基于开阖枢理论探讨血压昼夜节律

Exploring the circadian rhythm of blood pressure based on the theory of opening-closing-pivot

正常人体血压具有一定的昼夜节律,呈现出昼高夜低、双峰一谷的杓型变化。开阖枢理论是中医阴阳学说的重要组成部分,反映了三阴三阳气机运动变化的规律。根据《伤寒论》“六经欲解时”,三阴三阳的开阖枢各有其时,遵循一定的时间规律,使阴阳气机升降出入顺应昼夜节律,是维持人体血压正常昼夜节律的基础。厥阴阖、少阳枢主要调控清晨血压,阳明阖、太阴开及少阴枢主要调控夜间血压,三阴三阳的开阖枢相互协同、相互影响,共同维持血压昼夜节律的稳定。开阖枢失常会导致血压昼夜节律的紊乱,主要表现为厥阴失阖、少阳枢折导致的清晨高血压,以及阳明不降、太阴开折、少阴失枢导致的夜间高血压。通过调节三阴三阳的开阖枢运动,可以调控相应时段的血压,结合西医学研究,本文提出中医药调控血压昼夜节律的新思路、新方法。

Normal human blood pressure has a certain circadian rhythm,which is high during the day and low at night,and two peaks and one valley of the arytenoid change.The theory of opening-closingpivot is an essential part of the yin and yang theory in traditional Chinese medicine,which reflects the law of qi movement changes of the three yin and three yang.According to"time to heal six channels"in Shanghan Lun,the opening-closing-pivot of three yin and three yang have their own time.Following certain time laws,the ascending,descending,exiting,and entering of the yin and yang qi movement conform to the circadian rhythm,which is the basis for maintaining the normal circadian rhythm of human blood pressure.Jueyin closing and shaoyang pivot mainly regulate morning blood pressure,whereas yangming closing,taiyin opening,and shaoyin pivot mainly regulate night blood pressure.The openingclosing-pivot of three yin and three yang coordinate and influence each other to maintain the stability of the circadian rhythm of blood pressure.The abnormal opening-closing-pivot can lead to the disturbance of the circadian rhythm of blood pressure,which primarily manifests as early morning hypertension caused by jueyin closing and shaoyang pivot failure,and night hypertension caused by yangming closing,taiyin opening and shaoyin pivot failure.By adjusting the movement of opening-closing-pivot of three yin and three yang,the blood pressure of corresponding period can be regulated.Combined with Western medical research,a new idea and method of regulating the circadian rhythm of blood pressure with traditional Chinese medicine is put forward.