![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=1739371013-8oStcKjF6T7nLOlfdlTpwGxVVi5OOMmv-0-e82c989441d4104e4467c7cfd1fe96bd)
(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=1739371013-p44ZoqRYxg6KyMcJp3cMDHUUqUO1nrZT-0-dc92f14fd3246b42457807e7279ba7eb)
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=1739371013-q2RWZGEbKsrs5xxHO1INCDrMJArhBXlo-0-c49b565c26ec1f38d23211b1ddc41b15)
赤色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0002.jpg?sign=1739371013-wi5sopu8WO3tBSoH7PMpyqqv6oEaWIv3-0-fa5f1c576f73942e4069bb4083d21e7c)
青色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0003.jpg?sign=1739371013-yqyTyRANn9ZTMtmrtftZwJNu1BCuXcrX-0-7d8fcf089c56b3981577144f2329d002)
黄色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0004.jpg?sign=1739371013-Dcmj5DupDbQp5cfMzG2vhz0CetPZb73n-0-1f1a3923167577a1c7291ef0f9b78fc3)
白色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0005.jpg?sign=1739371013-0iY1yeuaudOQke1hh5gURPaEvtzffTak-0-dbf887ac62c3033af1449711ff63609d)
黑色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0006.jpg?sign=1739371013-7m9ldXANqXI7E9Z98R5hXbfPcKVqUgMf-0-23d0a16d79046a6406e7585efcc8a157)
指纹与病症的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0007.jpg?sign=1739371013-5tllDMr8Qa85NoFAt0A83sWaN5sHLboP-0-41692fa5f3a9fcac81d95da6c6c1d0d6)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0008.jpg?sign=1739371013-I1cSDtagRp99u3aWuaLrMXNtcjbHyGyA-0-22f8c867f37734c857577b1802dab9fe)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0009.jpg?sign=1739371013-LU3FaPKnV8emENx2gJY9sQ9ixMap9HXh-0-75250ea0d559587f8f1c4130be9f6022)
(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=1739371013-0aYMNRiI52jGhX1e8E5K4V2rTLMRTJMW-0-3a8a5dc3aa139c70d0ade82a27541657)
(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=1739371013-DkDpFcye9VePzOziwo2nga5hvJ5h4VcJ-0-19461580f668fcf94b314ba53a642fef)
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=1739371013-2HHskQvTNqAOFC7eO4bxyVs4fji9b8UP-0-c45e3a4e1500ed82bde1644d365158b7)
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=1739371013-28SCt6w9pOASJT57fmQ9IQ29hrLZs6hJ-0-ee907b783a958644db43deaee1c1a0be)
耳朵与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0003.jpg?sign=1739371013-QePnHsIT29JuJ3q91rAEmnf5wqPawNSm-0-5e9ccc9b3896fdc7222cc38db4570737)
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=1739371013-QtYxJoddLuUbM6LnZJSszPJN9a57r0Mv-0-148a32584ed7c2560aa017f42ef307b7)
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=1739371013-leFrxRTfK8fRCRe6m4siSkuxibhTZmmd-0-02fcf5708d3e6687144aa3ca612cc56a)
(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=1739371013-e605UpRpfpFtfuP30ujuMZyQ9pMY4Pas-0-fc663c50e6b26f60936b0a933b2eca22)
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=1739371013-1MX85q2Us3i1fpsEbUDIQ0Mf8cfxeDnR-0-96eb8112dfa121396d9778d2ad0c14d1)
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=1739371013-HXFasWF2QGEWmwJM23kTzWuGcmtatYXQ-0-1853d43059819fa804673ba4e711eb57)
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=1739371013-Pr3bXEnBlzacJvaYfw9i6rui59xjubJm-0-0638131088e4726a3ff6d7070eec1fcb)
发声
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0002.jpg?sign=1739371013-TCdWlOkjC1DjoSwKEfVnVQSfVPGp9L77-0-530077b7cc36475a3f0783f19fb33fe2)
呼吸
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0003.jpg?sign=1739371013-hPY8PBlGdsYe0HUmkEYm4BXM8jFPhbp0-0-826470f9550741e48c81a2f88b8b8290)
咳嗽
嗅气味
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0004.jpg?sign=1739371013-Ln911pZPE3tmZkfE5I7reWeLc2yHw7PC-0-557416718fb613bbbb068a6c7ee13a28)
口臭
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0005.jpg?sign=1739371013-tBGjmG8YYPTiHqfeq8MYdqdeUyvJU7bY-0-ab9a1b88cb7fbff5c3baaf31b9cee87e)
便便
问诊
知寒热
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0006.jpg?sign=1739371013-pSImTpJixd0IDZpL0W1oIy4kLfX28XB2-0-64291ab9c0e4e9e0500c2e7480e9ff39)
察二便
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0007.jpg?sign=1739371013-heTTBaNqG1fPMjYw384C4TJTOorDSk0F-0-a6428079e1594732981f0a59bca2eb30)
看睡眠
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0008.jpg?sign=1739371013-sOfTrVcBMeHv2BzIhOZzNJcSG2KKcFK1-0-08734ca949859d53b00a442fac6f9efe)
观饮食
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0009.jpg?sign=1739371013-esPGihKkaoZjIUwaRVUmXOTJj39krf6p-0-a68d63f6a90c2ea00e8519c3ce52a6a7)
脉诊
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0010.jpg?sign=1739371013-Gv6e2J4gimQx7q1YNoTGVoLEJy4nfuPm-0-5264a6103016cac3a7c13b0f18f3ff40)
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=1739371013-89jW38Qend7YtuQEFhhlfeuI271YpnXf-0-7c69469c764ca5cca6fa1ce1565bd284)
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=1739371013-ZwouhM5DzoWHAZ1eD4PCVkJlg1MgE6p4-0-9b58beffc11ff2bced10f0761390b88f)
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。