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8.4.2 Surging pulse, thin pulse, long pulse, short pulse课程教案、知识点、字幕

同学们好

下面我们来学习按脉宽分类的一对脉象

洪脉和细脉

首先 我们来学习洪脉

洪脉的脉象特征 是指脉提宽大而充实有力

来盛去衰 状若波涛汹涌

洪脉的脉象特征 主要表现为

脉搏显现的部位 形态和气势这三个方面

脉体宽大

搏动部位浅表 指下有力

由于脉管里的血流量增加 且充实有力

来时具有浮 大 强的特点

脉来如波涛汹涌 充盛有力

即所谓的 来盛

脉去如落下的波涛

较来时势缓而力弱

即所谓的 去衰

其实 无论是来还是去

洪脉的气势都很大

只是来时比去时更有力

所以称为 来盛去衰

我们用图来说明洪脉的临床意义

正常的脉象

寸关尺三部皆有脉 而且宽度适中

洪脉相比正常的脉象

脉体更加宽大

我们可以考虑一下

宽大的脉管中 主要的物质是什么呢

当然是气和血

因此 宽大的洪脉

气血一定是旺盛的

什么样的人会气血旺盛

首先是

气血旺盛的正常人 可以见到洪脉

而病变的时候

多见于气血旺盛的实热证

当邪热亢盛 正气不衰

气盛血涌 脉管扩张

就可以见到洪脉

另外 夏季

阳气亢盛 气血向外

也可以见到洪脉

所以洪脉为夏季的平脉

洪脉 既可以见于气血旺盛的正常人

也可以见于病变的实热证

如何区别洪脉到底是正常人

还是实热证呢

正常气血旺盛的人

通常除了洪脉之外 不会有数脉的特征

而实热证 除了有洪脉特征之外

因为热邪鼓动血脉而运行加速

所以脉象一定还有数脉的特征

因此 实热证应该见有洪数脉

所以洪脉 如果兼有数脉

则是病变的实热证

如果不见数脉

仅仅是洪而有力

这就是气血旺盛的正常人

或为夏季的平脉(正常脉象)

下面我们来学习

按脉宽分类的另外一个脉象 细脉

细脉的脉象特征是

脉细如线 应指明显

细脉的脉象特点是脉道狭小

手指下感觉往来如线 但按之不绝

应指起落明显

我们还是用图来说明细脉的临床意义

正常的脉象 气血充足

寸关尺三部皆有脉 而且宽度适中

相比较而言

细脉的脉象脉细如线

说明 细脉的气血不足 不能充盈脉道

所以细脉见于气虚 血虚

或者是气血亏虚的虚证

虽然细脉见于气虚和血虚

但是由于细脉

重点在于脉道不充而细

因此细脉与充盈脉道的阴血亏虚

关系最为密切

另外 湿邪重浊黏滞

脉道受湿邪阻遏 气血运行不利

也可以导致细脉

所以 细脉主要见于气血亏虚的虚证

以及湿邪引起病证

从上面可以看出

洪脉和细脉是一对脉宽相反的脉象

洪脉主实热证

而细脉主要是主虚证

洪脉和细脉 这一对脉象的特征是相反的

但是 它们的临床意义并不相反

这一对脉象不是纲领性脉象

下面我们来学习

按照脉的长度分类的一对脉象 长脉和短脉

首先 我们来学习长脉

长脉的脉象特征是

脉体较长 应指超过寸关尺

长脉的脉象特点 是指

脉搏的搏动范围较正常为长

超过寸关尺三部

我们用一个示意图来说明长脉的临床意义

正常的脉象 寸关尺三部均有脉

而长脉

脉体较长 寸关尺超过了本位

说明脉管中气血旺盛

因此 长脉

主要见于气血旺盛的正常人

如果脉长而柔和有力 是为强壮的表现

病变上 长脉可见于阳证 实证和热证

多因阳亢 热盛以及痰火内蕴

使气血壅盛 脉管充实所致

如果长脉见于实热证 除了长脉之外

还必须有数脉特征

在生活中

如果遇见超过寸关尺本位的长脉

而脉象中没有数脉的特征

这种长脉通常见于气血旺盛的正常人

下面我们来学习

按照脉的长度分类的另外一种脉象 短脉

短脉的脉象特征是 脉体较短 应指不及本位

常只显于寸关部

而在尺部多不显

我们还是用示意图来说明短脉的临床意义

正常的脉象 寸关尺三部均有脉

短脉 有两种短

第一种短脉 是指寸关有脉动

而尺脉没有脉象

而且寸关的脉象是短而无力的

这通常是属于气虚证

尺脉为肾脉 因此短而无力

常见于肾气亏虚 无力鼓动血行的病人

第二种短脉 是短脉只见于关部

而且脉象短而有力

这通常是属于气郁

关脉为肝脉

因此 短而有力 通常见于肝气郁结

脉气不能伸展的病人

所以短脉 主要气病有关

通常 短而有力为气郁

常见于肝气郁结

短而无力为气虚

常见于肾气亏虚

从上面可以看出

长脉和短脉 是一对脉长相反的脉象

长脉主 阳证 实证 热证

而短脉主气病

长脉和短脉 这一对脉象的脉象特征是相反的

但是它们的临床意义并不相反

这一对脉象也不是纲领性脉象

以上是我们学习的洪 细 长 短

四个脉象的脉象特征和临床意义

本节课就上到这里

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

8.4.2 Surging pulse, thin pulse, long pulse, short pulse笔记与讨论

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