中医把脉有办法！学会老中医的这几招，自己亦能做为把脉“能手”
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">一说到中医，人们就会自然而然地联想到把脉。脉诊是中医最鲜明的特征之一，<span style="color: black;">亦</span>是世人公认地中医诊断的<span style="color: black;">办法</span>之一。中医有<strong style="color: blue;">望闻问切</strong>四种诊断方式，而把切诊中的脉诊<span style="color: black;">做为</span><span style="color: black;">重点</span>的诊断方式，是有缘由的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">第1</span>，脉象能够比较全面且准确地反映出脏腑的病变，是<strong style="color: blue;"><span style="color: black;">做为</span>中医判断<span style="color: black;">病人</span>病情的重要依据</strong>，在<strong style="color: blue;">医书《内经》</strong>中已有不少阐述。第二，望闻问切中，前三种问诊方式常常容易受到<span style="color: black;">病人</span>主观<span style="color: black;">原因</span>的影响，而<strong style="color: blue;">脉象对病情的反映是真实且客观的</strong>，因而是中医问诊中必不可少的一步。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">久而久之，<span style="color: black;">把脉</span><span style="color: black;">作为</span>人们对中医问诊<span style="color: black;">必须</span>的认知，若看中医时缺少这一步，反而会使人感到中医在敷衍了事，由此<span style="color: black;">能够</span>看出，<span style="color: black;">把脉</span>不仅是辨识中医医术的关键，<span style="color: black;">亦</span>是中医诊断病情的重中之重。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">把脉</span>是专业人士掌控的技术，外行人只<span style="color: black;">晓得</span><span style="color: black;">把脉</span>的大概位置，但<span style="color: black;">把脉</span>时<span style="color: black;">到底</span>有何讲究呢？</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/pgc-image/c378b82262484a3c9eb809852859c9b3~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726085161&x-signature=ZACse8uu%2BCgjscgCDDPuLn%2BRUM0%3D" style="width: 50%; margin-bottom: 20px;"></div>
<h1 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">1、</span>学会这些，你<span style="color: black;">亦</span>能<span style="color: black;">作为</span>把脉“<span style="color: black;">能手</span>”</h1>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">实质</span>上，<span style="color: black;">初期</span>的<span style="color: black;">把脉</span><span style="color: black;">办法</span>比较<span style="color: black;">繁杂</span>，中医需<strong style="color: blue;">切按<span style="color: black;">病人</span>的颈部、手部、<span style="color: black;">脚步</span>等多个部</strong>位的脉搏，到了后来，才简化成只切按手腕的脉搏，<span style="color: black;">详细</span>位置在<strong style="color: blue;">手腕横纹上大约一寸</strong>，又分为<strong style="color: blue;">寸、关、尺</strong>三部位，这三部位分别对应着<span style="color: black;">区别</span>的脏腑，能够反映相应脏腑的病变。譬如右寸对应肺，右关对应脾胃，右尺则对应肾。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">把脉</span>的指力<span style="color: black;">亦</span>是有讲究的，<span style="color: black;">通常</span><span style="color: black;">来讲</span>，有三种<span style="color: black;">区别</span>的指力，<strong style="color: blue;">轻轻用力</strong>按在皮肤上叫做<strong style="color: blue;">浮取</strong>，<strong style="color: blue;">中等力度</strong>按至肌肉则是<strong style="color: blue;">中取</strong>，而<strong style="color: blue;">重重用力</strong>按至筋骨则为<strong style="color: blue;">沉取</strong>，<span style="color: black;">区别</span>指力取到的脉象，对应的临床<span style="color: black;">道理</span><span style="color: black;">亦</span><span style="color: black;">区别</span>，病位浅者适合浮取，病位深者则需沉取。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/dfic-imagehandler/5ed1c56a-d3d2-4f93-b93e-339169e3f42c~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726085161&x-signature=Glt7vQMPHDFWzi2W3PDiMrZoW8A%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">简而言之，<strong style="color: blue;"><span style="color: black;">把脉</span><span style="color: black;">重点</span>有三个讲究</strong>，分别是：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">第1</span>，<strong style="color: blue;"><span style="color: black;">需求</span>安静</strong>，<span style="color: black;">包含</span><span style="color: black;">外边</span>环境的安静和<span style="color: black;">大夫</span>、<span style="color: black;">病人</span>二人心神的安静。