Xu Qian, Tang Ping-Ping, Zhang Jian-Bin
Second Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing 210023, China.
Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 210029.
Zhen Ci Yan Jiu. 2019 Aug 25;44(8):615-9. doi: 10.13702/j.1000-0607.190109.
According to indications of Sanguan (, and , three places at the wrist where the pulse is usually taken) described in book (), the selection of acupoints is based on the location of problems and pulse conditions. WANG Shu-he (201-280, a well-known physician of the Wei and Jin dynasties) chose the operation method and stimulating intensity according to the nature of clinical disorders, that is, performing acupuncture or moxibusion in accordance with pulse conditions, or performing reinforcing or reducing needling manipulations based on pulse conditions. Clinical indications of Sanguan described in originate from (: ) and are also influenced by () and (). It inherits ZHANG Zhong-jing's clinical thinking of "pulse-syndrome-treatment" and supplements the content of acupuncture and moxibustion treatment, and also influenced the contents of indications of acupoints in book () and (). For this reason, it is necessary to unscramble the from clinical perspective of acupuncture and moxibustion, and to explore the thinking and practice mode of clinical diagnosis and treatment of clinical conditions by acupuncture and moxibustion.
依据《脉经》中所描述的三部（寸、关、尺，腕部通常用来诊脉的三个部位）诊法，穴位的选取是基于病症所在位置及脉象情况。王叔和（201 - 280，魏晋时期著名医家）根据临床病症的性质来选择操作方法及刺激强度，即根据脉象情况进行针刺或艾灸，或者依据脉象情况施行补泻手法。《脉经》中所描述的三部诊法的临床指征源自《内经》（《素问·脉要精微论》：“尺内两旁，则季胁也，尺外以候肾，尺里以候腹中。附上，左外以候肝，内以候膈；右外以候胃，内以候脾。上附上，右外以候肺，内以候胸中；左外以候心，内以候膻中。前以候前，后以候后。上竟上者，胸喉中事也；下竟下者，少腹腰股膝胫足中事也。”），同时也受到《难经》及《伤寒杂病论》的影响。它继承了张仲景“脉 - 证 - 治”的临床思维，并补充了针灸治疗的内容，还对《针灸甲乙经》及《千金要方》中穴位指征的内容产生了影响。因此，有必要从针灸临床角度解读《脉经》，探索通过针灸进行临床病症诊治的思维及实践模式。
