摘要
[目的]基于《黄帝内经》中以“天人合一”整体观为核心的中医时间医学理论,构建从“时”论治不寐的诊疗框架。[方法]通过古今文献考证与理论推演,阐述中医时间医学内涵,梳理《黄帝内经》中与不寐相关的时间节律及其衍生理论,归纳时间医学在不寐治疗中的应用思路。[结果]寤寐节律紊乱是导致不寐的主要病理机制。《黄帝内经》所论之昼夜、四时、超年、经气四大节律与不寐息息相关,将其系统归纳为阴阳消长、脏腑主时、五运六气与子午流注四大理论。紧扣时间医学理论与不寐之病机,提倡燮理阴阳、顺应四时、必先岁气、纳支补泄四层次防治理论。[结论]《黄帝内经》时间医学理念防治不寐具有客观疗效存在。临证辨治不寐时,应充分考虑时间节律,以期达到最佳疗效。
[Objective]Based on the holistic view of“correspondence between nature and humans”in Huangdi Neijing,which is central to traditional Chinese time medicine theory,to explore a new diagnostic and therapeutic approach to insomnia from the perspective of“time”.[Methods]By grounding in ancient and modern literature,this study elucidates the connotations of traditional Chinese time medicine and systematically reviews the temporal rhythms and derived theories related to insomnia in Huangdi Neijing,summarizing the approach to treating insomnia through time medicine.[Results]The disruption of the wake-sleep rhythm is a primary pathological mechanism of insomnia.The circadian rhythm,the four seasons rhythm,the exceeding the age rhythm and the meridians rhythm discussed in Huangdi Neijing are closely related to insomnia.They could be encapsulated into four major theories:the waxing and waning of Yin and Yang,the viscera and bowels managing time,the five movements and six climates,and the midnight-midday ebb flow theory.This study advocates a four-level strategy for insomnia,closely aligned with time medicine theory and the pathogenesis of insomnia,namely“regulating Yin and Yang”“adapting to the four seasons”“responding to annual Qi”and“reinforcement and elimination of Nazhi”.[Conclusion]The time medicine concept in Huangdi Neijing has objectively effects in the prevention and treatment of insomnia,providing a new breakthrough and integration point for clinical diagnosis and treatment of insomnia.In clinical diagnosis and treatment of insomnia,the consideration of time rhythms should be fully integrated to achieve optimal therapeutic outcomes.
作者
周晓青
唐盈盈
陈佳玲
周林水
陈瑞琳
郑苏群
王真
ZHOU Xiaoqing;TANG Yingying;CHEN Jialing(The First Affiliated Hospital of Zhejiang Chinese Medical Uni-versity(Zhejiang Provincial Hospital of Chinese Medicine),Hangzhou(310006),China;The First Clinical Medical School of Zhejiang Chinese Medical University)
出处
《浙江中医药大学学报》
2025年第9期1115-1120,共6页
Journal of Zhejiang Chinese Medical University
基金
国家自然科学基金面上项目(82174302)
浙江省自然科学基金项目(LTGD23H010001)
浙江省中医药科技计划项目(2021ZB124)。
关键词
《黄帝内经》
不寐
时间医学
寤寐节律
天人合一
阴阳消长
五运六气
子午流注
Huangdi Neijing
insomnia
time medicine
wake-sleep rhythm
correspondence between nature and humans
waxing and waning of Yin and Yang
five movements and six climates
midnight-midday ebb flow
