仝小林脉诊“十六字脉诀”探析

Analysis of Professor TONG Xiaolin's“16-Character Verse on Pulse Diagnosis”

根据多年临床实践经验,仝小林院士在传统脉诊的基础上提出“十六字脉诀”,即阴、阳、表、里、寒、热、虚、实、气、血、水、位、肤、管、律(率)、神。其中阴阳者,统领六纲,提示主纲;表里者,定位浮沉,提示顺势而为;寒热者,定性迟数,提示正治;虚实者,揭示强弱,提示邪正盈亏;气看充盛与否,提示张力;血看流畅与否,提示血流状况;水看磅礴与否,提示燥湿;位定四焦,提示病位;肤显温湿,提示寒热润燥;管显老稚,提示脉管的弹性和僵硬程度;律(率)见调控,提示机体调节功能;神见气定,提示情绪。通过脉诊辅助临床辨慢病寒、热、燥、湿、郁、瘀、瘠、壅、老、虚“十态”,作为“态靶辨证”下诊脉的重点,在诊脉、识脉、辨脉的基础上以期更准确地识态、辨态、调态,实现治疗的精准化。

Based on years of clinical experience,academician TONG Xiaolin proposed the“16-character verse on pulse diagnosis”on the basis of traditional pulse diagnosis theory,namely yin,yang,exterior,interior,cold,heat,deficiency,excess,qi,blood,water,location,skin,vessel,rhythm(rate),and minds.Yin and yang govern the other six principles and reflect the main principles.Exterior and interior,manifested as floating and deep pulse respectively,reveal the location of disease and indicate that the treatment should follow the tendency of disease.Cold and heat reflect the nature of disease and corresponds to slow and rapid pulse,respectively;positive treatment should be taken to correct the deviation.Deficiency and excess denote that the strength of pulse,and the weak and strong pulse indicate the depletion and fillingness of healthy qi and pathogenic qi,respectively.Qi being in exuberance or not reflects the different degree of pulse tension.Blood circulation fluency is manifested as unblocked pulse flow.Water condition in the body,either in dryness or dampness,can be judged from surging or thready pulse.Location of pulse-taking corresponds to the different disease location at four jiao(焦).Skin warmth and humidity of the wrist reflect the cold-heat and moisten-dryness of the body fluids.Blood vessels physical state denotes the elasticity and stiffness of pulse vessels.Rhythm(rate)disorder of the pulse shows the irregularity of body management.Mind of the pulse manifested as the qi condition helps judge the emotional condition.The pulse diagnosis can assist in differentiating the ten states,namely cold,heat,dryness,dampness,constraint,stasis,congestion,tough and deficiency of chronic diseases,which has been the focal point of“syndrome differentiation according to the state target”.This is a way to promote the precision of treatment by precisely understanding,differentiating and regulating the state in relation to the pulse taking,comprehension and differentiation.