Mach Hoc Tong Hop

Embed Size (px)

DESCRIPTION

ko

Text of Mach Hoc Tong Hop

  • 1

    www.facebook.com/sachdongyduoc

    MCH HC TNG HP

    Tc gi: Hong Duy Tn

    LI NI U

    Trong lm sng thc nghim, i vi cc thy thuc YHCT, mt trong nhng yu t chn on c coi l kh nht, l vic xem mch. Mch tng (hnh th ca mch) va l thc ti ( s, bt c) nhng cng rt tru tng. Xt v tng ngha ca mch, mi loi mch c th ch mt loi bnh khc nhau. Ngoi ra mch cc v tr khc nhau cng biu hin bnh l khc nhau. Th d: Mch Trm (thuc Thn - Thy), nu v tr b xch bn tay tri ( b v ca Thn) th rt tt nhng nu v tr b thn tay tri (thuc Tm) li rt nguy him, v l biu hin ca thy khc ha, bnh nng hn... Mun hiu ti sao cng mch Trm, b v ny th tt, b v khc li xu... i hi phi hiu bit v y l...

    Sch chuyn v mch bng ting Vit hin nay tng i rt t v ngay c trong cc sch gio khoa cng ch bn s qua v cc b mch, kh p ng c nhu cu ngy cng c chiu hng mun nghin cu su hn v YHCT (trong c mch hc).

    Hin nay, vi s tin b ca khoa hc k thut, nhiu nc nghin cu v s dng mt s my chn on mch. Vi pht trin nh v bo ca khoa thng cng ngh thng tin, rt c th trong tng lai, vic s dng my mc thit b hin i thay th i bn tay ca thy thuc trong vic xem mch. Tuy nhin, vn cn n s kho lo, tinh t ca bn tay thy thuc trong vic xem mch. V vy, chng ti cng s gii thiu mt cch tng quan v nhng thit b hin i dng trong vic h tr ghi nhn mch. Cc chuyn gia v my tnh nhn xt rng, khi chng mua mt my tnh, ra khi ca, c th my ca chng ta b tt hu ri. Cc thit b chng ti gii thiu by gi, c th ch vi nm na thi s tr thnh tt hu, nhng hy vng s phn no em n cho ngi c mt s nt chm ph v vic ng dng cc thit b mi trong vic ghi nhn hnh sng mch.

    V vy, trong tinh thn nghin cu, hc hi, chng ti c gng tng hp li cc sch mch (a s da theo cc sch mch bng ting Hn) xa v nay, sp xp li thnh h thng trong tng vn chuyn su v mch.

    Ni dung ca tng mch c trin khai di 9 tiu :

    1- i cng: Nu ln phn xut x hoc nh ngha v tng loi mch .

    2- Mch tng: Cch m t hoc hnh v biu din ca cc mch theo cc sch chuyn khoa. Trong phn ny, chng ti gii thiu thm (nu c th) hnh v biu din ca cc mch theo nhng sch mch hin i: trnh by ng biu din mch qua cc dng sng, c o bng cc my tng i hin i, gip ngi c c c s so snh hoc d nhn xt v cc sng mch.

  • 2

    3- Nguyn nhn pht sinh mch: Da theo quan im ca cc sch xa v nay, theo YHCT ln YHH. Th d: Nguyn nhn pht sinh ra mch PH:

    + Theo YHCT c th do t kh xm nhp vo 3 kinh dng bc bch mch kh ra ngoi...

    + Theo YHH c th do lng mu ca tim tng ra c tng ln...

    Nhng quan nim tuy khc nhau gia hai nn YHCT v YHH c th gip ngi c hiu r hn v nguyn nhn pht sinh ra loi mch .

    4- Mch ch bnh: Mi mch, ty tng b v (thn, quan xch) khc nhau, c th biu hin loi bnh chng khc nhau... Cc y gia, qua kinh nghim, ghi chp tng i kh y ... y, chng ti ch tng hp li v sp xp theo th t thi gian ca cc tc phm trch dn. Th d cng v mch PH, theo lch s phi k n sch Ni kinh T Vn ri n Thng hn lun, Kim qu...

    5- Mch ch kim mch bnh: Mi mch, khi kt hp vi mch khc, c th em li ngha bnh l khc nhau. Th d: mch Ph Sc ch cm phong nhit nhng Ph Khn li ch cm phong hn...

    6- Mch v tr liu: Qua kinh nghim, cc nh mch hc tng hp c cc phc iu tr cho tng loi mch, lm c s cho vic lp lun v nghin cu v mch.

    7- Cc li bn v mch: Trnh by cc quan im ring ca cc sch v mch c uy tn, k c nhng li bnh lun, tranh ci... gip hiu su hn v ngha v ng dng ca cc loi mch trong nghin cu v tr liu.

