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2.2 Heart课程教案、知识点、字幕

同学们好

我们继续学习五脏的心的生理功能和病理变化

心藏于胸中 为君主之官

心 主要从三个方面来学习

一是心的定位

二是心的生理和病理

三是心的联属功能

心在人体的定位 除了心脏本身之外

我们人的大脑的精神 意识 思维活动

也是属于心所主管的

所以中医所涉及的心不仅仅指心脏

还包括人的大脑

我们来看看心的生理功能

病理变化 以及联属功能又是什么呢

首先我们来看看心的生理功能

心理生理功能 主要有两个

第一个生理功能 就是心主血脉

这里的心是指的心脏

当心气充沛的时候

心脏搏动正常

从而推动血液在脉中正常的运行

周流不息 营养全身

可见面色红润光泽

脉象和缓有力

如果心气不足 就可能会出现

心血管系统的病变 比如心悸 怔忡 心痛等等症状

那什么是心悸呢

心悸就是心慌

是一种不自主的心脏的跳动的自觉症状

正常人是感觉不到自己的心脏在跳动的

心主血脉

主要的定位是心 因此

心悸 怔忡 心痛 是心的主要的定位症状

我们称为必有症状

心的第二个生理功能 称之为心主神志

这里的神志就是指的人体的

大脑精神 意识 思维活动

人体大脑的精神 意识 思维活动是归属于心的生理功能的

中医上所讲的心除了心脏之外 还包括大脑的精神 意识 思维活动

当心主神明正常

人体的精神 意识 思维就正常

就会表现为 神志清晰 思维敏捷 精神充沛

如果心有病变

影响到神志的活动

就可以表现出心烦失眠

多梦健忘 甚至神昏谵语 神志错乱等等临床表现

心烦 失眠 多梦 健忘

这是最大多数心主神志的病人会出现的一些表现

我们看这四个症状中

哪一个症状最令人痛苦呢

我们应该可以看出来

失眠 是让最大多数人痛苦的症状

所以失眠是心的第二个主要的定位症状

以上心主血脉 心主神志 是心的两个主要的生理功能

下面我们来学习心的联属功能

我们还是从四个方面来学习

心的第一个联属功能 就是心在志为喜

在志为喜是指心的生理功能和精神情志

与喜有密切的关系

一般来说

喜就是高兴的意思

是属于良性的刺激

喜乐愉悦的情绪

有益于心主血脉的功能正常

但是过度喜乐 则可导致心神受伤

比如说范进中举

过于高兴而诱发了癫狂

心神功能过度亢盛

则导致人喜笑不休

心神功能不及 则使人容易悲伤

因为心主神明 所以不但喜能伤心

五志过极 也能够损伤心神

所以《灵枢》有一句话叫做

愁忧恐惧则伤心

心的第二个联属功能 就是在体合脉 其华在面

就是指

全身的血脉都属于心

而心的功能是否正常 可以显露在面部的色泽表现

一般来讲

心的气血旺盛 血脉充盈

则面色红润光泽

当心的气血不足 则面色晄白无华

心的第三个联属功能 就是心开窍于舌

是指舌的味觉功能

正常的语言表达能力

均有赖于心的生理功能的正常

心功能正常 则舌体红活

柔软灵活 味觉灵敏 语言流利

而如果心功能失常

比如心阳不足 则舌淡白胖嫩

心阴血不足 则舌红瘦

心火上炎 则舌尖红而生疮

心神失常 则舌强 语言蹇涩

下面我们小结一下

心的主要生理功能是 主血脉和主神志

所以心的定位症状 我们也可以概括为两个方面

一方面是心的症状 包括心悸 怔忡 心痛

其中最常见出现的是心悸

另一方面是大脑的症状 包括心烦 失眠 多梦 健忘

其中失眠是让人最痛苦的症状

所以心的定位症状

我们又称为心的必有症状 最主要就是这两个

一个就是心悸 一个就是失眠

以上是我们学习的心的生理功能和病理变化

以及心的定位症状

本节课就讲述到这里

Diagnostics in Chinese Medicine课程列表:

Week 1 Introduction

-Introductory remark

--Introductory remark

--QQ groups、WeChat public account

-Introduction

--Introduction

--【Discussion 1】Why do you want to take this course?

