国医大师李士懋运用阴阳脉诊思路及临床诊治经验

摘要

This paper introduces the acquaintance of pulse-taking of yin and yang in Treatise on Febrile and Miscellaneous Diseases for the national physician master LI Shimao,and through the clinical basis re-flects his clinical thinking under the guidance of thinking methods of pulse-taking of yin and yang.LI puts forward the change of the pulse should be regarded as a whole in clinical practice,and should not only view the appearance of pulse position to correspond to a Zang or Fu.This is the best interpretation and supplement for the overall view of traditional Chinese medicine.Pulse-taking of yin and yang,that is treating three portions and nine pulse-takings as a whole,in order to distinguish the mutual influence and mutual relationship between the zang-fu organs,and transmission to each other.Including Chi pulse change and then change of Cun;Cun pulse change and then change of Chi;also pulse change of yin and yang separately and does not cause and effect mutually.After LI studies Treatise on Febrile and Miscella-neous Diseases in depth,worked out four elements for syndromes,disease location,nature of disease, disease tendency,and course of disease,that is “Four Sets”.To analyze the nature of the disease entire-ty through pulse-taking of yin and yang in clinic,to grasp the “Four Sets”,and treatment based on syn-drome differentiation.%本文介绍了国医大师李士懋对于阴阳脉诊的认识，并通过临床医案反映其在阴阳脉诊思想方法指导下运用经方的部分临床思路。李老师提出，临床上应当把脉的变动看成一个整体，而不应该只是孤立地、静态地看待不同脉位表象所对应的某脏某腑的病变，这也是对于中医整体观最好的诠释和补充。阴阳脉诊，即把脉的三部九候作为一个整体来看待，以分辨诸脏腑之间的相互影响、相互联系以及相互传变。其中有尺脉变化而后寸脉变化的；有寸脉变化而后尺脉变化的；也有阴阳脉各自变化不相因果的。李老师深研《伤寒杂病论》后，得出证的四大要素，病位、病性、病势、病程，即“四定”。而临床上亦是通过阴阳脉诊整体分析疾病的本质，从而把握“四定”，辨证论治。