《金匮要略》浮脉探析  

Analysis of Floating Pulse in Synopsis of Golden Chamber

作　　者：汪淼 吕翠霞[1] WANG Miao;LYU Cuixia(Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学,山东济南250355

出　　处：《山东中医药大学学报》2021年第6期748-751,共4页Journal of Shandong University of Traditional Chinese Medicine

基　　金：山东省名老中医药专家传承工作室建设项目(编号:2018-5)。

摘　　要：《金匮要略》前22篇共48条涉及浮脉的条文。经梳理发现:其一,此脉分部广泛,除位于寸口整部及单部外,也出现在趺阳、少阴等脉口,另外,对于文中“脉浮”字眼需反复推敲,未必皆指寸口;其二,浮脉通常和其他脉复合出现,以致指下形象多样化,而注重对兼脉信息的兼容是把握正邪之间、整体和局部之间等复杂联系及变化的关键要素,同时,张仲景以象思维表述无胃气、无神气、无根基之真脏脉形象,此类脉相对于一般复合病脉为变中之凶;其三,以表里为纲领分别从外邪袭表、里邪留表、里邪上迫、里热壅盛、里虚以及表里传变六方面阐释浮脉所主病机的多元性;其四,认为浮脉在确立治则上颇有启发意义,从“表里同治,顾护正气”“明确病位,因势利导”“明辨虚实,攻其所得”“调补阴阳,建中为本”四方面进行探讨。There are 48 items of original article about floating pulse in the first 22 chapters of Synopsis of Golden Chamber.①Floating pulse is widely distributed,in addition to the whole part and single part of Cunkou,it also appears in pulses of Fuyang,Shaoyin,etc.In addition,“floating pulse”in the text needs to be repeatedly deliberated,not necessarily referring to Cunkou.②Floating pulses usually appear in combination with other pulse conditions,so that the image of the finger is diversified.Paying attention to the compatibility of the pulse information is the key element to grasp the complex connections and changes between healthy qi and pathogenic factors,the whole and the part.At the same time,ZHANG Zhongjing expresses the image of visceral exhaustion pulse without stomach qi,no spirit qi,and no foundation with the imagery thinking.Compared with the general complex disease pulses,this type of pulse is the culprit in the pathological changes.③Taking the exterior and interior as the guideline,this paper explains the pathogenesis diversity of floating pulse from six aspects:external pathogen attacking the exterior,internal pathogen lingering exterior,internal pathogen distressing upward,internal heat congestion,internal deficiency,and external and internal transmission and change.④Through summarizing and analyzing the relevant article concerning floating pulse,it is believed that the floating pulse is quite enlightening in the establishment of the treatment principle.This article discusses the four aspects of“simultaneous treatment of the exterior and interior,protecting healthy qi”,“determining the location of the disease and taking advantage of the situation”,“clearly differentiating deficiency and excess,eliminating the excess”,“regulating and replenishing yin and yang,and fortifying the middle energizer as the root”.

关 键 词：《金匮要略》 浮脉 表里同治 明确病位 明辨虚实 调补阴阳 

分 类 号：R222.3[医药卫生—中医基础理论]