肠道功能的恢复,明显提高临床疗效.因此,以昼夜节律为切入点,将中医时间医学与现代医学生物节律相结合,能够为中西医结合辨治胃脘痛提供新思路.
Integreted Chinese and Western medicine differentiation and treatment of epigastralgia based on circadian rhythm
Modern medicine considers circadian rhythm as the rhythmic mechanism formed by the body under the regulation of bio-logical clock in response to the external diurnal variation.Correspondingly,more than 2000 years ago,chronomedicine in traditional Chinese medicine under the guidance of the concept of wholism,which took"unity of heaven and man"as the core,also indicated that the physiological functions of the vital organs of the human body change regularly with the change of day and night,reflecting the integrity and rhythm of the human body.Epigastralgia,which is also known as stomach pain,is a common and frequently occurring spleen-stomach disease in traditional Chinese medicine,with a rhythmic mechanism in its onset and regression.Migrating motor complex is a cyclic movement of the stomach and intestines that occur in cycles of resting and contraction during the sober fasting state,and the intensity of nocturnal activity for this movement is significantly weaker that in the day.In relation to the theory of Yingwei in traditional Chinese medicine,it is found that this coincides with the law of the flow of Weiqi(卫气)in traditional Chinese medicine,that is"Hiding at night and coming out at day".Moreover,through fur-ther analysis of relevant studies,it is found that the combination of traditional Chinese medicine and conventional western medicine triple therapy is used to build a theoretical framework for integrated Chinese and Western medicine treatment of epigastralgia.Under the guidance of the theory of circadian rhythm of the gastrointestinal tract,when taking the medicine at the period of the day from 7 a.m.to 11 a.m.,by taking advantage of the favorable timing of the infusion of Qi and blood of the spleen-stomach at the hours from 7 a.m.to 11 a.m.,harmonizing Qi and blood,Yin and Yang,it can accelerate the distribution of drugs around the body through the meridians and promote the absorption of drugs better.And it is more conducive to the recovery of gastrointestinal function and significantly improves clinical efficacy by taking measures such as taking acid suppres-sion and protection of gastric mucosa at night to relieve pain and supplemented with midnight-noon ebb-flow Najia acupuncture,moxibustion and massage at the same time.Therefore,taking the circadian rhythm as the starting point and combining traditional Chinese medicine chronomedi-cine and modern medical biological rhythm can provide new ideas for the integrated treatment of Chinese and Western medicine in the treatment of epigastralgia.

EpigastralgiaChronomedicineCircadian rhythm

王浩、庞晨旭、赵魁、夏雪萍、付姝菲

展开 >

天津中医药大学,天津,301617

南京中医药大学,江苏 南京,210023

胃脘痛 时间医学 昼夜节律

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(21)