![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=1739552557-OLaD1XN7JfMPnkLVO7RpgIJ0Chrjvuof-0-5704dcfaef5bcbb70527f4790fc53028)
(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=1739552557-ltJM6BL7BnOwd0hbtNNzcVKdeZW1tLtF-0-a1dfe5f49adf8d56ac376605466a5205)
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=1739552557-KW07qeTMiJsut5x7qegZ6xSbqF1B98VQ-0-57ef0f865ee4bc84c51ec34502e2f192)
赤色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0002.jpg?sign=1739552557-GcB0zfJqgq4XrZIHGRXUKVhlfhxxCB8R-0-54016f0453e9a806825365c104b47f1d)
青色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0003.jpg?sign=1739552557-iBC4KJ1MsdL7PqrKmjkzWVNRbfe4KPuT-0-b09b4e7b50ceff89bba9c996b2024728)
黄色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0004.jpg?sign=1739552557-NNVd37sm2ySOqCPoS2WBzPtDCcb4Mdj3-0-1f36f194e9aa3e252a5231b2f8c44f2e)
白色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0005.jpg?sign=1739552557-l9UE4dllSjtPJk20s9ulpAexFpMcSHXf-0-da9825d86f94e2608a2a9965982b08e6)
黑色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0006.jpg?sign=1739552557-36vCl8a93qQqqDmsLBOFzFBxU5EdEAXe-0-890eca83455f419a7c28498ec8ac4fce)
指纹与病症的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0007.jpg?sign=1739552557-VbfxxQNR2eZlTdUkrsMsshfj7xb1126S-0-960890be7bae2e3bfbde87002e8d405d)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0008.jpg?sign=1739552557-cK9szKh9XhMRHY7MkGYVuO4RGsfLfunQ-0-a64249e187b70805fac42a709602472a)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0009.jpg?sign=1739552557-dqhwpvrPuP37whJ3DJtUfp6wEByuzgUN-0-b9cc8ea272ef4217a6453cfeb0a1e110)
(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=1739552557-WSfazVOBLJmUuFlz27uyb9xBBq38FwY4-0-82fda4c02ae3b1a3bb248b3c58489f58)
(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=1739552557-G5YgHthvLrZ8gHmZHEofVq7DgmVVC30H-0-3112074cccaeade1c8ab3415cd609c40)
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=1739552557-PH6YYjCKUgSuU9OyJUNcUcGaYuLMbw6w-0-d7cd5d7f69ffbbd00e1406cdccce4e8b)
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=1739552557-mkXbQbQbIm9RA1dC2RTPBsUVjbvTzyqc-0-875bce49920e7ba32cd6bdb07e95c693)
耳朵与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0003.jpg?sign=1739552557-SYxTmQDCg0MqEmqtXLE9duwlpzipklcE-0-93dbc0904cd263b147a27c5a9b251b91)
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=1739552557-q3vzocYFmRfxic3hNJSLbe3cCIQCYU7t-0-d96e12c943de04dee17b14e15d5752e6)
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=1739552557-id0qQ4iMgvGjTTeXBmjinPzOZEiVyZoJ-0-c80801f34c01a8a3b6010cd893ecdee8)
(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=1739552557-qrrDiZqvBPDTVNlxAnyWZODpVLZ4pW8r-0-6ef090e579dc3ef41c7ba3629135b819)
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=1739552557-uy7xDv3jOHySp6dDlQmujuW61M4RF7nJ-0-d38c5b87885975efc9458472a8a12329)
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=1739552557-JlpIOuik1xsFN9bO1UGzfTsajXsILpp7-0-edb50c14352c43a98229ac6df7d1b56b)
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=1739552557-xRvm3GDI13KEwgt0wVPGN0Rxfg7qUuWK-0-286f196ee0fc354c932eae14c051ce7e)
发声
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0002.jpg?sign=1739552557-Ple0FxXfb39SEdND4y4SiMRVp9wsX5zd-0-05f2b792997293df7b4611f8a25150d8)
呼吸
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0003.jpg?sign=1739552557-OrV451NBmaZRqZ64uVfzetJp3JK1nb38-0-e6b845e80d67a7ac24502b35a2ba6e5b)
咳嗽
嗅气味
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0004.jpg?sign=1739552557-kP6IsjrF51nUk344kzUVSauDiRBijNqk-0-d74440ab2e923614be42b504639bafde)
口臭
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0005.jpg?sign=1739552557-6iEX7MBcMzCvRMyapC6wirdQKcTUZcJJ-0-68aa7f7c1084e99ce1a1e55545aadf41)
便便
问诊
知寒热
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0006.jpg?sign=1739552557-acGfTLtkIdZsdthWN3aXjTiMXyvOESAW-0-29adec2efc68b5ff9103c0891c6f96e6)
察二便
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0007.jpg?sign=1739552557-BeZy0zAw8RWyEfvXBcRILrlx4JdV8kKw-0-123507edabc9443e438fb117afcc952e)
看睡眠
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0008.jpg?sign=1739552557-3vl9buS8q9IW5UfVx8QaFGAH2tP7czfS-0-17008ce8607a4ff52d1c1bb830cb1ed4)
观饮食
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0009.jpg?sign=1739552557-XR5ZLzVUVVXb7Q38zAAKvpRYetnXG9o2-0-3b388b07595c970ddf96ef716bd14030)
脉诊
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0010.jpg?sign=1739552557-HuZjFOfpcVmCETzn1QSEZSukS7qbklmx-0-bb8a531ffab74b5b5cd71673a44c27e7)
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=1739552557-JVXrNciSsgJQOVDDXh8hRGggCLvgkg1h-0-81a9882012ad85e3525dd65b42c904bd)
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=1739552557-AVv1IYPEU951vd0BxZjoqz6ggtiY7fwP-0-5fb95fd767d651203443905671e4579a)
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。