    8- Cc y n lin quan n mch: Nu nhng kinh nghim thc tin ca cc danh y v cng l cch hay nht hiu r hn v l lun v ng dng mch trong chn on v tr liu.

    9- S lin h: (nu c) gia mch vi cc mch khc gip cho d nhn xt v d nh.

    V ti liu c hn, s hiu bit c chng mc m ti v mch qu rng... chc chn trong lc bin son kh trnh khi thiu st, rt mong nhn c nhng kin ng gp vic bin son c tt p v hon ho hn.

    Bin Ho, ngy 01 thng 04 nm 2006.

    HONG DUY TN

    A- i cng

    Ch MCH theo nguyn ngha c th hiu l:

    1- Ch Mch () mt bn l ch Huyt () mt bn l ch Phi () (l ngnh, l chi phi, nhnh), ni rng mch l mt phi, mt ngnh ca huyt, trong , huyt lu thng.

  • 3

    2- () Mt bn l ch Huyt () mt bn l ch Vnh () l lu di, ni c mch (c huyt), cn mch th c th cn sng lu di (mt mch, mch khng p na l cht).

    3- Mt bn l ch Nguyt (ng ra l b Nhc ) mt bn l ch (Vnh ) l lu di, ni c mch th sng lu ( khng cn mch th cht).

    Nh vy, theo YHCT, mch l biu hin ca Kh, Huyt, lu hnh ngy m khp c c th con ngi.

    Theo YHH, mch l ln sng p huyt, t tim chuyn ra ng mch, lan truyn di theo ng mch vi tc bnh thng l 9m/giy.

    Theo YHCT, chn mch l thy thuc dng ngn tay ca mnh, bt mch ca ngi bnh phn bit mch tng ri kt hp vi cc php Vng (nhn), Vn (nghe), Vn (hi), chn on m dng biu l, hn nhit, h thc ca bnh chng.

    Gi Tr Ca Vic Chn Mch

    - Sch 'Trung y hc khi lun' ghi: "Chn on mch tng c th hiu r c s bin ha ca bnh t, theo m phn bit chng hu, mt khc li c th d c s thng hoc bin ca kh huyt, theo m suy on c s thnh suy ca chnh kh, lm cho thy thuc c th nm vng c chiu hng tiu trng trn lm sng".

    - Thin 'Nghch thun' (Linh khu 55) ghi: "S thnh suy ca mch l xt bit c s h hoc thc, hu d hoc bt tc ca kh".

    - Thin 'Phng thnh suy lun' (T vn 80) nu ln c th gi tr ca vic chn mch: "... em nhng tnh hnh t m xem xt c m tng hp li, suy tm s bin ha ca m dng, hiu r bnh tnh ca ng tng, rt ra c kt lun ng n ri cn c vo im ct yu ca h thc, ng chn, ng phn on".

    B- Lch S Mch Hc

  • 4

    - Cun sch c nht cp n mch l cun 'Ni kinh T vn' ( khong 200 - 300 nm trc Cng nguyn), ng k nht l cc thin: 'Mch yu tinh vi lun (T vn 17), Bnh nhn kh tng lun (T vn 18), Kinh mch bit lun (T vn 21), Mch gii ( T vn 49), Th thung dung lun (T vn 76)...

    - Khong th k th 5 trc Cng nguyn, Tn Vit Nhn (Bin Thc) trong tc phm 'Nan kinh' ra 24 Nan (trong tng s 81 Nan) bn v mch.

    - Th k 2-3 sau Cng nguyn, Trng Trng Cnh, trong sch 'Thng hn lun' v 'Kim qu ngc hm kinh' ghi li kinh nghim v nhn nh v tng loi mch v chng.

    - Th k th 3, Vng Thc Ha ln u tin h thng ha ton b mch hc trong tc phm 'Mch kinh'.

    - i nh Nguyn, c hai quyn sch v mch ng c ch n l:

    1- 'Khit C ch Thc Ha mch hc' ca Trng Nguyn T (Trng Khit C) ch gii v sch mch ca Vng Thc Ha.

    2- 'Mch chng ch chng' ca Chu an Kh bn v mch v chng.

    - i nh Minh (1368) ti liu v mch c:

    Chn gia chnh nhn ca L Trung T (L S Ti).

    Mch l minh bin ca L Qu.

    ch mch chng ph trng ca Trng Th Hin.

    Tn H mch hc ca L Thi Trn.

    Chn mch i ch ca Chc Nhc.

    T chn php ca Trng Tam Dng.

  • 5

    - i nh Thanh (1644) sch bn v mch c:

    Mch hc hp bch ca Trm Kch.

    Chn mch tam thp nh bin ca Qun Ngc Hnh.

    Mch l v tham ca T Chi Tun.

    Mch hc ch thch ca Vng Vn K.

