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基于"子午流注"理论辨治溃疡性结肠炎OA

Differentiation and treatment strategies for ulcerative colitis based on the"midnight-noon and ebb-flow"theory

中文摘要英文摘要

溃疡性结肠炎是一种慢性复发性炎症性肠病,现代研究表明,昼夜节律改变所致的免疫失调与其发病密切相关.西医时间医学与中医"因时而治"均强调自然节律与人体生理病理的时间关联,"子午流注"理论是中医"因时而治"在时间医学范畴内的具体实践与深化.本文将溃疡性结肠炎的发作时间与"子午流注"理论中手阳明大肠经当令的卯时(05:00-07:00)、足太阴脾经当令的巳时(09:00-11:00)与足少阴肾经当令的酉时(17:00-19:00)对应,认为本病卯时发作,病机为湿热蕴结、气血乖戾,治宜清热利湿、调和气血,方用芍药汤或白头翁汤加减;巳时发作,病机为脾虚湿阻、气血失和,治宜健脾祛湿、振复气血,方用黄芽汤或参苓白术散加减;酉时发作,病机为火不暖土、气血耗溢,治宜温肾暖脾、固摄气血,方用四神丸或天魂汤加减.在中药内服的同时配合针灸、中药灌肠、穴位贴敷等综合治疗,可为临床诊疗溃疡性结肠炎提供新思路.

Ulcerative colitis is a chronic relapsing inflammatory bowel disease.Modern research indicates that immune dysregulation resulting from disruptions in circadian rhythm is closely associated with its pathogenesis.Both Western chronomedicine and traditional Chinese medicine(TCM)"treatment based on temporal factors"emphasize the temporal relationship between natural rhythms and human physiology and pathology.The"midnight-noon and ebb-flow"theory represents the concrete application and deepening of TCM"treatment based on temporal factors"within the realm of chronomedicine.This article correlates the onset time of ulcerative colitis with specific periods in the"midnight-noon and ebb-flow"theory:the Mao period(05:00-07:00),when the yangming large intestine meridian of hand is dominant;the Si period(09:00-11:00),when the taiyin spleen meridian of foot is dominant;and the You period(17:00-19:00),when the shaoyin kidney meridian of foot is dominant.According to this perspective,if the disease manifests during the Mao period,the pathogenesis is attributed to dampness-heat accumulation and disorder of qi and blood.Treatment should focus on clearing heat,resolving dampness,and harmonizing qi and blood,using modified formulas such as Shaoyao Decoction or Baitouweng Decoction.If it occurs during the Si period,the pathogenesis involves spleen deficiency with dampness obstruction and disharmony of qi and blood.Treatment should focus on strengthening the spleen,eliminating dampness,and restoring qi and blood,using modified formulas such as Huangya Decoction or Shenling Baizhu Powder.If it presents during the You period,the pathogenesis is characterized by fire failing to warm earth,and consumption resulting in qi and blood leakage.Treatment should focus on warming the kidney and spleen,and securing qi and blood,using modified formulas such as Sishen Pill or Tianhun Decoction.In addition to oral administration of Chinese herbal medicine,comprehensive therapies including acupuncture,herbal enemas,and acupoint application can provide novel insights for the clinical diagnosis and treatment of ulcerative colitis.

孟令飞;朱超伦;赵子旭;宋冉冉;王一帆;范聪玲;米刘悦;张双喜

河南中医药大学第一附属医院肛肠科 郑州 450000||河南中医药大学第一临床医学院河南中医药大学第一附属医院肛肠科 郑州 450000||河南中医药大学第一临床医学院河南中医药大学第一附属医院肛肠科 郑州 450000||河南中医药大学第一临床医学院河南中医药大学第一附属医院肛肠科 郑州 450000||河南中医药大学第一临床医学院河南中医药大学第一附属医院肛肠科 郑州 450000||河南中医药大学第一临床医学院河南中医药大学第一附属医院肛肠科 郑州 450000||河南中医药大学第一临床医学院河南省直第三人民医院河南中医药大学第一附属医院肛肠科 郑州 450000

医药卫生

溃疡性结肠炎子午流注时间医学气血

ulcerative colitismidnight-noon and ebb-flowchronomedicineqi and blood

《北京中医药大学学报》 2026 (1)

16-23,8

河南省科技研发计划联合基金(No.242301420114)河南省科技攻关计划项目(No.232102311221)河南省中医药科研专项课题(No.2025ZY3006)河南省医学科技攻关计划项目(No.LHGJ20240665)国家中医药传承创新中心科研专项(No.2023ZXZX1088)郑州市医疗卫生领域科技创新指导计划项目(No.2024YLZDJH077) Joint Fund for Science and Technology Research Project of Henan Province(No.242301420114)

10.3969/j.issn.1006-2157.2026.01.003

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