郑彩杏 周小青 曾逸笛 梁昊 李金霞 赖丽娜 童天昊

〔摘要〕 脉诊历史悠久，在数千年的应用中积累了丰富的理论和临床经验。但因为其模糊和难掌握的特征，脉诊成为中医界难解的课题，也成为饱受争议的话题。当代科技发展日新月异，如何整体把握脉诊的地位与作用，结合现代科技以实现脉诊客观化，应该受到中医学者的广泛关注。周小青教授认为脉诊是中医诊断的重要手段，但脉诊研究必须明确：脉诊并非万能，不能诊察所有疾病。周教授从时间、温度、年龄、状态、性别、情志、饮食、地域、劳逸、体质、切脉指法11项影响因素以及位、数、形、势、律、质、紧张度、流利度8项要素认识脉诊，认为脉象与体质、心血管疾病的关联性较高。

〔关键词〕 脉诊;中医诊断;现代化;客观化

〔中图分类号〕R241       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2020.11.008

〔Abstract〕 Pulse diagnosis has a long history and has accumulated rich theoretical and clinical experience in thousands of years of application. However， due to the characteristics of vague and difficult to grasp， pulse diagnosis has become an intractable topic in the field of traditional Chinese medicine （TCM）， and it has also become a controversial topic. With the rapid development of contemporary science and technology， how to grasp the status and function of pulse diagnosis as a whole and combine modern technology to realize the objectification of pulse diagnosis should be widely concerned by TCM scholars. Professor ZHOU Xiaoqing believes that pulse diagnosis is an important means of diagnosis in TCM， but pulse diagnosis research must be clear： pulse diagnosis is not a panacea and cannot diagnose all diseases. Professor ZHOU understood pulse diagnosis from 11 influencing factors of time， temperature， age， status， gender， emotions， diet， region， work and rest， constitution， and pulse cutting fingering， as well as 8 elements of pulse position， pulse counting， pulse shape， pulse force， pulse rhythm， pulse quality， pulse tension and pulse fluency， and believed that pulse condition is highly correlated with constitution and cardiovascular disease.

〔Keywords〕 pulse diagnosis; traditional Chinese medicine diagnosis; modernization; objectivity

周小青教授自1978年起从事中医科研、教学、临床工作，至今已42年，对脉诊研究颇为关注。周教授认为四诊之一的脉诊，是中医学最重要、最具特色的诊断方法之一，却也是中医界难解的课题之一。作为国家重点学科湖南中医药大学中医诊断学学科带头人，对脉诊这一难题有着不可推卸的责任。周教授总结多年学术经验，在尊重已知，探索未知的前提下，谈一些对脉诊的见解。

1 脈诊的涵义

脉诊[1]又称切脉、按脉、持脉、把脉、候脉、摸脉等，是医者运用手指对患者身体某些特定部位的动脉进行切按，体验脉动应指的形象，以了解身体状况，辨别病证的一种诊察方法。……