The kidney gang has the kidney pericardium, and the sea pepper is Chou Dan Gantong.

Twelve Classics and Meridians, a time series song, is often recommended by me to my friends.

Meridian flow is a law discovered by sages of traditional Chinese medicine. The twelve meridians of the human body correspond to twelve hours of a day. With the change of time, the qi and blood of different meridians will also rise and fall.

Knowing some knowledge of meridians is very helpful for understanding and learning Chinese medicine, and for the treatment of diseases and daily health care.

Many people think that the theory of TCM is mysterious, but in fact they still lack the minimum understanding of TCM.

Meridian flow has a lot in common with the biological clock often said in modern medicine. For example, Chinese medicine believes that the gallbladder meridian is at midnight (23: 00- 1: 00) and the liver meridian is at ugly time (1: 00-3: 00). Modern medical research also found that the liver is very active at 0-3 o'clock, which is also the time when the liver synthesizes cholesterol.

Of course, the significance of the meridian stream is far more than that.

I only know a little about Liu Zhu's theory of meridians, but I might as well use it to discuss some problems of hypertension medication.

Because, in the theoretical circle of western medicine, there has been some subversive understanding about when to take antihypertensive drugs.

First of all, find out when most hypertensive patients use antihypertensive drugs.

The 24-hour ambulatory blood pressure curve of normal people is "two peaks and one valley".

Blood pressure has a certain rhythm day and night, rising rapidly before and after waking up in the morning and reaching a peak around noon; Or there is a peak at 6-7 am and 3-4 pm respectively.

Blood pressure has been maintained at a high level during the day, decreased at night and dropped to a low point during sleep. Therefore, the 24-hour blood pressure curve presents a long-handled spoon shape.

Spoon-shaped hypertension is also called normal hypertension, and there are non-spoon-shaped hypertension, super-spoon-shaped hypertension and anti-spoon-shaped hypertension, which are well understood as the name implies.

Healthy people and most hypertensive patients have this spoon-shaped blood pressure, which is higher during the day than at night.

Based on this situation, most western antihypertensive drugs are recommended to be taken on an empty stomach in the morning. (Note: fasting means taking it before meals 1 hour or 2 hours after meals. )

Food will affect the absorption of drugs. For example, food will reduce the absorption of antihypertensive drugs such as Puli and Sartan, but will increase the absorption of antihypertensive drugs such as Horizon and metoprolol tartrate.

However, in order to reduce the fluctuation of blood pressure, it is generally not recommended to take drugs that can increase absorption through diet, but take them on an empty stomach.

But for many spoon-shaped hypertensive patients, it is difficult to take antihypertensive drugs in the morning.

First of all, many people, especially the elderly, often don't get enough sleep, so they get up very early. Before 4 or 5 o'clock, there is still a distance from eating. Many of these people take medicine as soon as they get up. Whether this method is appropriate or not has not yet been unified.

Secondly, the diseases most feared by hypertensive patients, such as stroke and heart disease, all occur at 4-6 am, when the blood concentration of antihypertensive drugs is the lowest.

The ideal state of taking antihypertensive drugs is that the time when antihypertensive drugs exert their maximum effect overlaps with the peak value of blood pressure fluctuation.

However, there are great differences in blood pressure fluctuation, symptoms, living habits and physique of patients with hypertension. At present, there are many kinds of antihypertensive drugs, complicated mechanism of action, many manufacturers, many contents and many dosage forms. Even on the basis of correct diagnosis and long-term monitoring, it is still very common to choose appropriate antihypertensive drugs and their own methods of taking them.

At the annual meeting of the European Cardiovascular Society in 2020, an expert released a research result of antihypertensive drugs, which lasted for 20 years and the research object reached 44 167 hypertensive patients.

It is found that taking calcium channel blockers (horizon antihypertensive drugs) or angiotensin II receptor blockers (sartan antihypertensive drugs) before going to bed is more effective than taking antihypertensive drugs in the morning, mainly in the following three aspects:

1, taking antihypertensive drugs at night can significantly reduce the 24-hour average systolic and diastolic blood pressure.

2. Compared with patients who take antihypertensive drugs in the morning, patients who take antihypertensive drugs at night have better blood pressure control effect.

3. Compared with morning medication, taking antihypertensive drugs at night can reduce the risk of major cardiovascular adverse events by 52%.

If this research can be verified on a larger scale, it will definitely have a subversive impact on the field of antihypertensive drugs.

It is better to take antihypertensive drugs before going to bed, and it is also feasible to explain them with meridian theory.

Meridian theory shows the periodic changes of yin and yang in human body and between zang-fu organs.

In the view of Chinese medicine, the healthiest state of human body is the state of harmony between yin and yang. Children are the most prosperous yin and the most declining yang. Yin dominates quietness, while Yang takes the initiative. At this time, people should rest. After that, the yin gradually weakened and the yang gradually recovered. If the strength of yin is too strong at this time, or the strength of yang is too weak, there will be a situation in which yang does not enter the yin. This is the disharmony between yin and yang, and people can be very dangerous.

This is the reason for the high incidence of cerebrovascular diseases at 4-6 am.

After people get up, 5-9 o'clock belongs to the responsibilities of yang meridian, large intestine and stomach, and they need to defecate and eat. Moreover, because of the strong yang, people's spirit will be strong and their blood pressure will be high.

At 9- 13, the spleen and heart belonging to the Yin meridian are on duty. At this time, there is more yin than yang, so it is necessary to be a little quieter and let the stomach digest slowly. You'd better take another nap, and then your blood pressure will be low.

At 13- 17, the small intestine and bladder meridian belonging to Yang meridian were on duty, and Yang prevailed at this time. Because the small intestine is on duty, you can eat a richer lunch. When the bladder meridian is on duty, people's mental and physical state will be good and their work efficiency will be higher. Another blood pressure peak, of course.

17-2 1, which belongs to the kidney and pericardium meridians of the Yin meridian. At this time, the yin has overwhelmed the yang, and you will feel tired after a day's work. It is appropriate to adopt a quieter method to adjust, and your blood pressure will gradually stabilize.

The next day, at 2 1- 1, the triple energizer meridian and the gallbladder meridian to which Yang meridian belongs were on duty. At this time, Yang spirit prevailed slightly, so people appeared to be more energetic than before. But at this time, yang has become a spent force, yin is getting heavier and heavier, it's time to go to bed, and blood pressure has reached the bottom.

The rise and fall of blood pressure changes with the continuous rotation of yin and yang. The appearance of hypertension may be the physical manifestation of excess yang caused by imbalance of yin and yang, and it can also explain the formation of non-spoon blood pressure.

In recent years, more and more evidence shows that antihypertensive drugs have side effects on human body. Will western medicine antihypertensive drugs forcibly control blood pressure through a series of mechanisms, or will it harm the yang or yin of the human body, or change the fundamental harmony between yin and yang?

The new argument that taking antihypertensive drugs before going to bed is more effective for blood pressure control, although there is a lot of strong evidence, is not necessarily brilliant, or because taking drugs at night will do less harm to Yang.

Of course, at present, the control of hypertension mainly depends on western medicine, and the control effect is more accurate. When applying antihypertensive drugs, we should still find a personalized plan that suits us under the guidance of existing medical theories. However, the treatment of hypertension should not be limited to the use of antihypertensive drugs, but should focus on the overall health and longevity of the body and adopt a more positive attitude and means.