结、代、促三脉源流嬗变  

Evolution of knotted,intermittent,and rapid pulse patterns

作　　者：赵世举 哈凯婷 许家佗[1] 张志枫[1] 崔骥[1] ZHAO Shiju;HA Kaiting;XU Jiatuo;ZHANG Zhifeng;CUI Ji(School of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学中医学院,上海201203

出　　处：《上海中医药杂志》2025年第3期48-56,共9页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委科技计划项目(22S31901100,21010504400)。

摘　　要：位、数、形、势是脉象四要素,脉律是脉象四要素的主要特征之一。脉律不齐的常见脉象包括结、代、促3种,被称为“不整脉”,古代医家对这3种脉象的脉率并未提出明确范围。通过梳理历代古籍及文献中有关结、代、促3种脉象的源流、不同时期的脉象特征及临床意义的嬗变规律,旨在帮助学者、医者更准确地识别这3种脉象,并为中医脉诊学发展提供文献支持及为临床辨证提供脉学理论依据。The characteristics of pulse are essential in traditional Chinese medicine(TCM),with four key elements:position,number,shape,and force.Among these,pulse rhythm is a primary feature.Common pulse patterns with irregular rhythms include knotted,intermittent,and rapid pulses,collectively referred to as"irregular pulse".Historical TCM texts do not provide precise ranges for the pulse rates associated with these patterns.This paper explores the evolution of knotted,intermittent,and rapid pulses through a review of TCM classic texts and literature,examining the changing characteristics and clinical significance of these pulse patterns over time.It aims to enhance the ability of scholars and TCM doctors to accurately identify these pulse patterns,provide literature support for the development of TCM pulse diagnosis,and offer a theoretical basis for clinical syndrome differentiation.

关 键 词：结脉 代脉 促脉 中医脉诊 中医诊断 心律失常 

分 类 号：R241.1[医药卫生—中医诊断学]