熊鸣峰+兰琴+吴春红

[摘要] “扁鹊”十层脉法相传由“扁鹊”菽法权重定位脉象层次的脉诊法演变而来，以脉象层次命名，由表及里依次为肺、大肠、心、小肠、脾、胃、肝、胆、肾、膀胱十层。此脉法与传统脉法除在脉位分层上存在差异，还表现为各脉位点与人体脏腑对应关系和运指法上的不同，另外还创新性提出“脉级”理论。所以，十层脉法不仅是一种诊脉方法，更是一套疾病分析治疗评估体系，它能用于明确病因、推测主症、确立治法、推断预后、评估疗效。

[关键词] “扁鹊”十层脉；脉学体系；脏腑

[中图分类号] R241；R22 [文献标识码] A [文章编号] 1673-7210（2017）12（c）-0121-04

[Abstract] According to record in the literatures， “ten layers pluse” is evolved from the pulse method of “Bianque” soybean weighting positioning pulse level. This method is named based on the levels of the pulse， which are lung， large intestine， heart， small intestine， spleen， stomach， liver， gallbladder， kidney and urinary bladder from the outside to the inside. There are differences of the levels of the pulse between this pulse method and traditional pulse method， which also shows that each pulse site has different relationship with zang-fu viscera and the fingering of the body， and puts forward the theory of "pulse level" innovatively. Ten layers pulse is not only a pulse diagnosis method， but also a series of disease analysis and treatment evaluation system， which can be used to identify the cause of disease， predict major symptoms， establish therapeutic methods， deduce prognosis and assess the efficacy.

[Key words] Ten layers pulse of "Bianque"； Sphygmology system； Zang-fu viscera

脉诊是最具中医特色的征象[1]。古往今来，凭脉推因、凭脉知证、凭脉定法、凭脉断死生的医家大有人在，而其中集大成者，当属扁鹊。早在《史记·扁鹊仓公列传》记载：“至今天下言脉者，由扁鹊也。”[2]遗憾的是扁鹊对脉学的研究成果鲜有流传，传世之作更是少之又少。据史料考证，虽然没有扁鹊亲撰之作存世，但扁鹊学派代表人物的医疗实践活动及其学术思想，通过《韩非子》《鹖冠子》《史记》《难经》《脉经》等著作记录下来，以此为线索可以窥见其学术思想和特点[3]。如王叔和《脉经》完善了“独取寸口”的脉法，明确提出寸口三关的划分及其分属脏腑，开创了脉象鉴别之先河[4]，其中载“扁鹊阴阳脉法”“扁鹊脉法”“扁鹊华佗察声色要诀”“扁鹊诊诸反逆死脉要诀”篇，均承袭了扁鹊的脉学思想。

“扁鹊”十层脉法相传为扁鹊所创，是一种以脉象的层次来命名的脉诊方法。……