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8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven课程教案、知识点、字幕

同学们好

下面我们来学习 按脉力分类的一对脉象

虚脉和实脉

首先 我们来学习虚脉

虚脉的脉象特征是

三部脉举之无力 按之空豁 应指松软

举是指轻按

按是指重按

虚脉的脉象特点是脉搏(搏动)力量软弱

寸关尺三部脉 轻按和重按都无力

所以 虚脉是一切无力脉的总称

虚脉即无力脉 因此

虚脉主要见于虚证

主要与气血亏虚有关

气虚时 无力推动血行 所以见脉虚无力

血虚时 不能充盈脉道 所以见脉细无力

阴虚 脉数而无力

阳虚 脉迟而无力

下面我们来学习

按脉力分类的另外一个脉象 实脉

实脉的脉象特征 是脉来充盛有力

其势来去皆盛

应指愊愊 举按皆然

愊愊 坚实貌

实脉的脉象特点是

脉博搏动力非常强盛

寸关尺三部 浮中沉三候 均有力量

脉管宽大 来去俱盛 脉大而长

寸关尺三部 举按皆有力

实脉 是三部脉轻按和重按都有力的脉象

所以实脉是一切有力脉的总称

有力的实脉 既可见于实证

也可见于正常人

实脉见于邪气亢盛 正气不虚的实证

如果脉实 偏浮数

通常见于感受热邪的实热证

如果脉实 偏沉迟

通常见于感受寒邪的实寒证

如果实脉见于正常人 主要是指气血旺盛的正常人

正常人的实脉 必兼有和缓之象

不会有偏数 或偏迟的特征

从上面可以看出 虚脉和实脉

这一对脉力相反的脉象

也是一对纲领性的脉象

主要是来区别邪正盛衰

区别虚证和实证

其中 虚脉主虚证 实脉主实证

下面我们来学习 按照脉的流利度分类的一对脉象

滑脉和涩脉

首先 我们来学习滑脉

滑脉的脉象特征是 往来流利 应指圆滑 如盘走珠

滑脉的脉象特点是 脉搏形态应指圆滑

如同圆珠在盘子上 流畅地从尺部向寸部滚动

浮 中 沉取皆可以感受得到

滑脉 总体上讲 气血是旺盛的

只有气血旺盛 脉象才能 流利 圆滑

因此 滑脉常见于气血旺盛的正常人

比如强壮的青壮年或孕妇等

通常见于滑而和缓有力的脉象

孕妇的气血必须充足 才能养育胎儿

因此孕妇的脉象多为滑脉

这种妊娠脉 又称为喜脉

病变上 滑脉主要见于

痰湿 饮食积滞 实热等实证

而正气不虚 气血旺盛

它主要是因为

痰湿 食滞等阴邪内盛 充盈脉道

而气血不仅不虚 还非常旺盛

因此阴邪助长气血

使气实血壅 鼓动脉气

故见脉来圆滑流利

或火热实邪波及血分

血热运行加速 则脉滑

但必兼数脉 而见滑数脉

总之 见到滑脉是比较好的

无病的时候说明身体健康

有病的时候也说明正气也不虚

下面我们来学习按照脉的流利度分类的

另外一种脉象 涩脉

涩脉的脉象特征 是形细而行迟

往来艰涩不畅 脉律与脉力不匀

应指如轻刀刮竹

涩脉的脉象特点 是脉形较细 脉势艰涩不畅

至数较慢而不匀

脉力大小也不均

总之 涩脉在力量 大小 快慢 流畅度上

都显得不匀 成三五不调之状

就像一把轻轻的小刀

刮在粗糙的竹子表面那样

艰涩不畅

涩脉不如滑脉流利圆滑

自然涩脉的气血也不如滑脉那样旺盛

涩脉 脉来艰涩不畅

脉搏要来 又不能很畅快的来

这种主要见于

气滞 血瘀 痰浊和饮食积滞的实证

也可以见于伤精和血少等虚证

通常来讲

当气滞 血瘀 痰浊 饮食积滞等等

邪气内停 脉道受阻

以致于脉气往来艰涩

由于实邪内盛 正气未衰

就会表现出 涩而有力的脉象

当精亏血少 脉道失去濡润 血行不畅

就可以见到 涩而无力的脉象

滑脉和涩脉 一个是流利圆滑 一个是艰涩不畅

这是一对在脉流利度上相反的脉象

滑脉主痰湿 食积和实热证

而涩脉见于气滞 血瘀 痰浊 饮食积滞的实证

及精亏血少的虚证

滑脉可以见于气血旺盛的正常人

但是涩脉只见于病变

以上是我们学习的

虚 实 滑 涩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

8.4.3 Feeble pulse, forceful pulse, slippery pulse, uneven笔记与讨论

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