1.北京中医药大学东直门医院,北京市东城区海运仓5号,100700
2.北京中医药大学
sshijing87@163.com
收稿:2025-02-28,
修回:2025-05-18,
纸质出版:2025-07-02
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孙行云,李傅尧,时晶.基于子午流注理论探讨阿尔茨海默病日落综合征辨治思路[J].中医杂志,2025,66(13):1340-1344.
SUN Xingyun,LI Fuyao,SHI Jing.Treatment Strategies for Sundowning Syndrome in Alzheimer's Disease Based on the Zi Wu Liu Zhu Theory[J].Journal of Traditional Chinese Medicine,2025,66(13):1340-1344.
孙行云,李傅尧,时晶.基于子午流注理论探讨阿尔茨海默病日落综合征辨治思路[J].中医杂志,2025,66(13):1340-1344. DOI: 10.13288/j.11-2166/r.2025.13.007.
SUN Xingyun,LI Fuyao,SHI Jing.Treatment Strategies for Sundowning Syndrome in Alzheimer's Disease Based on the Zi Wu Liu Zhu Theory[J].Journal of Traditional Chinese Medicine,2025,66(13):1340-1344. DOI: 10.13288/j.11-2166/r.2025.13.007.
基于子午流注理论探讨阿尔茨海默病日落综合征的中医病机及辨治思路。将日落综合征的发作时间与子午流注理论中膀胱经当令的申时(15:00—17:00)、肾经当令的酉时(17:00—19:00)与心包经当令的戌时(19:00—21:00)对应,认为申时膀胱经当令时发作,病机为阳气浮越、瘀热内结,治宜补肾填精、逐瘀泄热、引火归元,方用桃核承气汤合二至丸加减;酉时肾经当令时发作,病机为髓海空虚、阴不潜阳,治宜补肾填精、安神潜阳,方用六味地黄丸合二至丸加减;戌时心包经当令时发作,病机为痰浊上蒙、阻滞清窍,治宜清热化痰、开窍安神,方用温胆汤加减。同时可在口服中药汤剂时配合针刺、耳穴压丸、穴位贴敷进行综合治疗,为临床诊治疾病提供思路。
This paper explores the traditional Chinese medicine (TCM) pathomechanism, as well as pattern differentiation and treatments for sundowning syndrome in Alzheimer's disease through midnight-noon and ebb-flow theory. The syndrome's onset aligns with three critical time periods governed by three specific channels, including the bladder channel (3:00—5:00 pm,
Shen
period), the kidney channel (5:00—7:00 pm,
You
period), and the pericardium channel (7:00—9:00 pm,
Xu
period). It is believed that when the symptoms occurred at the bladder channel (
Shen
period), the pathomechanism manifested as
yang
qi
floating upward and internal heat-blood stasis, and the treatment should supplement the kidney and essence, expelling stasis and discharging heat, as well as returning fire to its origin, using modified
Taohe Chengqi Decoction
(桃核承气汤) combined with
Erzhi Pill
(二至丸). When the symptoms occurred at the kidney channel (
You
period), the pathomechanism characterized by marrow sea deficiency and
yin
failing to anchor
yang
, so treatment follows the principles of supplementing the kidney and filling essence, as well as calming the mind and subduing
yang
, using modified
Liuwei Dihuang Pill
(六味地黄丸) combined with
Erzhi Pill
(二至丸). When the symptoms occurred at the pericardium channel (
Xu
period), the pathomechanism characterized as phlegm-turbid
ity clouding the mind and obstructing the brain, then the intervention need clear heat and dissolve phlegm, as well as open the orifices and calm the mind, using modified
Wendan Decoction
(温胆汤). Additionally, comprehensive therapy combining oral administration of TCM decoctions with acupuncture, pressure pills on ear points, and point application therapy, which provides clinical insights for the treatment of this disease.
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