中醫自古以來講究“天人相應”、人的作息應與天時相順應,這一理念在最重要的中醫經典《黃帝內經》里貫穿始終,尤其是“春三(san)(san)月(yue),此(ci)謂(wei)發陳,天(tian)(tian)地(di)俱生(sheng),萬(wan)物以榮(rong),夜(ye)臥(wo)(wo)早起……夏三(san)(san)月(yue),此(ci)謂(wei)蕃秀,天(tian)(tian)地(di)氣(qi)交,萬(wan)物華實,夜(ye)臥(wo)(wo)早起……秋三(san)(san)月(yue),此(ci)謂(wei)容平,天(tian)(tian)氣(qi)以急,地(di)氣(qi)以明(ming),早臥(wo)(wo)早起……冬三(san)(san)月(yue),此(ci)謂(wei)閉藏,水冰地(di)坼(che),無擾乎陽(yang),早臥(wo)(wo)晚起……”這四段經文(wen)可謂(wei)是按時(shi)(shi)(shi)養(yang)生(sheng)的(de)入門指(zhi)南了。時(shi)(shi)(shi)辰(chen)(chen)(chen)在(zai)(zai)中醫里的(de)重要(yao)性不僅(jin)僅(jin)體現在(zai)(zai)季節(jie)的(de)變換,更(geng)體現在(zai)(zai)子午(wu)流注的(de)時(shi)(shi)(shi)辰(chen)(chen)(chen);不僅(jin)體現在(zai)(zai)日常作息與節(jie)氣(qi)、時(shi)(shi)(shi)辰(chen)(chen)(chen)規律相符,更(geng)體現在(zai)(zai)疾病的(de)治療也(ye)要(yao)遵循(xun)時(shi)(shi)(shi)辰(chen)(chen)(chen),找出發病規律,在(zai)(zai)最佳時(shi)(shi)(shi)間進(jin)行(xing)治療,是為“因(yin)時(shi)(shi)(shi)制宜(yi)”。
根據子午(wu)流注學說,一天中的(de)十二個時(shi)(shi)辰(chen)與人(ren)體的(de)十二條(tiao)經(jing)(jing)絡相對應,每(mei)條(tiao)經(jing)(jing)絡有著(zhu)各自的(de)主(zhu)(zhu)時(shi)(shi),分別在其各自的(de)主(zhu)(zhu)時(shi)(shi)里(li)經(jing)(jing)氣運行最(zui)(zui)為旺(wang)盛,其對應規律為:子時(shi)(shi)(23點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)1點(dian)(dian)(dian)(dian)(dian)(dian)(dian))膽經(jing)(jing)最(zui)(zui)旺(wang),丑時(shi)(shi)(1點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)3點(dian)(dian)(dian)(dian)(dian)(dian)(dian))肝經(jing)(jing)最(zui)(zui)旺(wang),寅時(shi)(shi)(3點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)5點(dian)(dian)(dian)(dian)(dian)(dian)(dian))肺經(jing)(jing)最(zui)(zui)旺(wang),卯(mao)時(shi)(shi)(5點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)7點(dian)(dian)(dian)(dian)(dian)(dian)(dian))大(da)腸經(jing)(jing)最(zui)(zui)旺(wang),辰(chen)時(shi)(shi)(7點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)9點(dian)(dian)(dian)(dian)(dian)(dian)(dian))胃(wei)經(jing)(jing)最(zui)(zui)旺(wang),巳時(shi)(shi)(9點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)11點(dian)(dian)(dian)(dian)(dian)(dian)(dian))脾(pi)經(jing)(jing)最(zui)(zui)旺(wang),午(wu)時(shi)(shi)(11點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