【摘要】 张子和为金元四大家中“攻邪派”的代表人物,善用汗法、吐法、下法治疗疾病。张子和脉诊思想源于《黄帝内经》《伤寒论》《脉经》等医籍,集中呈现于《儒门事亲》所载脉案之中。本研究基于张子和医学理论体系,结合中医气机理论,通过文献梳理,探究张子和脉诊与汗、吐、下三法以及中医气机理论之间的内在联系。研究发现,张子和通过对脉势、脉位、脉体等要素的分析,达成病位、病性、病机的三维辨证;结合人体气机升降状况,将脉象与三法精确对应,选取适宜汗、吐、下治法,同时依据脉象的动态演变预判疾病的转归;其核心逻辑在于通过脉诊辨识气机,以攻邪之法恢复气机正常运行。更多还原

【Abstract】 Zhang Zihe,a representative figure of the expelling pathogenic factors school among the four great masters of Jin and Yuan dynasties,was good at using sweating,vomiting and purgative methods to treat diseases. His pulse diagnosis philosophy was derived from medical classics such as Inner Canon of Huangdi,Treatise on Cold Damage Diseases, and Pulse Classic,and is prominently reflected in the medical records documented in Ru Men Shi Qin. Based on Zhang Zihe’s medical theoretical system and combined with the theory of Qi movement in traditional Chinese medicine,this study explores the intrinsic connections among Zhang Zihe’ s pulse diagnosis,the three therapeutic methods(diaphoresis,emesis,and purgation),and the theory of Qi movement through literature review. The research finds that Zhang Zihe achieved a threedimensional pattern identification of disease location,nature,and pathogenesis by analyzing elements such as pulse momentum,pulse position,and pulse body. By integrating the ascending and descending conditions of the human body’s Qi movement,he precisely correlated pulse manifestations with the three therapeutic methods,selecting the appropriate treatment of sweating,vomifing,or purgation. At the same time,he predicted the progression of diseases based on the dynamic evolution of pulse manifestations. The core logic lies in identifying Qi movement through pulse diagnosis and restoring the normal circulation of Qi by expelling pathogenic factors.更多还原