《伤寒论》时间医学应用探析

Application Analysis of Chronomedicine in Treatise on Cold Pathogenic Diseases

时间医学源于中医“天人相应”的学术观点,自然界的气候变迁会使人体发生相应的生理与病理变化。《伤寒论》中条文主要涉及四季节律、周节律、昼夜节律及发病周期节律4种时间医学概念。四季节律反映出自然界中的阴阳寒温变化,季节气候反常或不顺应气候规律容易形成时行之气,治疗应“因时制宜”,用寒远寒,用热远热,顺应四季的寒温性质。周节律反映了疾病的痊愈周期,大多疾病此时容易痊愈,若不痊愈,则有“传经、加重、转危”等不同的变化,因而常作为观察疾病变化的时间节点,治疗应“观其脉证,知犯何逆,随证治之”。昼夜节律反映自然界一天内阳气的变化,阳气盛衰使疾病有“自愈”和“加重”两种不同转变,治疗常于阳气旺时用药,因势利导。发病周期节律是指下利、发热、汗出等病证具有病情反复、届时而发的特征,其根源在于正气循行的节律性,治疗应“先其时”而治,扶助正气,截断病程。

Chronomedicine originates from the academic view of“correspondence between nature and human”in traditional Chinese medicine.The climate changes in nature will lead to corresponding physiological and pathological changes in human body.The items in Treatise on Cold Pathogenic Diseases mainly involve four concepts of chronomedicine:four seasonal rhythm,week rhythm,circadian rhythm and periodic rhythm of onset.The four seasonal rhythm reflects the changes of yin,yang,cold and warm in nature.The abnormal seasonal climate or not conforming to the law of climate is easy to form epidemic qi,which should be treated by“administering treatment during the most optimal time”,avoiding cold materia medica during cold weather,avoiding heat medicinals during hot weather,and conforming to the cold and warm nature of the four seasons.The week rhythm reflects the recovery cycle of the disease.Most diseases are easy to recover at this time.If they are not cured,there are different changes such as“meridian transmission,aggravation and turning to danger”.Therefore,it is often used as the time node to observe the changes of the disease.The treatment should“observe its pulse and syndrome,know what goes wrong and treat it according to the syndrome”.The circadian rhythm reflects the changes of yang qi in nature in a day.The rise or fall of yang qi makes the disease have two different changes of“self-healing”and“aggravating”.The treatment is often used when yang qi is exuberant to get the best results.Periodic rhythm of onset refers to diseases such as diarrhea,fever and sweating,which have the characteristics of recurrence and occurring at certain time.Its root cause lies in the circulation rhythm of healthy qi.It should be treated before onset to help healthy qi and cut off the disease course.