摘要：自古以来，中医脉诊作为中医诊断的重要方法之一，一直在临床实践中发挥着重要作用。梁世杰主任在继承传统中医理论的基础上，结合自己多年的临床经验，形成了独特的五行脉法。本文将重点探讨梁世杰主任的五行脉法纪要，详细解析五脏本脉相乘脉法，并结合清代医家张璐的理论，探讨五
自古以来，中医脉诊作为中医诊断的重要方法之一，一直在临床实践中发挥着重要作用。梁世杰主任在继承传统中医理论的基础上，结合自己多年的临床经验，形成了独特的五行脉法。本文将重点探讨梁世杰主任的五行脉法纪要，详细解析五脏本脉相乘脉法，并结合清代医家张璐的理论，探讨五行脉法的历史渊源和实践应用。
一、五脏本脉相乘脉法
梁世杰主任在五行脉法的基础上，深入研究了五脏本脉及其相乘脉法。他认为，通过寸口单取、三部九候脉法，可以清晰地辨别各脏腑的气血状况，从而指导临床治疗。
1. 三部九候脉法
寸口脉诊法，是中医脉诊的基础。梁世杰主任在三部九候脉法的基础上，将左寸对应心、肝、肾，右寸对应肺、脾、命门，明确了各脏腑在寸口脉上的定位。这种方法既简单又实用，能够迅速定位病变脏腑。
2. 五行五脏本脉
梁世杰主任认为，五行五脏本脉是中医脉诊的核心。他根据五行理论，将肺（大肠）对应金，其脉象为浮脉；肾（膀胱）对应水，其脉象为沉脉；脾（胃）对应土，其脉象为迟、涩脉；心（小肠）对应火，其脉象为滑、数脉；肝（胆）对应木，其脉象为弦脉。
3. 正邪消长——虚、实脉
脉象的虚实反映了正邪的消长。邪气胜则实，精气夺则虚。梁世杰主任强调，脉象的虚实是判断疾病进退的重要依据。若脉象由实转虚，说明正气渐衰，病情可能加重；若脉象由虚转实，说明正气渐复，病情可能好转。
4. 非其位而现其脉——他脏来乘
梁世杰主任指出，若脉象出现在与其对应的脏腑不符的位置，即为他脏来乘。例如，左寸本应出现心脉，若出现肺脉，则为肺乘心。这种脉象无论生克乘辱，皆是病脉。虽病此脏，但本非此脏，脉从所来，应随脏治之。
二、张璐五行脉法的历史渊源
张璐是清代著名的医家，他在五行脉法方面有着独到的见解。他的理论不仅丰富了中医脉诊的内容，也为后世医者提供了宝贵的参考。
1. 脏腑分候与五行方位
张璐在《诊宗三昧·脉位》中指出：“火旺于南，故心居左寸；木旺于东，故肝居左关；金旺于西，故肺居右寸；土旺于中，而寄位西南，故脾胃居于右关；水旺于北，故居两尺。”张璐将脏腑五行属性对应天地方位进行阐述，使脏腑分候更加清晰明了。
2. 命门学说与三焦之火
张璐受明清时期命门学说的影响，对命门相火等分候进行了深入分析。他指出：“以分野言，则肾当箕尾燕冀之界……人应其气，则三焦之火，从此交通。况三焦鼎峙两肾之间，以应地运而右转。是虽右尺偏属相火，为生人生物之源，因有命门之号。其实两肾皆有水火，原无分于彼此，以故岐伯于寸关二部，俱分左右，尺独不分者，一皆主乎肾也。”张璐将肾与星宿对应，认为三焦之火源于肾并居于两肾之间，随地运右转而使命门相火寄于右尺。这一理论不仅丰富了中医脏腑理论，也为临床脉诊提供了新思路。
3. 天人合一与体悟为主
张璐的脉法不仅注重理论与实践的结合，还强调天人合一的思想。他认为，医者诊脉时应心无杂念，掌握要领，对脉象加以认真体会。他提倡“心空为宗”，指出：“除却胸中落索，空空地向己灵上究去……触类旁通，诸脉皆了无余蕴矣。”张璐的这一思想，体现了中医诊脉的精髓，即注重自身对脉象的体悟与思考，把握核心，不囿于既有理论。
三、梁世杰主任五行脉法的实践应用
梁世杰主任在继承传统中医理论的基础上，结合自己多年的临床经验，将五行脉法广泛应用于临床实践中。他通过脉诊，准确判断病情，指导治疗，取得了显著的临床效果。
1. 精准定位病变脏腑
梁世杰主任运用三部九候脉法，精准定位病变脏腑。例如，若患者左寸脉象浮大有力，而右寸脉象平和，则可判断为心火亢盛。若患者右关脉象沉迟无力，而左关脉象平和，则可判断为脾虚。这种精准的定位，为临床治疗提供了有力的依据。
2. 判断病情进退
梁世杰主任通过脉象的虚实变化，判断病情的进退。例如，若患者脉象由实转虚，说明正气渐衰，病情可能加重；若脉象由虚转实，说明正气渐复，病情可能好转。这种判断方法，使医者能够及时调整治疗方案，提高治疗效果。
3. 随脏治之
梁世杰主任强调，脉诊不仅要定位病变脏腑，还要随脏治之。例如，若患者左寸脉象浮大有力，为心火亢盛，则应清心泻火；若患者右关脉象沉迟无力，为脾虚，则应健脾益气。这种随脏治之的方法，体现了中医治病求本的思想。
四、五行脉法的生动实践案例
以下是一个梁世杰主任运用五行脉法治疗失眠的案例，以进一步说明五行脉法的实践应用。
