基于“经脉”内涵的“凡将用针,必先诊脉”之“脉”解  

Interpretation of Pulse in‘When Using Acupuncture,the Pulse Must Be Diagnosed First’Based on Connotation of‘Meridian’

作　　者：赵志恒[1] 赵曼霖 ZHAO Zhiheng;ZHAO Manlin(The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第二附属医院,天津300250 [2]天津中医药大学,天津301617

出　　处：《针灸临床杂志》2024年第9期88-91,共4页Journal of Clinical Acupuncture and Moxibustion

基　　金：天津市教委科研计划,编号:2022KJ181。

摘　　要：“凡将用针,必先诊脉”出自《灵枢经·九针十二原》,是针刺的重要原则。对于所诊之“脉”目前临床中多从脉诊的角度认识,“脉诊”的解释忽视了“脉”作为“经脉”本义在针灸疗法中的重要意义,以及《灵枢经》作为“针经”以经脉理论为核心的针灸纲领性内容。本研究从此句话及其前后文义角度进行分析,并结合古典医籍中“脉”“血脉”“经脉”的认识,认为《灵枢经》中“脉”当有两种解释:作“经脉”解,以候气血之虚实;作“脉象”义,以探五脏之盛衰。因此,认为“凡将用针,必先诊脉”之“脉”当有“经脉”之义,针刺时必须细审“脉”之气血虚实,同时也强调临床实际应用针刺操作时要重视诊脉,即“爪切”经络和腧穴的应用。‘Before using the needle,the pulse must be diagnosed first’is an important principle in acupuncture,which originated from Spiritual Pivot·Nine Needles and Twelve Yuan-Source Acupoints.Regarding the diagnosed pulse,current clinical practices often emphasize the perspective of pulse diagnosis.However,this interpretation overlooks the important significance of the pulse as the essence of meridians in acupuncture therapy,as well as Spiritual Pivot as a classic content of acupuncture with meridian theory at its core.This passage is analyzed from the perspective of its surrounding context combined with the understanding of pulses,blood vessels,and meridians in classical medical texts.It is believed that in Spiritual Pivot,the term pulse could have two interpretations:as meridians,to assess the deficiency or excess of Qi and blood;and as pulse patterns,to examine the strength or weakness of five viscera.Therefore,it is believed that the‘pulse’in‘before using the needle,the pulse must be diagnosed first’should have the connotation of meridians.When needling,it is necessary to carefully examine the deficiency or excess of Qi and blood in the meridian.At the same time,it also emphasizes the importance of pulse diagnosis in clinical practice,that is,the application of palpitation along the meridians and acupoints.

关 键 词：灵枢经 九针十二原 诊脉 经脉 脉象 

分 类 号：R245-0[医药卫生—针灸推拿学]