从“阳浮而阴弱”探讨仲景阴阳脉法  

Discussion on Zhongjing′s Yin-Yang Pulse Method from Perspective of"Yang Floats While Yin Is Weak"

作　　者：范继东 谷松[1] FAN Jidong;GU Song(Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning China 110847)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《中医学报》2022年第5期905-909,共5页Acta Chinese Medicine

基　　金：国家重点基础研究发展计划(“973”计划)项目(2013CB532004)。

摘　　要：《伤寒论》中“阳浮而阴弱”中阴阳的具体指代应为尺脉与寸脉,“阳浮而阴弱”当为“寸浮而尺弱”。阳脉即寸脉,主表主阳;阴脉即尺脉,主里主阴。寸浮而尺弱,为里气不足,邪侵肌表之象,故以桂枝汤养胃生津,同时配合热稀粥以扶正祛邪。张仲景阴阳脉并不是指代病机,而是传承于《难经》的阴阳脉法。阴阳脉法以关为界,关前诊察人体之上与表,关后诊察人体之下与里,并结合阴阳二部的脉象,通过诊察人体之气血状态来判断表里、上下的邪正盛衰,尤其适合指导外感病的诊断及治疗。In Treatise on Febrile Diseases,the specific meaning of yin and yang in"yang floats and yin is weak"should be Chi pulse and Cun pulse,and"yang floats and yin is weak"should be"Cun pulse floats and Chi Pulse is weak".The yang meridian is the Cun meridian,which means man′s exterior and yang aspect;the yin pulse means Chi pulse,which means man′s interior and yin aspect.Yang floating and yin being weak is a sign of insufficient internal Qi and evil factor invading the surface of the muscle.Therefore,Guizhi Decoction is used to nourish the stomach and produce body fluid,and it is often used c with hot gruel to strengthen the Zheng Qi of man and eliminate the evil factor.In Zhang Zhongjing′s book,yin and yang pulse does not refer to the pathogenesis,but the yin and yang pulse method inherited from the Nan Jing.The yin and yang pulse method takes Guan as the boundary.Before the Guan,the top and the surface of the human body are examined,and after the Guan,the bottom and the inside of the human body are examined.Combined with the pulse conditions of the two parts of yin and yang,the blood state of the human body is diagnosed to determine the evil factor and Zheng Qi of the outside,inside as well as up and down.It is especially suitable for guiding the diagnosis and treatment of exogenous diseases.

关 键 词：阴阳脉法 “阳浮而阴弱” 尺脉 寸脉 桂枝汤 伤感病 《伤寒论》 《难经》 张仲景 

分 类 号：R222.19[医药卫生—中医基础理论]