案例：失眠患者
患者李某，女，45岁，因失眠半年就诊。患者自述入睡困难，易醒，多梦，伴有心悸、烦躁、头晕等症状。梁世杰主任通过脉诊，发现患者左寸脉象浮大有力，右寸脉象平和，判断为心火亢盛。结合患者症状，诊断为失眠（心火亢盛型）。
梁世杰主任采用清心泻火的治法，给予患者黄连阿胶汤加减治疗。经过一个疗程的治疗，患者失眠症状明显改善，入睡容易，睡眠质量提高，心悸、烦躁、头晕等症状均有所缓解。再次脉诊，发现患者左寸脉象由浮大有力转为平和，说明心火已降，病情好转。
这一案例充分展示了梁世杰主任运用五行脉法精准定位病变脏腑、判断病情进退、随脏治之的能力。通过脉诊，他能够迅速抓住疾病本质，给予患者有效的治疗，取得了显著的临床效果。
五、结语
梁世杰主任的五行脉法，是在继承传统中医理论的基础上，结合自己多年的临床经验形成的独特脉法。它通过对五脏本脉及其相乘脉法的深入研究，精准定位病变脏腑；通过脉象的虚实变化，判断病情的进退；通过随脏治之的方法，体现了中医治病求本的思想。这一脉法不仅丰富了中医脉诊的内容，也为临床治疗提供了有力的依据。
张璐的五行脉法理论，为梁世杰主任的五行脉法提供了重要的历史渊源。他通过脏腑分候与五行方位的对应、命门学说与三焦之火的深入分析、天人合一与体悟为主的思想，为中医脉诊注入了新的活力。
梁世杰主任的五行脉法，不仅在临床实践中取得了显著的效果，也为中医脉诊的传承与发展做出了重要贡献。它让我们深刻认识到，中医脉诊是一门博大精深的学问，需要我们不断学习和探索，才能更好地服务于广大患者。愿每一位中医工作者都能像梁世杰主任一样，用心体悟脉象，把握疾病本质，为人类的健康事业贡献自己的力量。
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
Director Liang Shijie Notes on the Law of the Five Elements
Since ancient times, acupuncture as one of the important methods of traditional Chinese medicine diagnosis has been playing an important role in clinical practice. On the basis of inheriting traditional Chinese medicine theory, Director Liang Shijie combined his own years of clinical experience to form a unique five-line meridian method. This article will focus on Dr. Liang Shijie's chronicle of the five-line pulse method, analyze in detail the pulse method of the meridians of the five organs, and combine the theory of Qing Dynasty medical practitioner Zhang Lu to explore the historical origins and practical application of the five lines pulse method.
I. A multiplication of the meridians of the five organs
Dr. Liang Shijie has conducted an in-depth study of the meridians of the five bodies and their reciprocal meridians on the basis of the five-line meridian method. He believes that through a single oar and three-part nine-pulse pulse method, the air and blood conditions of the various internal organs can be clearly distinguished, thereby guiding clinical treatment.
