脉象理论研究述评  

A Review of Pulse Manifestation Theory

作　　者：韩心 鲁明源[1] HAN Xin;LU Mingyuan(Shandong University of Chinese Medicine,Jinan Shandong China 250355)

机构地区：[1]山东中医药大学,山东济南250355

出　　处：《中医学报》2020年第3期573-578,共6页Acta Chinese Medicine

基　　金：国家中医药管理局迟华基全国名老中医药专家传承工作室项目(520786)。

摘　　要：目前,对于经典脉象的研究主要包括脉象思维方法、脉象分类及其影响因素等。受西方医学思维方法的一系列影响,现代学者进一步对脉象进行了精细化、客观化研究,或致力于对脉象要素的描述与分析,或运用客观化数据规范脉象,或关注血管壁结构、血流动力、血液流变、自主神经等对脉象变化的影响,或将中西医理论有机结合构建新脉学理论体系。围绕脉-学展开的各种研究丰富和发展了中医脉学理论,但与经典脉学理论的认知存在或多或少的差异,仍有下列亟待解决的问题:①重象轻意,忽视气机。忽略对脉象变化本质即气机状态的探讨,对同一脉象的分析难以统一。②主观性强,认同性差。各家对脉象要素的归纳总结主观色彩浓重,缺乏规范化。③标准刻板,忽视人本。脉象标准化的研究模式背离以人为本的思维方法,且检测设备缺乏标准化。④偏重细节,忽视神机。现代的脉象研究更加侧重于血管结构、血流动力特性、血液流变特性等因素的客观分析,一定程度上忽略了脉象要素及对神机的把握。⑤脉学新解,有待发展。新脉学理论体系与中医脉学通过诊察气机流变以认知脉象的方法存在本质差别,两者不能相互取代。脉象研究存在的问题主要是源于对中医原创思维的背离,今后的研究须根植于中医学文化土壤,即以气一元论作为脉象研究的立论基础,明确"气机为脉象本质"这一基本前提,进而剖析脉象特征,分析脉象要素,促进中医脉学体系的发展。因此,回归中医学固有的本体论、方法论是脉象研究的关键所在。At present,the study of classic pulse manifestation mainly includes pulse manifestation thinking method,pulse classification and its influencing factors,etc.With a series of western medical thinking methods,modern scholars have further refined and objective research on pulse manifestation,or devoted to the description and analysis of pulse manifestation elements,or used objective data to standardize pulse manifestation,or concerned about the influence of vascular wall structure,hemodynamics,hemorheology,autonomic nerves,etc.on pulse changes,or organically combined Chinese and western medical theories to build a new pulse manifestation theory system.Various researches on pulse science have enriched and developed the theory of pulse science of Chinese medicine,but there are more or less differences with the cognition of classical pulse theory,and there are still the following problems to be solved:①Emphasis on image,neglect of meaning,and neglect of qi movement.Ignore the discussion of the nature of pulse manifestation changes,that is,the state of the qi movement.It is difficult to unify the analysis of the same pulse.②The subjectivity is strong,and the identity is poor.The summary of pulse factors by various medical scientists is subjective and lacks standardization.③The standard is rigid,neglecting humanism.The research mode of pulse manifestation standardization deviates from the people-oriented thinking method,and the detection equipment is lack of standardization.There are differences in parameter standard,extraction method and analysis method of pulse instrument.④Pay attention to details and ignore magic machine.To some extent,modern pulse research ignores the pulse manifestation elements and the mastery of the spiritual mechanism.⑤A new understanding of pulse needs to be developed.There are essential differences between the new pulse theory system and the method of TCM pulse manifestation recognition by observing the changes of qi movement.They cannot be replaced each other.The existing problems in

关 键 词：脉象 气机 意象思维 神机 气一元论 

分 类 号：R241[医药卫生—中医诊断学]