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">第二，<span style="color: black;">把脉</span>时，<span style="color: black;">大夫</span>应用<strong style="color: blue;">三指定位</strong>，<span style="color: black;">亦</span><span style="color: black;">便是</span>先以中指定好关部，再<span style="color: black;">按照</span><span style="color: black;">病人</span>身高<span style="color: black;">调节</span>三个手指的疏密程度，身材<span style="color: black;">高挑</span>者，布指疏，身材矮小者，布指则密。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">第三，学习诊脉，<strong style="color: blue;">必须要先<span style="color: black;">认识</span>正常的脉象</strong>。正常的脉又被<span style="color: black;">叫作</span>为<strong style="color: blue;">平脉或常脉</strong>。<span style="color: black;">所说</span>平脉或常脉，指的是<strong style="color: blue;">正常<span style="color: black;">状况</span>下，脉搏每分钟跳动70-80次，节奏规律，且脉二型不沉不浮，不刚不弱。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">不外</span>，<strong style="color: blue;"><span style="color: black;">区别</span>人的脉象有所<span style="color: black;">区别</span></strong>，对脉象的观察<span style="color: black;">通常</span>是<span style="color: black;">包含</span>两个方面。一是<strong style="color: blue;">气血的充盈程度</strong>，二是<strong style="color: blue;">运行状态</strong>。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/pgc-image/6c18efb64fd34774abc3a25e60addb33~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726085161&x-signature=xZVs8jrAuiF6ewjl7dxcdurp3TE%3D" style="width: 50%; margin-bottom: 20px;"></div>
<h1 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">2、</span>中医将脉象分为这五种<span style="color: black;">区别</span>的类型</h1>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">脉象<span style="color: black;">按照</span>气血充盈程度和运行状态<span style="color: black;">区别</span>，可分为以下五种类型的脉象：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">虚实：</strong>阳气旺盛者脉动有力，阳气虚的人脉象则无力，<span style="color: black;">不外</span>，<span style="color: black;">倘若</span>脉象过于有力，则<span style="color: black;">寓意</span>着<span style="color: black;">身体</span>有火热。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">粗细</strong>：指的是脉象的形体，脉象过于细小，或坚硬如钢，常<span style="color: black;">寓意</span>着阴血不足，但<span style="color: black;">倘若</span>脉形边界不清，常是湿邪<span style="color: black;">导致</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">另外</span>，弦象、滑象和濡象<span style="color: black;">亦</span>是最基本的三种脉象。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">弦象：</strong>受寒或郁闷时，脉象收紧，似琴弦紧绷，而肝脏主疏泄，弦象又是肝脏<span style="color: black;">疾患</span>的脉象。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/dfic-imagehandler/6344708e-feb5-4ef0-9eaf-67b9a2222bc7~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726085161&x-signature=bsCe5CxxEIiWpK4Z1aNaStTKZzg%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">滑象：</strong>脉象流利，是实热、伤食的脉象，<span style="color: black;">同期</span>，<span style="color: black;">亦</span>是怀孕的脉象。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">濡象：</strong>核心表现是软，即脉象柔软、弥漫，是水湿的表现。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">正<span style="color: black;">一般人</span>脉象，又<span style="color: black;">叫作</span>平脉或常脉。常脉为三部有脉，一息四至（每分钟脉搏在７０－８０次），不浮不沉，不大不小，节律均匀，从容和缓，流利有力，尺脉沉取<span style="color: black;">不停</span>。<span style="color: black;">不外</span>，脉象<span style="color: black;">亦</span>受年龄等<span style="color: black;">原因</span>影响，婴儿的脉象急，每分钟为120-140次，年老者体弱，脉象<span style="color: black;">亦</span>弱，且女性比男性的脉象更细弱且快。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当脉象<span style="color: black;">显现</span>何种<span style="color: black;">状况</span>时，是身体有病变的反映呢？</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/pgc-image/99aeb6f7f1474f2d9da5e6e4ea5480a8~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726085161&x-signature=sQzQZNu7YnNYLOy7of6%2B3qK5yQI%3D" style="width: 50%; margin-bottom: 20px;"></div>
