急性胰腺炎发作时间与人体阴阳昼夜节律初探

A Preliminary Study on Onset Time of Acute Pancreatitis and Circadian Rhythm of Yin and Yang in Human Body

目的:研究急性胰腺炎发病时间与体内阴阳昼夜节律的关系,指导中医药及早干预,避免急性胰腺炎向重症及死亡方向发展。方法:以午时为分界线,将患者分为午时前、后两组,并将两组病人的发病时间按十二时辰进行统计。根据《黄帝内经》昼夜节律中有关阴阳消长的理论将1日分为4个时间段,根据其发病时间将病人分为4组:夜半组(22:00-次日3:59)、平旦组(4:00-9:59)、日中组(10:00-15:59)、日西组(16:00-21:59),对各组的病人数量进行统计分析。将患者按发病的中医证型分为3组,分别是胃肠实热组、肝胆湿热组、其他证型组,其中其他证型组包括肝郁气滞型、胃阴不足型以及瘀热(毒)互结型患者,并将各组发病人数进行统计。结果:与午时前组发病人数相比,午时后组发病人数明显较多,差异有显著统计学意义(P<0.05),且患者发病时间主要集中在午时至申时。与日中组相比,夜半组发病人数明显较少,差异有显著统计学意义(P<0.05);日中组发病人数最多,此后随着时间推移发病人数逐渐减少。胃肠实热组发病患者人数最多,为201例,占总人数的51.15%,与其他证型组比较差异有统计学意义(P<0.05);肝胆湿热组发病患者人数为136例,占总人数的34.6%,与其他证型组比较差异有统计学意义(P<0.05)。结论:人体阴阳昼夜节律参与急性胰腺炎发病的调节过程,认识急性胰腺炎发病的昼夜节律能够通过早期中医药干预避免急性胰腺炎向重症及死亡方向发展。

Objective:To study the relationship between the onset time of acute pancreatitis and the circadian rhythm of Yin and Yang in the body,to guide the early intervention of Chinese medicine,and to avoid the development of acute pancreatitis in the direction of severe disease and death.Method:Taking noon as the dividing line,the patients were divided into two groups before and after the noon period,and the onset time of the two groups of patients was counted according to 12 two-hour periods.According to the theory about the ebb and flow of Yin and Yang in the circadian rhythm of Huang Di Nei Jing,a day is divided into 4 time periods,and patients are divided into 4 groups according to their onset time:midnight group(22:00-3:59 the next day),morning group(4:00-9:59),noon group(10:00-15:59),and dusk group(16:00-21:59),the number of patients in each group was statistically analyzed.The patients were divided into 3 groups according to the TCM syndrome types of the onset,which were the gastrointestinal excess Heat group,Liver and Gallbladder Damp-Heat group,and other syndrome type groups.Among them,other syndrome groups include patients with Liver depression and Qi stagnation,stomach Yin deficiency,and Blood stasis(toxin) combined,and the number of patients in each group is counted.Results:Compared with the number of patients in the group before noon,the number of patients in the group after noon was significantly higher,the difference was statistically significant(P<0.05),and the onset time of patients was mainly concentrated from the Noon period to the Shen period.Compared with the Rizhong group,the number of cases in the Yeban group was significantly lower,and the difference was statistically significant(P<0.05).Rizhong group had the largest number of cases,and then gradually decreased over time.The gastrointestinal excess heat group took the largest number of patients,201 cases,accounting for 51.15% of the total number,and the difference was statistically significant compared with other syndrome groups(P<0.05).And there were 136 patients in the liver and gallbladder damp-heat group,accounting for 34.6% of the total,and the difference was statistically significant compared with other syndrome groups(P<0.05).Conclusion:The circadian rhythm of Yin and Yang in the human body is involved in the regulation process of acute pancreatitis,and understanding it can prevent acute pancreatitis from developing into severe disease and death through early intervention of traditional Chinese medicine.