从精气神学说探讨生物钟系统对睡眠昼夜节律的影响

The Influence of Biological Clock System on the Circadian Rhythm of Sleep Based on Essence-Qi-Spirit Theory

精气神学说是中医学的重要组成部分,精气神稳态是机体阴阳平衡的物质和功能基础,精气神合一,则形神俱全。以精气神学说为基础,提出精气亏耗,神散气消,阴阳失交是睡眠障碍的核心病机,故以聚精、养气、存神的调和阴阳之法治疗睡眠障碍。影响睡眠昼夜节律变化的生物钟系统,受生物钟基因转录产生的分子震荡所调控,是生物体不断适应自然规律而逐渐形成的时钟。精、气、神分别作为寤寐安和的物质基础、动力与体现,能感知传递自然信号,其功能类似现代医学认识的振荡放大节律信号,同步调控生物钟基因表达信号,形成以“输入—振荡—输出”为反馈周期的生物钟系统。认为聚精、养气、存神的调和阴阳方法可能通过大脑/肌肉芳香烃受体核转位因子样蛋白1(BMAL1)/昼夜运动输出周期蛋白(CLOCK)-周期蛋白(PER)/隐花色素(CRY)转录反馈环,实现对生理活动综合调控,以适应自然界环境变化,对睡眠障碍发挥积极的治疗作用,以期为中医药重塑内源性生物钟分子调控系统防治睡眠障碍提供新思路。

The essence-qi-spirit theory is an important part of traditional Chinese medicine,whose steady state is the material and functional basis for the balance of yin and yang in the body,making the essence,qi and spirit integrated,and body and spirit harmonized.Based on this theory,it is proposed that essence and qi depletion,spirit dissipation and qi dispersion,disharmony between yin and yang is the main pathogenesis of sleep disorders.Therefore,the method of regulating and harmonzing yin and yang by essence gathering,qi nourishing and spirit storing can be used to treat sleep disorder.The biological clock system of the circadian rhythm of sleep is regulated by the molecular oscillation that is generated by the transcription of the biological clock gene,and is a clock gradually formed by organisms constantly adapting to the laws of nature.As the material basis,power,and embodiment of sound and peaceful sleep,essence,qi and spirit can perceive and transmit natural signals,whose functions are similar to what is recognized by modern science that oscillation amplifies the rhythm signal,and synchronously regulates the expression signal of the biological clock gene,thereby forming a biological clock system with“input-oscillation-output”as the feedback cycle.It is believed that the regulation method of yin and yang by essence gathering,qi nourishing and spirit storing may comprehensively regulate the physiological activities through brain/muscle aryl hydrocarbon receptor nuclear translocator-like protein 1(BMAL1)/circadian locomotor output cycles kaput(CLOCK)-period protein(PER)/cryptochrome(CRY)transcriptional feedback loop,thereby adapting to the natural environment changes,playing an active role in the treatment of sleep disorders,and provideing a new idea for traditional Chinese medicine to reshape the molecular regulation system of the endogenous biological clock to prevent and treat sleep disorders.