【目的】 通过现代气象数据验证癸卯年（2023年）五运六气的实际变化模式，结合中医舌诊探讨气候特征变化对高血压 病机的影响，为高血压的中医防治提供理论依据。【方法】 收集2023癸卯年北京地区气象数据，对比近十二年历史数据，分 析各六气时段的气候特征与常规运气模式的一致性和偏差。每个六气时段采集2023年2月4日至2024年2月3日北京中医药 大学东直门医院心血管内科的高血压患者和健康人群（医院工作人员及患者家属）数据各 100例，共 1 200例样本。对比 2组 舌象特征差异，分析气候与高血压病机变化的关联。【结果】 初之气温暖潮湿，高血压患者舌象反映湿热、气滞血瘀；二之 气火盛，患者舌象反映热邪伤阴、血瘀；三之气燥热，患者舌象反映燥热伤阴、痰湿内盛；四之气寒热错杂，患者舌象反 映阳虚、痰湿内阻；五之气温暖异常，阳气不敛，患者舌象提示阳虚湿盛；终之气寒湿，患者舌象显示脾阳虚、痰湿壅盛。 【结论】 除三之气、五之气外，各六气时段理论与实际气候均存在差异，高血压患者的舌象变化与五运六气实际模式相吻 合，证实了运气理论结合气象数据对高血压病机变化预测的有效性。

Objective To verify the actual variation pattern of the five circuits and six qi in the Gui-Mao year （2023） using modern meteorological data， and to explore the influence of climatic characteristics on the pathogenesis of hypertension by integrating traditional Chinese medicine （TCM） tongue diagnosis， thereby providing a theoretical basis for TCM prevention and treatment of hypertension. Methods Meteorological data from Beijing in 2023（Gui-Mao year） were collected and compared with historical data from the past twelve years to analyze the consistency and deviations between climatic characteristics in each six qi period and the conventional five-circuit and six-qi model. During each of the six qi periods from February 4，2023 to February 3，2024， 100 hypertension patients and 100 healthy individuals （hospital staff and patients’ family members） from the Cardiology Department of Dongzhimen Hospital，Beijing University of Chinese Medicine were recruited，totaling 1 200 samples. Tongue manifestations were compared between the two groups to analyze the association between climate and changes in hypertension pathogenesis. Results The initial qi was warm and humid，with hypertensive patients’ tongue manifestation reflecting damp-heat and qi stagnation with blood stasis；the second qi was marked by intense fire，with tongue manifestation indicating heat pathogen damaging yin and blood stasis；the third qi was dry and hot，with tongue manifestation showing dry-heat damaging yin and internal phlegm-dampness；the fourth qi exhibited mixed cold and heat，with tongue manifestation reflecting yang deficiency and internal obstruction by phlegm-dampness；the fifth qi was unusually warm with failure of yang qi to consolidate，and tongue manifestation suggested yang deficiency with damp exuberance； the terminal qi was cold-damp， with tongue signs demonstrating spleen yang deficiency and exuberant phlegm-dampness. The terminal qi was cold-damp， with tongue manifestations demonstrating spleen yang deficiency and exuberant phlegm-dampness. Conclusion Except for the third qi and fifth qi，discrepancies existed between the theoretical and actual climatic conditions across the six qi periods. Changes in tongue manifestations among hypertensive patients corresponded to the actual five-circuit and six-qi pattern，confirming the effectiveness of combining the five-circuit and six-qi theory with meteorological data in predicting changes of hypertension pathogenesis.

R226；R259.441

国家重点研发计划项目（编号：2022YFC3502301）；国家“双一流”重大标志性成果后补助项目（编号：BZY-BZX-2022-04）