《黄帝内经》脉时相关理论与应用

Exploration of Speculative Method about Comprehensive Consideration of Both Pulse and Time in “Yellow Emperor’s Canon of Medicine”

[目的]探究《内经》脉时合参思想和经验,以期更全面地学习中医学脉学理论,提高临床疗效。[方法]撷选《内经》相关原文,对脉诊理论中的时间因素做简要分析,探讨昼夜、月相、季节等时间因素对脉象的影响,总结《内经》脉时合参思辨方法。[结果]昼夜、月相、季节等时间因素与脉象关系密切,自然界的阴阳消长等具有明显的时间性,人体脉象与其相适应。脉时合参不仅可以知晓脉象随昼夜、月相、季节等的生理变化,还可根据脉、脏、时的关联准确判定病位,通过脉逆四时与否细测病情轻重,依据脉象随病情发展的阶段性规律预判病势预后,以及因时制宜指导临床治疗。[结论]《内经》脉时合参思想,内容丰富,在临床中运用广泛,蕴涵着天人一体的整体观和中医学哲学思辨方法,值得深入挖掘和学习。

[Objective] To explore the thoughts and experiences of comprehensive consideration of both pulse and time in "Yellow Emperor’s Canon of Medicine", to learn more about the theory of traditional Chinese medicine and improve the clinical efficacy. [Methods]Selecting relevant original texts of"Yellow Emperor’s Canon of Medicine", analyzing the time factors in the pulse diagnosis theory briefly, discussing the influence of time factors such as day and night, moon phase and season on the pulse, to summarize the speculative method of comprehensive consideration of both pulse and time in "Yellow Emperor’s Canon of Medicine". [Results] Time factors such as day and night, moon phase and season are closely related to pulse, the nature ’s ebb and flow of Yin and Yang and so on, have obvious timeliness, which human body pulse adapts to. Comprehensive consideration of both pulse and time can not only know the physiological changes of the pulse with day and night, moon phase and season, but also accurately determine the disease location by the relationship among pulse, viscera and time, measure the severity of the disease according to whether pulse disagrees with seasonal variations or not,predict the tendency and prognosis of the disease by the phasic rule of pulse with disease development, and guide the clinical treatment in accordance with time. [Conclusion]The thoughts of comprehensive consideration of both pulse and time in "Yellow Emperor’s Canon of Medicine" are rich in content,which is widely used in clinical practice. It contains the holistic view of the unity of the heaven and human being and the philosophical speculation method of Chinese medicine, which worth deep exploration and learning.