A Literature Study On The Pulse Characteristics And Clinical Significance Of The Pulse, The Collaterals And The Veins

Background:Pulse diagnosis is one of the four diagnostic methods in traditional Chinese medicine.Nowadays,the clinical significance of pulse diagnosis is mainly based on 28 pulses.The rapid but intermittent pulse,knotting pulse and generating pulse are belong to 28 pulses.But in the relevant textbooks of modern higher TCM colleges and in the monographs of pulse diagnosis,the pulse characteristics and clinical meaning of the three pulses are inconsistent,which directly affects the guidance of clinical practice and the development ofTCM pulse diagnosis.So how do the rapid but intermittent pulse,knotting pulse and generating pulse record in ancient books?How do modern doctors know?Based on the above problems,it is of great theoretical value and practical significance to carry out literature research on the three pulses.Objective:To explore the development of the three pulses in the ancient books,and analyzes the reasons for the inconsistency between the three pulses of promoting,knot and generation Combined with the research of the three pulses's characteristics and clinical significance in modern literature,to provide reference for the standardization study ofthe three pulses and the guidance of clinical practice.Method:1.Ncorporation ofthe literature:According to the ancient historical dynasties order,fromthe pre-Qin period to the Republic of China.Searching classic Chinese Medicine books such as 'The Yellow Emperor Nei jing' 'Treatise on Typhoid Fever''The pulse theory'.And the pulse of the Study Monographs,such as 'Guide to Disease' 'Lake Vein Science' 'Pulse tactic Journal',etc.Modern literature selection from 1985 to present,a representative monograph in different periods,such as'Pulse of Traditional Chinese Medicine' 'Modern pulse Diagnosis''Modern pulse diagnosis'and so on.2.Search methods:Combine the electronic retrieval and manual retrieval.Search the characteristics and clinical significance of promoting,knot and slow but intermittent pulses from the fifth edition of the Chinese Medical code.While,Search the same contents in the books.Then compare the two results to ensure accurate.3.Data collation:Analysis and summarize the above search content.Reslut:1 The brief introduction of development source of promoting,knot and slow but intermittent pulse1.1 The rapid but intermittent pulse'Huangdi's internal classics' first contains the rapid but intermittent pulse,in which'promote'as 'shortness',but there is no specific description about the shape of the pulse.'The Treatise on Typhoid Fever' and 'Pulse Sutra' refer the shape of rapid but intermittent pulse as 'come and go,time and again',with the characteristics of Fast beat,have a rest,self-recovery',which has been widely recognized by doctors in the future.Shu Zhao put forward to promote the pulse ofthe absence of regular characteristics.Since then,the doctors in the past dynasties inherited the description.The Doctors of the past dynasties have the same understanding ofthe Yangsheng and evil as the main diseases of the pulse.1.2 The knotted pulse'Huangdi Nei Jing'first recorded the knotted pulse,but only described it's main disease,without the description of pulse shape.'The Difficult Sutra'frst describes the knotted pulse has a 'pulse to stop,and stop irregular characteristics.' 'Treatise on Typhoid' supplements the characteristics of the pulse,which is rating slow.Since then,the past generations of doctors inherited the description.The main disease of the knot is divided into two ends,which are xu and shi.1.3 The slow but intermittent pulseThe slow but intermittent pulse was first recorded in the 'Huangdi Nei Jing'.The word 'Dai' in 'Nei Jing' has three different meanings,such as stopping,weakening and substituting.'Treatise on Typhoid'first points out the pulse characteristics ofthe slow but intermittent pulse,but does not discuss the pulse rate and the resting law of the pulse.'Pulse Meridian' records the rate of tenderness,which can be understood that the rate can be normal or fast.In 'Guide to Disease' 'The type of living book' 'Medicine is easy' and other books,many doctors describe the tenderness to slow.The 'pivotal of Diagnosis 'sums up the main diseases which performance the slow but intermittent pulse.2 Modern academic circles' understanding of promoting,knot and slow but intermittent pulses2.1 Pulse characteristicsModern physicians put forward that the shape of rapid but intermittent pulse is innormal.The shape of the knotted pulse and the slow but intermittent pulse is small.The rate ofthe rapid but intermittent pulse is more than 90/min,serious ancient can reach to 140/min.The rate of the kont pulse is less than.60/min.The rate of the slow but intermittent pulse can be normal,fast or solw.2.2 Clinical significance2.2.1 The rapid but interrmittent pulseThe rapid but intermittent pulse can be seen in Yang-hyperactivity,deficiency of the real element,Unbalance of yin and yang,phlegm,food stagnation,qi and blood stasis and poor prognosis.By inducing the relationship between the pulse and arrhythmia,it is found that the pulse can be seen in atrial fibrillation,premature beats,tachycardia(short vibration tachycardia onset and compensatory intermittent after termination),atrial flutter with atrioventricular conduction ratio irregular,digitalis poisoning caused by double junction tachycardia with block,etc.It can also be found in acute pericarditis tachycardia accompanied by the pulse.2.2.2 The knotted pulseThe knotted pulse is mainly seen in cathode,cold syndrome,accumulate syndrome,qi stagnation and blood stasis,phlegm,deficiency syndrome and so on.By inducing the relationship between knotted pulse and arrhythmia,it was found that this pulse are commonly seen in atrial premature beats,atrial fibrillation,ventricular premature beats and complete atrioventricular block.2.2.3 The regular intermittent pulseThe regular intermittent pulse mainly found in endowment anomaly,qi deficiency,wind syndrome,pain syndrome,panic,injury,pregnancy and so on.Combined with the theory of arrhythmia,it is found that this pulse is generally seen in regular arrhythmia such as the two-union law,the triple Law,the Sinus block,and atrioventricular conduction block.Conclusion1.The commonly used 'knot slow but intermittent pulse' in clinical practice is that the pulse has intermittent performance,which is regular or irregular.It is suggested that doctors face this situation in practice,they could use 'the kont pulse and the slow but intermittent pulse alternate appearance'to describe.2.The kont pulse and the slow but intermittent pulse can be found in normal people.3.It is suggested that the textbook of TCM diagnostics should combine the Western medicine arrhythmia knowledge with the rapid but intermittent pulse,knotted pulse and slow but intermittent pulse,which can make the formation mechanism and significance perfect.