)13點(dian)(dian)(dian)(dian)(dian)(dian)(dian))心(xin)經(jing)(jing)最(zui)(zui)旺(wang),未時(shi)(shi)(13點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)15點(dian)(dian)(dian)(dian)(dian)(dian)(dian))小腸經(jing)(jing)最(zui)(zui)旺(wang),申時(shi)(shi)(15點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)17點(dian)(dian)(dian)(dian)(dian)(dian)(dian))膀(bang)胱(guang)經(jing)(jing)最(zui)(zui)旺(wang),酉時(shi)(shi)(17點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)19點(dian)(dian)(dian)(dian)(dian)(dian)(dian))腎經(jing)(jing)最(zui)(zui)旺(wang),戌時(shi)(shi)(19點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)21點(dian)(dian)(dian)(dian)(dian)(dian)(dian))心(xin)包經(jing)(jing)最(zui)(zui)旺(wang),亥時(shi)(shi)(21點(dian)(dian)(dian)(dian)(dian)(dian)(dian)至(zhi)23點(dian)(dian)(dian)(dian)(dian)(dian)(dian))三焦經(jing)(jing)最(zui)(zui)旺(wang)。
子午流注學說的(de)(de)(de)(de)(de)出現最早(zao)(zao)被用于(yu)指導(dao)(dao)臨(lin)床針灸的(de)(de)(de)(de)(de)“候時(shi)(shi)(shi)而治”,后來也逐漸用在指導(dao)(dao)人們一(yi)天(tian)的(de)(de)(de)(de)(de)作(zuo)息(xi)(xi)與自身臟腑氣血(xue)、經氣的(de)(de)(de)(de)(de)運行(xing)相(xiang)應:子時(shi)(shi)(shi)為人體(ti)的(de)(de)(de)(de)(de)進入(ru)睡眠(mian)的(de)(de)(de)(de)(de)最佳時(shi)(shi)(shi)間(jian),丑時(shi)(shi)(shi)為肝(gan)臟排毒的(de)(de)(de)(de)(de)時(shi)(shi)(shi)間(jian),寅時(shi)(shi)(shi)進入(ru)深(shen)度的(de)(de)(de)(de)(de)睡眠(mian)有(you)利于(yu)呼吸(xi)道及(ji)肺(fei)部的(de)(de)(de)(de)(de)清肅,卯時(shi)(shi)(shi)要養(yang)成飲水和(he)排便的(de)(de)(de)(de)(de)習慣(guan),而辰時(shi)(shi)(shi)應補充一(yi)天(tian)的(de)(de)(de)(de)(de)早(zao)(zao)餐(can),巳時(shi)(shi)(shi)脾經旺,有(you)利于(yu)養(yang)血(xue)和(he)吸(xi)收(shou)營養(yang),故辰時(shi)(shi)(shi)的(de)(de)(de)(de)(de)早(zao)(zao)餐(can)需營養(yang)全面;午時(shi)(shi)(shi)養(yang)心(xin)(xin),需進行(xing)短時(shi)(shi)(shi)間(jian)的(de)(de)(de)(de)(de)休(xiu)息(xi)(xi),未時(shi)(shi)(shi)消(xiao)化吸(xi)收(shou)功(gong)能(neng)最旺,故有(you)午餐(can)需飽說法,申時(shi)(shi)(shi)屬膀胱,是一(yi)天(tian)中最重要的(de)(de)(de)(de)(de)喝水時(shi)(shi)(shi)間(jian),多飲水有(you)助于(yu)膀胱排毒,酉時(shi)(shi)(shi)工作(zuo)完(wan)需充足休(xiu)息(xi)(xi),戌時(shi)(shi)(shi)要保持心(xin)(xin)情愉快,亥時(shi)(shi)(shi)休(xiu)息(xi)(xi)以修養(yang)生息(xi)(xi)。
