Abstract：By systematically analyzing the passages related to acupuncture and moxibustion and pulse diagnosis in ZHANG Zhongjing's Shang Han Za Bing Lun （Treatise on Cold Damage and Miscellaneous Diseases）， this study summarizes ZHANG's acupuncture and moxibustion-pulse diagnostic philosophy across three dimensions： disease syndromes， the nutritive and defensive qi， and the eight principles. Building on ZHANG's theories and scholarly interpretations of pulse-guided acupuncture and moxibustion，combined with the authors' insights from studying Shang Han Za Bing Lun， we explore the necessity of pulse diagnosis prior to acupuncture and moxibustion and propose a "pulse-syndrome-meridian-acupoint" diagnostic and treatment model. This model emphasizes the principle of "prioritizing syndrome differentiation through pulse assessment" to guide clinical acupuncture and moxibustion practice， aiming to enhance therapeutic precision and effects.