-Unit test for Introduction

Week 1 Basic Theory of Chinese Medicine 1:Yin-Yang and Five Elements Theory

-1.1 Yin-yang theory

--1.1 Yin-yang theory

-1.2 The theory of five elements

--1.2.1 The theory of five elements

--1.2.2 Application of the theory of five elements

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 1

Week 2 Basic Theory of Chinese Medicine 2:Zang-Fu Theory

-2.0 Outline

--2.0 Outline

--【Discussion 2】How to understand the holistic view centered on the Zang Fu theory?

-2.1 Liver

--2.1 Liver

--【Discussion 3】Why is repose more important than vigorous exercise in recuperation for patients with

-2.2 Heart

--2.2 Heart

-2.3 Spleen

--2.3 Spleen

-2.4 Lung

--2.4 Lung

-2.5 Kidney

--2.5 Kidney

-2.6 Six fu organs

--2.6 Six fu organs

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 2

Week 3 Basic Theory of Chinese Medicine 3:Qi,Blood and Body Fluid Theory

-3.1 Qi

--3.1 Qi

-3.2 Blood

--3.2 Blood

-3.3 Body fluid

--3.3 Body fluid

-3.4 The relationship of qi, blood and body fluid

--3.4 The relationship of qi, blood and body fluid

--【Discussion 4】A discussion about the theory of qi, blood and body fluid

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 3

Week 4 Basic Theory of Chinese Medicine 4: The theory of etiologic factor

-4.0 Outline

--4.0 Outline

-4.1 Six exogenous factors

--4.1.1 Six exogenous factors

--4.1.2 Nature and pathogenicity of wind and cold

--4.1.3 Nature and pathogenicity of summer heat and damp

--4.1.4 Nature and pathogenicity of dryness and fire

-4.2 Etiology of visceral impairment

--4.2 Etiology of visceral impairment

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 4

Week 5 Diagnosis methods: Inquiry (1)

-5.0 Outline of inquiry

--5.0.1 Outline of inquiry(1)

--5.0.2 Outline of inquiry(2)

--【Discussion 5】If you were a patient, how would you describe your condition to your doctor first?

-5.1 Inquiry of Chills and fever

--5.1.1 Chills and fever(Aversion to cold with fever)

--5.1.2 Chills and fever(Chills without fever)

--5.1.3 Chills and fever(Fever without chills)

--5.1.4 Chills and fever(Alternative chills and fever)

--【Discussion 6】How to understand "if you have clinical manifestations of cold, that is exterior syndr

-5.2 Inquiry of perspiration

--5.2 Inquiry of perspiration

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 5

Week 6 Diagnosis methods: Inquiry (2)

-5.3 Inquiring of pain

--5.3 Inquiring of pain

--【Discussion 7】How to understand "stagnation leading to pain and innourish leading to pain"?

-5.4 Inquiring of head, body, thorax and abdomen

--5.4 Inquiring of head, body, thorax and abdomen

-5.5 Inquiring of ears and eyes

--5.5 Inquiring of ears and eyes

-5.6 Inquiring of sleep

--5.6 Inquiring of sleep

-5.7 Inquiring of food and drink, appetite and taste

--5.7 Inquiring of food and drink, appetite and taste

-5.8 Inquiring of defecation and urination

--5.8.1 Inquiring of defecation

--5.8.2 Inquiring of urination

-5.9 Inquiring of infantile and women's disease

--5.9 Inquiring of infantile and women's disease

-Unit test for week 6

Week 7 Diagnosis methods: Observation (1)

-6.0 Outline of Observation

--6.0 Outline of Observation

--【Discussion 8】Please use the whole body inspection (including the expression, complexion and figure)

-6.1.1 Observation of vitality

--6.1.1 Observation of vitality

-6.1.2 Observation of the color

--6.1.2.1 The content, principles of inspection of the color

--6.1.2.2 Indication of diseases by five colors

--【Discussion 9】How do you understand the normal complexion of a normal people?

