![儿童经络按摩刮痧全集](https://wfqqreader-1252317822.image.myqcloud.com/cover/232/26797232/b_26797232.jpg)
中医四诊观察孩子
望、闻、问、切四诊,是中医诊察疾病的主要方法,儿科疾病的诊断也是根据四诊参合的病史资料进行辨证,诊断为某一性质的证候的过程。同时,由于小儿自身的生理和病理特点,小儿的四诊的运用又与大人的不同。
望
(1)望颜面
颜部面色是脏腑气血盛衰的外部表现,小儿面色以红润而有光泽为正常,枯槁无华为不良。中医望诊的主要色泽以五色主病,即赤、青、黄、白、黑。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0022_0001.jpg?sign=1738966260-mZptRQ1pY2y8ySADRJRiOy4ta0FF6mDQ-0-35c882d5ff5263512f8d3bd25489ab04)
(2)察指纹
指纹是指小儿食指虎口内侧的桡侧面所显露的一条脉络,按指节可分为风关、气关、命关三部分。在光线充足的地方,一手捏住小儿食指,用另一只手拇指桡侧,从小儿食指段命关到风关,用力且适中地推几下,指纹即显露。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0022_0002.jpg?sign=1738966260-4BNcizNZSRGHqrkrrIBbH77jis1tJNrO-0-9262507f15ef9f4cccf71408fa7cae34)
察颜色知健康
面色与病症的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0001.jpg?sign=1738966260-4naoxbsarG6BdOwyoAkVV6i3tenzRODq-0-8665bd076b8cc4317d7edddd145a93d2)
赤色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0002.jpg?sign=1738966260-uWWiLtU1bvlCohahm08Mr0Q5chiPFRpv-0-f0edad2d96802c7cc033804088041092)
青色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0003.jpg?sign=1738966260-OoBsT8BS5YFzhAoKe5CgdblMyKaKzFe8-0-f4f3ba5385ea4e201ffa4fec61541844)
黄色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0004.jpg?sign=1738966260-D5BgmZECp8a5mCega5WEn7UuglropSmj-0-54f4a59a9fb9b4e250e59a473f346e3f)
白色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0005.jpg?sign=1738966260-zqApI31mJUDqXjsHYYOrr3v3lHjzMhJN-0-c0d298b775dcd368ebc8a26ffb572f74)
黑色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0006.jpg?sign=1738966260-vjBjU0YD3lwqKTqGzdgxkqFTvC2cmAsJ-0-f52956477404387b86c07a2f5cbcf641)
指纹与病症的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0007.jpg?sign=1738966260-QoSqKsKXZPmWm7P8hMj5sJR8SjswxDLR-0-26d4b14d07dda84d139fb379dbd0dee7)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0008.jpg?sign=1738966260-w3bP1J23Ecf2ASpaTUfqNyw93Vd3BZoJ-0-3a0ae2ce4d10abfe5d064396c5146e1b)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0009.jpg?sign=1738966260-L99I5pfthoVIibVI5W7ETN2SegFEEJxI-0-52852e587659273c95ae6ef815c70508)
(3)望五官
中医认为,人体内五脏与外在的五官有着密切的关系,脏腑的病变往往反映在五官的变化上。因此,察看五官,可以找到脏腑病变的痕迹。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0024_0001.jpg?sign=1738966260-6sGh6HNa5oNrz8xwjcblhkVhl1qpztKA-0-2b580f2c7d4051828d97e149aadb19ec)
(4)察二便
孩子大小便的变化对疾病诊断有一定意义,尤其是腹泻的患儿,来看病时,家长要带一份新鲜的大便,给医生看看,便于做化验检查。若发现尿有不正常时,就需带一瓶清早的第一次尿,化验检查。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0024_0002.jpg?sign=1738966260-D26V4F0YL418pQc4A95OXtYBVIYY9zug-0-675a934147f97eedaed30790978e85d6)
表里合一的有趣机体
五官与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0001.jpg?sign=1738966260-6Ivk8cMgKbz7bUYJ41qtSIr9VjM5VpRv-0-7680992e0e565f765e5794b7f1ccd708)
五脏荣枯在面色上的表现
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0002.jpg?sign=1738966260-NkHa4W1I8wGw0P99sMWlEu2XNnrnEbuh-0-9f0309f58e77452db24743825b407512)
耳朵与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0003.jpg?sign=1738966260-1ORFJqGcnDlVY6OE8HfyRm9T38fn702e-0-c8cc3f5997cc4d3be84bc4f6d8997779)
耳朵与脏腑关系密切,耳朵位于头部两侧,司听觉,主平衡。全身各大脉络皆汇于耳,使耳与全身各部及脏腑发生密切联系。