1. The three nine meridians
The acupuncture method is the basis of traditional Chinese medicine. Dr. Liang Shijie, on the basis of the three tripartite nine-meridian pulse method, identified the left inch as corresponding to the heart, liver, and kidney, and the right inch as corresponded to the lung, spleen, and vital gates, and determined the position of the various internal organs on the meridian. This method is simple and practical, and can quickly locate the diseased stomach.
2. The Five Elements of the Five Organs
Director Liang Shijie believes that the five branches and the five livers are the core of traditional Chinese medicine. According to the five-line theory, he compared the lung (the large intestine) to gold, whose pulse was a floating vein; The kidney (bladder) corresponds to water, and its pulse is a sedimentary pulse; The spleen (stomach) corresponds to the earth, and its pulse is late and shallow; The heart (small intestine) corresponds to fire, and its pulse is smooth and several pulse. The liver (chole) corresponds to the wood, and its pulse is a string.
3. Right and evil diminish - the vein and the vein
The falseness of the pulse reflects the decline of good and evil. The victory of evil is true, and the deprivation of energy is false. Director Liang Shijie emphasized that the falseness of pulse signals is an important basis for judging the progress or failure of the disease. If the pulse turns from solid to weak, it indicates that the positive qi is beginning to decline, and the condition may be aggravated. If the pulse changes from weak to solid, it means that the positive qi is returning, and the condition may improve.
4. He shows his pulse beyond his throne - and his dirty ways travel.
Director Liang Shijie pointed out that if a pulse appears in a location that is not in accordance with its corresponding inner lining, it is a transit of other sins. For example, the left inch should have a heart vein, and if a lung vein appears, the lung is multiplied by the heart. These signs are diseases, whether they occur from birth or death. Although this organ is ill, it is not this organ. The pulse comes from the organ and should be treated with it.
II. The historical origins of Zhang Lu's five-chakra method
Zhang Lu was a famous medical practitioner in the Qing Dynasty who had unique insights into the five branches of the meridian. His theory not only enriched the content of traditional Chinese medicine consultations, but also provided valuable reference for future practitioners.
1. The meridian and the orientation of the five branches
Zhang Lu pointed out in "Diagnosis of Three Minds: Pulse Position":“The fire is strong in the south, so the heart is left in the right. Wuwang is in the east, so the liver lives in Zuguan; The gold is abundant in the west, so the lungs are in the right inch. The earth is prosperous in the middle and sits in the southwest, so the spleen resides in the right hand. The water was abundant in the north, and the old house was two feet tall.”Zhang Lu explained the attributes of the five branches of the stomach to the heavenly place, making the sickness sorting more clear and clear.
2. The Theory of Destiny and the Three Burning Fire
Zhang Lu was influenced by the Feng Shui doctrine during the Ming and Qing Dynasties and conducted an in-depth analysis of Feng Shui's waiting for fire. He pointed out:“In other words, the kidney stands at the boundary of Qiuai and Yanji... When people respond to their anger, three burning fires occur, and traffic begins thereafter. Furthermore, the Jiaoding stood between the two kidneys and turned right in response to the earth. It is true that although the right feet are relatively related to flame, they are the source of living things, because they are called the Gate of Destiny. In fact, the two kidneys have water and fire, and they are not separated from each other. Therefore, the two parts of Immun are divided between the right and the left, and the foot is not separated. Both are masters of the kidneys.”Zhang Lu corresponded the kidney with the horoscope, believing that the three-hot fire originated in the kidney and lived between the two kidneys, traveled right around the earth, and the mission door fire was placed at the right foot. This theory not only enriched the theory of the internal organs of Chinese medicine, but also provided new ideas for clinical ambulatory care.
3. Oneness between man and nature and understanding are the mainstays.
Zhang Lu's pulse not only focuses on the combination of theory and practice, but also emphasizes the idea of the unity of nature and man. He believes that when examining the pulse, the doctor should be mindless, master the gist, and carefully experience the pulse signs. He advocated "empty mind as a vocation," saying, "But let nothing fall into your heart, and go to your spirit in empty space... All the chakras are connected, and there is no residue in all the veins.”Zhang Lu's thought reflects the essence of traditional Chinese medicine to diagnose the pulse, which is to focus on his own understanding and thinking about the pulse and to grasp the core, not being limited to existing theories.
