Abstract: The systematic syndrome differentiation pulse study takes the five-dimensional elements, position, rate, shape, property, and dynamics, as its framework, deconstructing the overall pulse presentation into a clear and operable structural system. Addressing the challenge in traditional pulse diagnosis often described as “clear in theory, but ambiguous to the fingertips”, the key breakthrough lies in clarifying the non-linear interactive and coupling relationships among these elements. From a systems theory perspective, this article elucidates the interconnections among the representational significance, systemic effects, and disease pathogenesis of the interactive coupling of pulse elements. Using patterns such as liver depression transforming into fire, phlegm and blood stasis interbinding, and yin deficiency with yang hyperactivity as examples, it analyzes how their coupling modes guide the formulation of treatment principles and the composition of herbal formulas. This provides methodological support for achieving an integrated diagnosis and treatment approach of syndrome pattern-pulse presentation-treatment method-formula and herbs, thereby promoting the evolution of pulse diagnosis from experiential perception towards systematic pattern differentiation.