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脉诊学习笔记--分辨脉象(2)

  • 2026-05-24 00:40:50
脉诊学习笔记--分辨脉象(2)
3、沉脉
《脉经》：沉脉，重手按至筋骨乃得
沉脉，字面意思就是脉搏下沉，即在最深层。诊断沉脉时，用举法在浮位轻取是无法察觉的，只有重按沉取的时候才能清楚感觉到脉博。
脉位：寸、关、尺三部在浮中取少力，沉取有力
脉形：浮取无，沉取有力
脉管：搏动主要在脉管底部
脉症：主里症。与身体内部的疾病相关
沉脉有力——多为里实，邪盛内郁，正邪相争于里，阳气补遏，无法鼓动脉气于外，因此脉沉而有力，气滞、血瘀、食积、痰饮等症常见此脉象；
脉沉而无力——多为里虚，气血不足或阳虚气少的人，阳气无力升举、鼓动脉气而脉沉、无力，可见于各脏腑的虚症。
注：有的正常人的脉象也会出现沉脉，要看以下情况：
1）尺脉代表的为肾和命门，肾以封藏为本，所以寸、关、尺中尺脉本就偏沉。
2）寸、关、尺三部皆沉，但并没有明显疾病表现，那这个沉脉也属于健康脉象 ，只是体质特殊。
4、迟脉
特点：迟脉在脉位、脉形及脉管上无特别表现。主要体现在频率上，比正常脉频率要低，即每分钟脉博次数少于正常脉博次数，一个呼叫跳动低于4次，每分钟脉博次数少于60次的，均为迟脉
脉症特点：寒症、阴症
迟脉多与寒症有关。中医认为寒性收引、凝滞，脉搏的快慢是依靠阳气推动，身体一旦寒邪入体，气血运行受阴，在脉象上体现就是迟脉。
实症则脉博有力，虚症则脉博无力。
个人体会：
左寸迟而无力——寒凝心脉 、心气虚实
表现：常心悸气短；睡眠质量差、多梦，易醒
我在脉诊学习笔记里写了给自己摸脉试了一下，对应迟脉，学到迟脉这里情况很符合，心悸、睡眠问题完全对症，正在积极调理中。
另，心悸明显的人，寒湿重的人不能吃寒性食物和寒性水果，已经确诊的病症，治疗中寒性水果一定不要吃，对身体无益，会有影响
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  140. /yingpanguazai/ssd/ssd1/www/no.67808.cn/vendor/topthink/think-trace/src/Html.php ( 4.42 KB )
  1. CONNECT:[ UseTime:0.000636s ] mysql:host=127.0.0.1;port=3306;dbname=no_67808;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000727s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000337s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000291s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000563s ]
  6. SELECT * FROM `set` [ RunTime:0.000217s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000693s ]
  8. SELECT * FROM `article` WHERE `id` = 490378 LIMIT 1 [ RunTime:0.000395s ]
  9. UPDATE `article` SET `lasttime` = 1779569714 WHERE `id` = 490378 [ RunTime:0.001399s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000231s ]
  11. SELECT * FROM `article` WHERE `id` < 490378 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000436s ]
  12. SELECT * FROM `article` WHERE `id` > 490378 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.000413s ]
  13. SELECT * FROM `article` WHERE `id` < 490378 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.000832s ]
  14. SELECT * FROM `article` WHERE `id` < 490378 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.005684s ]
  15. SELECT * FROM `article` WHERE `id` < 490378 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.001613s ]
0.083423s