早在《黃(huang)帝內經》中(zhong)就提到(dao)“夫(fu)百病(bing)(bing)者,多(duo)以旦慧、晝(zhou)安(an)、夕(xi)加(jia)、夜(ye)甚”;東漢張仲(zhong)景提出“六(liu)經辨證”強調了人體生(sheng)理、病(bing)(bing)理與時(shi)間(jian)周(zhou)期(qi)的(de)(de)關(guan)系;到(dao)了金元時(shi)期(qi),李東垣(yuan)更明(ming)確提出“夫(fu)百病(bing)(bing)晝(zhou)則增(zeng)劇,遇(yu)夜(ye)安(an)靜,是陽病(bing)(bing)有余,乃氣病(bing)(bing)而(er)血不病(bing)(bing)也(ye);百病(bing)(bing)夜(ye)則增(zeng)劇,晝(zhou)則安(an)靜,是陰(yin)病(bing)(bing)有余,乃血病(bing)(bing)而(er)氣不病(bing)(bing)也(ye)”。中(zhong)醫(yi)發(fa)展(zhan)到(dao)今天,越來越多(duo)人認識到(dao)時(shi)間(jian)在疾病(bing)(bing)發(fa)生(sheng)發(fa)展(zhan)中(zhong)的(de)(de)重要(yao)(yao)性,在治療(liao)、給藥(yao)(yao)的(de)(de)時(shi)機上也(ye)開始更有目的(de)(de)性地去選擇(ze)。如對于(yu)癌(ai)癥(zheng)需要(yao)(yao)化療(liao)的(de)(de)患者,選擇(ze)在辰(chen)時(shi)胃(wei)(wei)經最旺的(de)(de)時(shi)候給藥(yao)(yao),能夠減輕胃(wei)(wei)腸道對于(yu)化療(liao)藥(yao)(yao)物(wu)的(de)(de)反(fan)應,降低藥(yao)(yao)物(wu)對胃(wei)(wei)腸的(de)(de)毒副作用。
如(ru)今(jin),不僅是(shi)中醫,現代醫學也發現許多疾病(bing)的(de)發生(sheng)具有時間規(gui)律(lv)的(de)共(gong)性(xing)(xing),比如(ru)血壓的(de)晝(zhou)夜(ye)節律(lv)、心律(lv)失常的(de)晝(zhou)夜(ye)節律(lv)與人體神經(jing)、內(nei)分泌調節的(de)關(guan)系。2017年(nian)諾貝爾醫學獎的(de)獲得者也正(zheng)是(shi)因為(wei)在分子層面(mian)發現了調節細胞晝(zhou)夜(ye)節律(lv)的(de)蛋(dan)白質而(er)收獲這一殊榮。可見不論是(shi)過去還(huan)是(shi)今(jin)日,不論是(shi)中醫還(huan)是(shi)西(xi)醫,時間的(de)重要性(xing)(xing)是(shi)作(zuo)為(wei)共(gong)性(xing)(xing)而(er)存在的(de)。
對于生活、工作壓(ya)力大、節(jie)奏快的(de)現代人(ren),時間往(wang)往(wang)不能把握在(zai)自己(ji)手里,熬夜(ye)、加班是(shi)家常便(bian)飯,出差、時差也(ye)難(nan)以避免(mian),怎(zen)樣做才能在(zai)一天里最(zui)大程度上地順(shun)應自然和自身(shen)的(de)節(jie)律變化呢?
1.如果必(bi)須熬(ao)夜(ye),就(jiu)多喝點水吧。
最好(hao)的(de)入睡(shui)時間在子時,熬夜到1、2點(dian),常(chang)常(chang)會損(sun)耗肝膽精血,久(jiu)而(er)久(jiu)之(zhi)容(rong)易出現肝膽之(zhi)火上亢的(de)陰虛之(zhi)象。如(ru)果不(bu)能保(bao)證早睡(shui),至少多補充(chong)點(dian)水分讓自(zi)己的(de)津液不(bu)致耗傷太(tai)過。
2.難以(yi)入睡,拍拍膽經(jing)
長期作息不規律,終于有早(zao)睡的(de)機(ji)會,卻遲(chi)遲(chi)難(nan)以(yi)入睡,這時可以(yi)敲(qiao)打(da)自(zi)己(ji)的(de)膽經至微(wei)微(wei)發(fa)熱,有助于更(geng)快、更(geng)好地(di)入睡。
3.不能按(an)時排便,也要按(an)摩一下腸道
