肺病见弦脉之理论探讨

弦脉的脉象是指"端直以长,如按琴弦"的脉形,为临床常见且极为重要的脉象之一。弦脉在临床中有生理性弦脉和病理性弦脉的区别,其在脉象上有不同的表现。弦脉所主病证主要有肝病、疼痛、痰饮、疟疾等,主要以实证为主,亦可见于虚证或者虚实夹杂之证。其形成机制主要是各种原因引起的气机失调或邪气内阻导致肝气失于疏泄,脉气紧张,脉道拘急。肺病可见弦脉,主要多见于肺系慢病重病之中,其形成主要与气机失调、痰瘀邪气内阻、肺脾肾亏虚有关,肺系慢病和重病中可根据弦脉的软硬程度以判断胃气的多少或有无,注重脾胃的运化功能,同时根据弦脉的兼夹脉象辨证灵活用药,为临床肺病的诊断与治疗提供一定的参考与借鉴。

Discussion of Stringy Pulse in Lung Disease

The pulse manifestation of stringy pulse is straight and long,like pressing on the string. Stringy pulse is an important and common pulse in clinic. In clinic,stringy pulse could be physiological and pathological,and manifests differently. The diseases indicated by stringy pulse are liver diseases,pain,phlegm and fluids retention,malaria,usually the excessive diseases,and sometimes the deficient types and mixed deficient and excessive diseases. Such diseases are usually caused by disorder of qi activity due to various reasons or liver qi failing to regulate due to evil qi blocking internally,both leading to strained pulse qi and spasm of pulse tract. Lung diseases could show the stringy pulse,usually in the chronic and severe cases,usually due to qi disorder,internal blockage of phlegm,stasis and evil qi,deficiency of lung,spleen and kidneys. The tension degree could indicate the state of stomach qi and the transportation and transformation function of spleen and stomach in the chronic and severe lung diseases. Therefore,in clinic,stringy pulse in the lung disease could guide the diagnosis and treatment.