    Mch php nhin tri ca Tin Kinh Lun.

    Mch chng iu bin ca H Chnh.

    Tr t mch hu chng ca Du Chnh Tip.

    T chn quyt vi ca Lm Chi Hn.

    Hot nhn tm php chn thit knh ca Lu D Nhn.

    - L S Ti (1624) cng dnh hn mt chng ('T Ngn Mch Quyt' trong sch 'Y tn tt c') bn v mch.

    - Trng Cnh Nhc (1624) trong b 'Cnh Nhc ton th' cng c hn mt chng 'Mch thn' bn kh su v mch.

    Th k 18 vi b 'Y tng kim gim' Ng Khim v cc cng s c hn mt tp 'T chn tm php yu quyt' bn v mch...

    Qua th k 20, vi nhng tin b v khoa hc k thut, nhiu hc vin Trung Y ni ting nh Thng Hi, Bc Kinh, Qung Chu, Thnh ... dng cc thit b hin i o v ghi li c cc dng sng mch, ng thi cng nu ln c s tng quan gia mch v cc chc danh bnh l theo thut ng y hc hin i...

    Ti Vit Nam, vo th k 18, Nguyn B Tnh (Tu Tnh) trong sch 'Hng ngha gic t y th' c nhiu ch bn v mch. V Hi Thng Ln ng, trong chng 'Y gia quan min' cng c hn mt phn bn v cc mch v cch xem mch...

  • 6

    Ring sch chuyn v Mch ( ting Vit), c rt t:

    Phng php xem mch ng phng ca Nguyn Vn Minh.

    nh Ninh ti hc mch ca L c Thip.

    Cm nang mch hc ca Nguyn Khc Nhn.

    Mch l v phng dc ca Nguyn Hu Khai.

    Sch dy xem mch ca Nguyn An Nhn, in 1942.

    C- C CH CA MCH

    a- Theo Y Hc C Truyn

    - Thin 'Tuyn minh ng kh lun' (T vn 23) ghi: 'Tm ch mch', da vo cu ny, sch 'Mch hc ging ngha' gii thch nh sau: "Mch vi Tm c quan h vi nhau theo tng nhp th. Tm li c quan h mt thit vi ton b c th. V vy, c th b bnh chc chn s nh hng n mch".

    - Thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Mch l ph ca huyt, mch Trng th kh c trng, mch on th kh b bnh, mch Sc th tm phin, mch i th bnh ang tin trin...".

    - Sch 'Mch hc ging ngha' gii thch ca thin 17 sch T vn nh sau: "Mch l ph ca huyt, Vinh kh da vo m i trong mch, V kh da vo m i ngoi. Mch theo kh i, huyt theo mch chy. Vinh V iu ha, kh v huyt thng ng, l ngi bnh thng".

    b- Theo Y Hc Hin i

    Qua nghin cu mt s mch YHCT bng cc thit b hin i, sch ' Tn bin Trung y hc khi yu'(1973), 'Trung y hc c s' (1974) v sch 'Trung y bin chng lun tr ging ngha' (1976) cng nhn nh: "Nhng lin quan v hnh nh in tim, ting tim ghi ng thi vi ng cong ng mch cnh v ng mch quay ni ln trng lc tng hoc gim ca mch... lm nh hng trc tip n s thay i hnh thi ca mch...

    Nhng s thay i , hoc do bnh ca tim mch gy ra hoc do bnh ca ton thn tc ng n tim mch gy ra. Ngoi ra, yu t thn kinh, tm l, thi tit... cng c th nh hng n s thay i ca mch.

    Th d: Khi theo di mch PH, cc tc gi nhn thy:

    Mch PH c th pht sinh do:

    Lng mu tim tng ra c tng ln.

  • 7

    Sc co bp ca thnh mch km.

    Hoc s thay i ca mch TRM c th do:

    Lng mu tim tng ra bnh thng hoc h thp.

    Cc mch mu ngoi bin co li...

    D- CC B V CHN MCH

    B v chn mch, theo cc sch xa, c nhiu cch khc nhau, c th tm vo ba cch sau:

    1- Cch chn mch ton thn (Bin chn php), thin 'Tam b cu hu lun' (T vn 20) trnh by nh sau:

    a- Thng b (u) chia l ba vng:

    Thng b thng : ng mch hai bn trn (Thi dng) chn bnh kh cnh bn u.

    Thng b trung: ng mch trc tai (tng ng vng huyt Nh mn) chn bnh v tai v mt.

    Thng b h: ng mch hai bn m (tng ng vng huyt C liu) chn bnh ming v rng.

    b- Trung B (Tay), chia lm ba vng:

    Trung b thng: th Thi m (vng thn khu - huyt Thi uyn) chn bnh v Ph.

    Trung b trung: th Thiu m ( vng h