III. Practice application of the five-line meridian method by Director Liang Shijie
Dr. Liang Shijie, based on inheriting traditional Chinese medicine theory and combining his own years of clinical experience, has widely applied the five-line meridian method in clinical practice. He has achieved remarkable clinical results through ambulatory diagnosis, accurately judged the condition, and directed treatment.
1. Precisionly locate the diseased stomach
Dr. Liang Shijie used the three-part nine-pulse method to accurately locate the diseased stomach. For example, if the patient's left-inch pulse is strong and vigorous, while the right-inch Pulse is calm, it can be judged to be hypertensive. If the patient's right chakra appears to be slow and weak, while the left chakra looks calm, then spleen can be judged. This precise positioning provides a strong basis for clinical treatment.
2. Judging the progress or failure of the condition
Dr. Liang Shijie judged the progress or failure of the condition by false changes in pulse patterns. For example, if the patient's pulse changes from solid to weak, it indicates that the positive qi is declining, and the condition may be aggravated; If the pulse changes from weak to solid, it means that the positive qi is returning, and the condition may improve. This judgment method allows the doctor to adjust the treatment plan in a timely manner and improve the treatment effectiveness.
3. Heal your sickness with it.
Dr. Liang Shijie emphasized that a pulse diagnosis should not only locate the diseased lining, but also treat it with the lining. For example, if the patient's left-hand side pulse is strong and strong, indicating an increase in heart fire, it should clear the heart and lay the fire. If the patient's right chakra appears to be slow and weak and is characterized by spleen, he should strengthen his spleen and promote good health. This method of healing with the sickness reflects the idea of traditional Chinese medicine to seek the root cause of illness.
IV. Examples of vivid practice of the five chakras
The following is a case of Dr. Seiji Leung using the five-line meridian to treat insomnia to further illustrate the practical application of the five- line meridian.
Case: Patient with insomnia
The patient, Li, a 45-year-old woman, visited the doctor for six months because of insomnia. The patient reported difficulty falling asleep, waking easily, dreaming a lot, with symptoms such as heart palpitations, irritability and dizziness. Through a pulse diagnosis, Dr. Liang Shijie found that the patient's left-inch pulse was large and strong, and the right-inch Pulse was peaceful, which was judged to be high heart fire. Combined with the patient's symptoms, insomnia (hyperthermia type) was diagnosed.
Dr. Liang Shijie applied the treatment of clearing the heart from laryng cough and gave the patient Huang Lian jiao jiao soup supplemental treatment. After one course of treatment, the patient's insomnia symptoms improved significantly, falling asleep easily, improving sleep quality, and relieving heart palpitations, irritability, dizziness and other symptoms. Once again, the patient's left-inch pulse changed from large and powerful to calm, indicating that the heart fire had dropped and the condition was improving.
This case fully demonstrates the ability of Director Liang Shijie to use the five-line vein method to accurately locate the diseased lining, judge the progression of the disease, and cure it with the lining. Through acupuncture, he was able to quickly grasp the nature of the disease and give patients effective treatment, achieving significant clinical results.
V. CONCLUSIONS
Dr. Liang Shijie's five-line meridian method is a unique meridian method developed on the basis of inheriting traditional Chinese medicine theory and combining his own years of clinical experience. It can accurately locate the diseased organs by in-depth study of the meridians of the five organs and their adjunct meridians; Judging the progress or failure of the disease through false changes in pulse patterns; Through the method of treating the ailments along with them, it embodies the idea of traditional Chinese medicine to seek the root cause of the illness. This pulse method not only enriched the content of traditional Chinese medicine pulse diagnosis, but also provided a strong basis for clinical treatment.
Zhang Lu's theory of the five-line meridian provides an important historical source for Director Liang Shijie's principle of the five - line meridian. He injected new vitality into TCM acupuncture through the correspondence between the meridian and the orientation of the five branches, the in-depth analysis of the theory of fate and the three burning fires, the unity of nature and man and the principle of understanding as the mainstay.
Director Liang Shijie's five-line meridian method has not only achieved remarkable results in clinical practice, but also made an important contribution to the inheritance and development of traditional Chinese meridian medicine. It gives us a deep understanding that traditional Chinese acupuncture is a great and deep knowledge that requires constant learning and exploration in order to better serve the vast number of patients. May every practitioner of Chinese medicine can, like Director Liang Shijie, sincerely understand the pulse, grasp the nature of disease, and contribute their own strength to the cause of human health.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
来源：老梁谈养生