从“天人相应”探讨中医痹证与二十四节气、五季的发病关系

The relationship between TCM Bi syndrome and the 24 solar terms and the five seasons from the perspective of“correspondence between nature and man”

目的:通过探讨中医痹证与二十四节气、五季的发病相关性总结出相应规律,为痹证的临床预防和治疗提供一定的参考。方法:通过收集筛选江苏省中医院风湿免疫科住院部中医诊断为“痹证”且西医诊断为“类风湿性关节炎”的患者共1907例,应用Excel表格进行归纳整理,统计出各年度各节气、季节发病人数,对各年度、节气、季节发病人数之间进行比较,绘成相应表格及统计图。结果:痹证各节气、季节皆可发病,同一年份不同节气、季节发病人数高低起伏,走势呈波浪式锯齿状,无明显规律性,不同年份同一节气、季节相比,发病趋势存在一定的重合性和相似性。将3年各节气发病人数累加,得出单个节气发病人数最多的节气为小满,发病人数最少的节气为大寒。将3年各季节发病人数累加,得出五季中发病人数最高的季节为春季,其次是长夏、冬季、秋季、夏季。五季与五气对应,则发病人数由多到少为风、湿、寒、燥、暑,排在前三位的为风、湿、寒,从而与《黄帝内经》所讲的“风寒湿三气杂至,合而为痹也”不谋而合。结论:中医痹证的发病与节气、季节存在一定的周期节律相关性,顺应各节气、五季的自然特性,做到天人相应,能够在一定程度上降低痹证的发病率。

Objective:To explore the correlation between TCM Bi syndrome(痹证)and 24 solar terms and five seasons,and to summarize the corresponding law,so as to provide some reference for the clinical prevention and treatment of Bi syndrome.Methods:A total of 1907 patients diagnosed as“Bi syndrome”in TCM and“rheumatoid arthritis”in Western medicine were collected and screened by the Inpatient Department of Rheumatology and Immunology of Jiangsu Hospital of Traditional Chinese Medicine.The Excel table was used to summarize and sort the data,and the number of annual solar terms and seasonal morbidity was calculated.The number of annual solar terms and seasonal morbidity was compared,and the corresponding table and statistical chart were drawn.Results:The incidence of Bi syndrome occurred in all solar terms and seasons.The incidence of Bi syndrome rose and fell in different solar terms and seasons in the same year,and the trend showed a wave-like zigzag without obvious regularity.Compared with the same solar terms and seasons in different years,the incidence trend had some overlap and similarity.By summing up the number of cases in each solar term in three years,it was concluded that Grain Buds had the largest number of cases in a single solar term,and Great Cold had the least number of cases.By summing up the number of cases in each season in three years,it was concluded that the highest number of cases in the five seasons was spring,which was followed by long summer,winter,autumn and summer.The five seasons corresponded to the five Qi(气),and the number of patients corresponded to wind,dampness,cold,dryness,and heat in descending order.The top three were wind,dampness,and cold,which coincided with the theory of“wind,cold,and dampness come together to cause Bi syndrome”in Huangdi Neijing(《黄帝内经》).Conclusion:The incidence of Bi syndrome in traditional Chinese medicine is correlated with solar terms and seasons in a certain periodicity.It can reduce the incidence of Bi syndrome to a certain extent by conforming to the natural characteristics of each solar term and five seasons and keeping the correspondence between nature and man.