卯時(shi)(shi)(shi)是大腸(chang)經主(zhu)時(shi)(shi)(shi),建議(yi)養(yang)成在(zai)這個時(shi)(shi)(shi)間(jian)排(pai)便(bian)(bian)的習(xi)慣。但許多人早上(shang)(shang)著(zhu)急上(shang)(shang)班,根本顧不(bu)上(shang)(shang)腸(chang)道(dao)的感受,時(shi)(shi)(shi)間(jian)一久,導致排(pai)便(bian)(bian)不(bu)規律或便(bian)(bian)秘。因此(ci),早上(shang)(shang)起來(lai),不(bu)管有沒有便(bian)(bian)意,都順時(shi)(shi)(shi)針按摩一下自己的腹部、點壓(ya)一下肚臍兩(liang)旁的天(tian)樞(shu)穴(xue),有助(zhu)于(yu)腸(chang)道(dao)的蠕動,逐漸(jian)養(yang)成早晨排(pai)便(bian)(bian)的習(xi)慣。
4.中午(wu)沒有條件休息,就(jiu)試(shi)試(shi)冥(ming)想吧(ba)
午(wu)時為心經主時,中午(wu)若能小憩(qi)片刻,對于調節壓(ya)力、放松(song)心情很有(you)(you)幫助(zhu)。但許多上(shang)班族中午(wu)并沒有(you)(you)午(wu)休(xiu)的條件,那么,帶上(shang)耳機(ji),選一首舒緩的音(yin)樂(le)或者冥想(xiang)的聲音(yin)教學,閉上(shang)眼(yan)睛(jing)讓腦袋放空一會兒,也能緩解一上(shang)午(wu)的緊(jin)張壓(ya)力,以(yi)更好的狀態面對下(xia)午(wu)的工(gong)作。
參考文獻:
[1]左(zuo)彪,譚(tan)彪,肖(xiao)堯,吳應彬,黃勇.淺(qian)談2017年諾貝(bei)爾醫學(xue)獎(jiang)最(zui)新(xin)成果生物節律(lv)和中(zhong)醫傳統時間醫學(xue)的(de)關系[J].世界最(zui)新(xin)醫學(xue)信息文摘,2018,18(45):48-49.
[2]徐歡,馬(ma)琍,李(li)彥斌(bin),熊(xiong)建華.現代中(zhong)(zhong)醫時間(jian)醫學研究評述[J].江西中(zhong)(zhong)醫藥,2018,49(01):78-80.
撰稿:賴潤民 徐浩
美編:賴潤民
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徐浩(hao),醫(yi)(yi)學(xue)博士,主(zhu)任(ren)醫(yi)(yi)師(shi),教授,博士生導師(shi),現為(wei)中(zhong)(zhong)國(guo)中(zhong)(zhong)醫(yi)(yi)科學(xue)院(yuan)(yuan)心(xin)血管(guan)研究所副所長,西苑醫(yi)(yi)院(yuan)(yuan)心(xin)血管(guan)一(yi)科主(zhu)任(ren),兼任(ren)世界(jie)中(zhong)(zhong)聯心(xin)血管(guan)專業(ye)委員(yuan)會(hui)副會(hui)長兼秘書長,中(zhong)(zhong)國(guo)中(zhong)(zhong)西醫(yi)(yi)結(jie)合學(xue)會(hui)循證醫(yi)(yi)學(xue)專業(ye)委員(yuan)會(hui)副主(zhu)委,活(huo)血化瘀專業(ye)委員(yuan)會(hui)秘書長,中(zhong)(zhong)華醫(yi)(yi)學(xue)會(hui)老年醫(yi)(yi)學(xue)分會(hui)常委等職務。入(ru)選第三批(pi)全國(guo)優(you)秀(xiu)中(zhong)(zhong)醫(yi)(yi)臨床人(ren)(ren)才,榮(rong)獲百千(qian)萬人(ren)(ren)才國(guo)家級(ji)人(ren)(ren)選,科技部中(zhong)(zhong)青年科技創新領(ling)軍人(ren)(ren)才等榮(rong)譽稱號,享受國(guo)務院(yuan)(yuan)政府特殊(shu)津貼。
擅(shan)長:中西醫結合治療冠心(xin)(xin)病、高(gao)血(xue)壓、心(xin)(xin)衰、早搏、心(xin)(xin)動過緩(huan)、陣發房(fang)顫、心(xin)(xin)肌炎(yan)后遺(yi)癥、高(gao)脂血(xue)癥、動脈硬化斑塊、心(xin)(xin)臟神經官(guan)能癥等(deng);失眠、頭(tou)痛(tong)、眩暈、咳喘、胃痛(tong)、便秘、自汗(han)盜汗(han)等(deng)內科(ke)雜病癥及亞健(jian)康狀態(tai)的中藥調理(li)。
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