舌与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0004.jpg?sign=1738966260-MKzViB82iDnEii7eEo4sZfYdQbexI5cA-0-2bd24038f04f0124e63561e4abbbbe44)
舌头与人体脏腑经络关系密切。舌体是全舌的肌肉脉络组织,中医认为舌体有赖于气血的濡养和津液的滋润,舌体的形态、舌色与气血的盈亏、运行状态有关系。
闻
(1)听声音
包括闻听小儿的啼哭、咳嗽、声息、呼吸等声音的变化,以及利用听诊器倾听小儿的呼吸和心音。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0026_0001.jpg?sign=1738966260-5NKw3rlnLLCQMjFe1TADNmnKEpa5Y93Y-0-805a1e118cc9653fcff15c918748fab4)
(2)嗅气味
嗅气味包括通过嗅觉辨析口气、呕吐物和大、小便的气味等。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0026_0002.jpg?sign=1738966260-bUsauODsjXQ4zFmOsQVHZeUjGsNuocvY-0-5e3afa03582b3d51e60f5ef357585f93)
问
由于婴幼儿或者儿童对自我的感受表达不是很清晰,同时对于自己的身体状况了解不全面,因此家长主要观察小儿的发病情况,以及孩子的饮食情况、生活起居等情况。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0026_0003.jpg?sign=1738966260-PnPzo40k3R7dBmBCL7RzWUGnToJIgnbT-0-aaaf5efabcb96807b7ede7073538f7d4)
切
切诊主要是父母通过在小儿身体的某些部位按或触,以了解孩子的疾病状况,主要包括脉诊和按诊两个方面。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0026_0004.jpg?sign=1738966260-nv1FauLX1dVUTvi6Z3FUL5bwJvY2gZir-0-eb0787ce9643f8897b649e014ee5a53a)
调动敏感的听觉、触觉、嗅觉来观察孩子
闻诊
听声音
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0001.jpg?sign=1738966260-A1ktovK75NxsFVNdNxU2y3q1TVGfPPzA-0-f31318e455597ae58133e299b39ac15f)
发声
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0002.jpg?sign=1738966260-y3DVhLsuxaIVaUdr8SjL52fSqUn3G3Sf-0-e43eb80a6af141871de33c9690887e99)
呼吸
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0003.jpg?sign=1738966260-G8JOXEgsc3ZRZ10sMMJRTYoTnoqziQDP-0-2d64509579a7c0aed8f26ed760a801be)
咳嗽
嗅气味
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0004.jpg?sign=1738966260-kqFvZiu2JabckHwEZQdFrp1P5SeYgScw-0-94c963ead75476368495c26489d62dba)
口臭
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0005.jpg?sign=1738966260-IddnwgcHHXUsfYT3Ow31i9RSH8bQoIle-0-44ec639102a1bf3ba7561ce6dc8300d5)
便便
问诊
知寒热
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0006.jpg?sign=1738966260-PfOfY9JHBO90lvhLpYNcewZNgd2G5MJx-0-822e6cd22d8d15debe5aa2c713f7e1b1)
察二便
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0007.jpg?sign=1738966260-cOKJTihYgTMoe5u43yRFI10LY0Dp0tQF-0-419d78be44c69014ff74a1a6996e7ff9)
看睡眠
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0008.jpg?sign=1738966260-eH51C1Chxd9s6mKTGpNvCHx02tAmryHp-0-0c040a023d271c75897c957333bf5d91)
观饮食
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0009.jpg?sign=1738966260-Buva1KhFnbiIa0buEA0kMRNRbbPEQ3e4-0-9f34ca32272c4988cd3399933554ae68)
脉诊
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0010.jpg?sign=1738966260-nKHuqaJVvRdRgrErkdiBWXmhWgpqOhSK-0-44e2d7f6c9b4fbad1bcf7d33c25149f6)
小儿一般采用“一指定三关”的切脉方法,即用一个拇指或食指面切按寸、关、尺。
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0011.jpg?sign=1738966260-7nGd978ZCuHMAECTb1C6efJpbsAKNX7Z-0-8d4215d8ed94f8af105280dde8340306)
左右手的寸、关、尺都与脏腑有着密切的关系。
按诊
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0012.jpg?sign=1738966260-M9LGN9SzxJXlenAvyuW1WcZLxGUjtKoI-0-eb57ac84db1532a08a63ea16216b8be3)
皮肤:了解皮肤的寒、热、汗情况。
淋巴:了解质地、形状以及是否肿大。
头部:检查囟门的闭合、凹陷或隆起等。
胸肋部:检查胸骨、脊柱以及胸骨的形状。
腹部:检查腹部有无疼痛、有无隆起。
四肢:检查四肢以及脊柱的温度、有无畸形以及有无关节肿胀等情况。