<h1 style="color: black; text-align: left; margin-bottom: 10px;"><span style="color: black;">3、</span><span style="color: black;">平常</span>的<span style="color: black;">反常</span>脉象有<span style="color: black;">那些</span>？</h1>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">若是<span style="color: black;">把脉</span>时<span style="color: black;">显现</span>这五种脉象，说明身体可能<span style="color: black;">显现</span>了<span style="color: black;">反常</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">迟脉：</strong><span style="color: black;">所说</span>迟脉，<span style="color: black;">亦</span><span style="color: black;">便是</span>脉象来得比较慢，每分钟在60次以下，该脉象<span style="color: black;">都数</span>反映寒证，因寒<span style="color: black;">引起</span>血流速度减慢。迟脉<span style="color: black;">亦</span>分为两种<span style="color: black;">状况</span>，一是迟而有力，一是迟而无力，前者为冷积实证，后者则为阳虚之证。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">数脉：</strong>与迟脉相反，每分钟在90次以上，来去急促的脉象<span style="color: black;">叫作</span>为数脉，<span style="color: black;">都数</span>为热证，因火热<span style="color: black;">引起</span>血流速度加快。数而有力的<span style="color: black;">状况</span>为实热，数而无力则为虚热。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://p3-sign.toutiaoimg.com/dfic-imagehandler/94cf95c9-a872-48c9-8847-23221cf33728~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726085161&x-signature=h1DPPU%2B32HsefoO7fKkWyBkgjPM%3D" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">细脉：</strong>脉象如细线，软弱无力，是湿证和虚证的脉象，<span style="color: black;">都数</span>是<span style="color: black;">因为</span>湿邪阻滞或气血虚弱<span style="color: black;">引起</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">滑脉：</strong><span style="color: black;">重点</span>分为两种<span style="color: black;">状况</span>，一是脉在指下快速划过时，略有黏滞感，二是脉形<span style="color: black;">很强</span>，但不见黏滞感，前者主痰，后者主火热。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">虚脉：</strong>若三部脉举都无力，则<span style="color: black;">叫作</span>为虚脉，是为虚证的表现，<span style="color: black;">重点</span>是气虚或气血两虚之证。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">把脉</span>是中医辩证的重要治疗依据，但一种病症<span style="color: black;">亦</span>可能<span style="color: black;">表现</span>出多种脉象，一种脉象<span style="color: black;">亦</span>可能出<span style="color: black;">此刻</span>多种病症上，唯有<span style="color: black;">按照</span><span style="color: black;">详细</span><span style="color: black;">状况</span>加以分析，<span style="color: black;">才可</span>达到最佳的治疗效果。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;">#39健康超能团#</a> <a style="color: black;">#清风计划#</a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考资料：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《中医把脉手把手教，最全动图展示<span style="color: black;">包含</span>心法口诀！！看完就学会了》.医术交流.2020-06-15</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">蒋力生.中医把脉<span style="color: black;">为么</span>能辨病?.中国中医药现代远程教育,2006:61-62.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《一篇<span style="color: black;">文案</span>读懂中医诊脉！》.人卫中医.2020-07-31</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">未经作者<span style="color: black;">准许</span>授权，禁止转载</strong></p>
真情实感，其含义为认真了、走心了的意思，是如今的饭圈常用语。 我们有着相似的经历，你的感受我深有体会。 你的努力一定会被看见，相信自己，加油。 你的见解独到，让我受益匪浅，期待更多交流。
页:
[1]