-6.1.3 Observation of the appearance

--6.1.3 Observation of the appearance

-6.1.4 Observation of figure and posture

--6.1.4 Observation of figure and posture

-Unit test for week 7

Week 8 Diagnosis methods: Observation (2)

-6.2.1 Observation of head and face

--6.2.1 Observation of head and face

-6.2.2 Observation of five sensory organs

--6.2.2.1Observation of five sensory organs(observation of eyes,ears,nose)

--6.2.2.2Observation of five sensory organs(observation of lips,teeth and gums,throat)

-6.2.3 Observation of body

--6.2.3 Observation of body

-6.2.4 Observation of limbs

--6.2.4 Observation of limbs

-6.2.5 Observation of two lower orifices

--6.2.5 Observation of two lower orifices

-6.2.6 Observation of skin

--6.2.6 Observation of skin

-6.3 Observation of excreta

--6.3 Observation of excreta

-6.4 Observation of infantile fingerprints

--6.4 Observation of infantile fingerprints

-Frequently Asked Questions

--Frequently Asked Questions

-Unit test for week 8

Week 9 Diagnosis methods: Inspection of tongue

-7.1 Outline of tongue inspection

--7.1.1 The morphology and structure of the tongue

--7.1.2 The principle of tongue examination

--7.1.3 The method and precaution of tongue examination

--7.1.4 The content of tongue examination, normal tongue

-7.2 Inspection of tongue structure

--7.2.1 Observe the color of tongue

--7.2.2 Observe the shape of tongue

--7.2.3 Observe the states of tongue

--7.2.4 Observation of sublingual vein

-7.3 Observation of tongue coating

--7.3.1 Observation of coating texture

--7.3.2 Observe the color of coating

-7.4 Clinical significance of tongue diagnosis

--7.4 Clinical significance of tongue diagnosis

--【Discussion 10】Why to observe the tongue can be used to diagnose disease?

-Unit test for week 9

Week 10 Diagnosis methods::Pulse examination

-8.1 The principle of pulse examination

--8.1 The principle of pulse examination

-8.2 The regions and methods of pulse examination

--8.2 The regions and methods of pulse examination

-8.3 The elements of pulse examination and the normal pulse

--8.3 The elements of pulse examination and the normal pulse

-8.4 Characteristics and significance of pulse

--8.4.1 Superficial pulse, deep pulse, slow pulse, rapid pulse

--8.4.2 Surging pulse, thin pulse, long pulse, short pulse

--8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven

--8.4.4 Taut pulse, tense pulse,soggy pulse, moderate pulse

--8.4.5 Knotted, slow-regular-intermittent, irregularly abrupt

-8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--8.5 Similar pulse, concurrent pulse, pulse indicating deterioration of visceral qi۞

--【Discussion 11】Why is complex pulse more common than single-factor pulse?

-8.6 Women’s pulse, children’s pulse

--8.6 Women’s pulse, children’s pulse

-8.7 The clinical significance of pulse diagnosis

--8.7 The clinical significance of pulse diagnosis

-Unit test for week 10

Week 11 Diagnosis methods:Listening and smelling examination

-9.1 Listening

--9.1 Listening

-9.2.1 Abnormal sound

--9.2.1 Abnormal sound

-9.2.2 Abnormal language

--9.2.2 Abnormal language

-9.2.3 Respiratory abnormality

--9.2.3 Respiratory abnormality

-9.2.4 Cough

--9.2.4 Cough

--【Discussion 12】How to observe the patient's cough sound and sputum changes to determine whether the

-9.2.5 Abnormal sounds of the stomach and intestines

--9.2.5 Abnormal sounds of the stomach and intestines

-9.3 Smelling

--9.3 Smelling

--【Discussion 13】How to diagnose by smelling?

-Unit test for week 11

Week 12 Diagnosis methods:Palpation

-10.1 The method, meaning and precautions of palpation

--10.1 The method, meaning and precautions of palpation

-10.2 Contents of palpation

--10.2.1 Palpating chest and hypochondrium

--10.2.2 Palpating stomach and abdomen

--10.2.3 Palpating skin

--10.2.4 Palpating hands and feet, palpating acupoints

--【Discussion 14】How to determine whether external or internal injuries?

-Unit test for week 12

Conclusion

-Conclusion

--Conclusion

Final Exam

-Final Exam

--Final Exam

2.2 Heart笔记与讨论

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