濡脉的脉象特征与临床意义

Characteristics and Clinical Significance of Soft Pulse

在濡脉的脉象特征上,西晋的《脉经》明确定义濡脉脉象特征为"浮软而细"。自此之后,各代医家大多继承《脉经》观点,认为濡脉为浮、细、软三者兼具的脉象,并沿用至今。明清时期,少数文献中还出现了濡脉的沉、细、大等不同观点,但在理论与临床实践上对后世均影响较小。现代文献中,存在濡脉与其他脉象组合为相兼脉的现象,忽略了濡脉本身浮、细、软的脉象特征。在濡脉的临床意义上,在宋代以前,以主诸虚证为主,亦可见于平人。宋代医家陈无择在《三因极一病证方论》中首次提出濡脉除主诸虚证外还可主湿证,这一新观点多被后人沿用。现代中医流行病学在调查中发现,濡脉的临床意义仍以主诸虚证与湿为主,且与脾联系密切。

The pulse characteristics of the Soft Pulse,in Mai Jing,which was written in the Western Jin Dynasty,was clearly defined as " floating,soft and thin". Since then,generations of medical doctors have inherited the view of recorded in Mai Jing,thinking that this pulse is floating,fine and soft,and it has been used to this day. In the Ming and Qing Dynasties,there were different views about Soft Mai,by saying that it is Chen,Xi and Da,etc. in a few literatures,but the influence on later generations in theory and clinical practice was small. In modern literature,there is a phenomenon in which the Soft Pulse are combined with other Mai cases,and the floating,thin,and soft pulse characteristics of it are ignored. In the clinical sense of Xunmai,before the Song Dynasty,the Soft Pulse means deficiency syndromes or it can also be found in healthy people. In the Song Dynasty,a physician named Chen Wuze,for the first time,in his San Yin Ji Yi Bing Zheng Fang Lun,proposed that the pulse can be used for Dampness syndrome in addition to the above mentioned ones,which was followed in later generations. Modern Chinese medicine epidemiology has found in the investigation that the clinical significance of Soft Pulse is still dominated by deficiency syndromes and dampness,and is closely related to the Spleen.