伍怀芝 杨佳

摘要 脉诊是中医诊断中的重要手段，针刺是中医治疗里的重要方法，为了解脉诊在近代针刺治疗中的运用情况，并了解近代临床针刺运用脉诊的适应范围及临床意义，检索“针刺+脉诊”相关文献后发现近代针刺治疗中配合诊脉的文献较少，然而诊脉对临床针刺的指导意义有理论依据可循，脉诊对针刺得气的重要性确有依据，脉诊指导针刺的原则多源于《黄帝内经》，针刺运用的脉法丰富多样，未涉及临床实践内容的文献占近1/3;针刺治疗配合诊脉有理论依据并具有临床意义，目前现代针刺治疗中诊脉不受重视是事实，《灵枢·九针十二原》所言之“凡将用针，必先诊脉”，是目前中医传承中被忽视的珍贵内容，亟需继续传承发展，利用现代科研技术与先进的设备，期望可促进脉诊的中医科学研究。

关键词 针刺;脉诊;得气;黄帝内经;经典;中医;医学;疾病;健康;研究进展;临床研究;文献检索

Literature Study on the Current Situation of Pulse Diagnosis in Acupuncture Treatment

WU Huaizhi，YANG Jia

（School of Acupuncture Moxibustion and Tuina，Beijing University of Chinese Medicine，Beijing 100029，China）

Abstract Pulse diagnosis is an important mean to diagnose diseases in traditional Chinese medicine（TCM）.Acupuncture is an important treatment method of traditional Chinese medicine.In order to find out the application of pulse diagnosis in modern acupuncture treatment，and understand the adaptation range and clinical significance of pulse diagnosis in modern clinical acupuncture，the literature related to“Acupuncture+Pulse Diagnosis”was retrieved.It was found that there was few literature on cooperating with pulse diagnosis in modern acupuncture treatment.However，there is a theoretical basis for the clinical significance of pulse diagnosis on clinical acupuncture.There were importance evidences of pulse diagnosis for gaining qi for acupuncture.The guiding principle of pulse diagnosis is mostly derived from Huangdi′s Canon of Medicine.Acupuncture uses a variety of pulse methods，and the literature that does not involve clinical practice accounts for nearly 1/3;Acupuncture treatment combined with pulse diagnosis have theoretical basis and has clinical significance.At present，it is a fact that the diagnosis of pulses in modern acupuncture treatment is not paid attention to.In Lingshu·Nine Needles and Twelve Originals，it is said that“when a needle will be used，the pulse must be diagnosed”，which is currently neglected in traditional Chinese medicine inheritance.The precious content needs to continue to be inherited and developed.Using modern scientific research technology and advanced equipment，it is expected to promote research on pulse diagnosis of TCM.

Keywords Acupuncture; Pulse diagnosis; Qi arrival; Huangdi′s Canon of Medicine; Classic; Traditional Chinese medicine（TCM）; Medicine; Disease; Health; Research progress; Clinical research; Bibliography retrieval

中图分类号：R241.1;R245.3文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.02.028

脈诊是中医诊断疾病的重要手段，是中医学中代表性的特色之一。纵观中医发展史，脉诊一直是中医确定疾病证型、区分疾病性质和预测疾病预后的重要依据。脉诊与经络诊断有着密切的关系，其发展经历了由具体到抽象、由繁至简的过程。早期脉诊用于确立针灸的疗法，针刺与脉诊有着密切的关系，之后的中医发展对方药应用与脏腑辨证逐渐重视，脉诊与开方用药的关系逐渐紧密联结，针灸治疗与脉诊的关系则不再像早期一样密切，现代中医治疗中脉诊多用于遣方用药之时，针灸临床治疗中配合脉诊使用的情况已很少，脉诊在中医针灸临床上的重要性与地位正在逐渐下降[1]。……