![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=1739352234-Ha47L8DUC4wB7eajRdX4ApiYelWaC79e-0-246d394f4612e79970dab81ef6ccc0ff)
(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=1739352234-sMoO0LDREYPBvvm6mohRC1sMkmyKS2xB-0-a6a47a14ced519eb71546eecbf940c8b)
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=1739352234-jzovI1yiV49vorlpO8UW8Sy0Wtia8rw5-0-25beacfbb67d857f400daaa6c818bf17)
赤色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0002.jpg?sign=1739352234-nFc0JFB2IceTtS8Bb5r37eQR6OMT2RNZ-0-1522b754ab8a5357cc1c2ef72c229579)
青色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0003.jpg?sign=1739352234-iD9TJdfsKLWjYUlYB56WwvKLn7Cge9bx-0-b8aac1ad7c76c7ad1ddc646e3f4a1abd)
黄色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0004.jpg?sign=1739352234-rmwM6qInGtcIXbhyrJfbHhpiRaeLf0lt-0-b359e22759775455cebab96547bc88d6)
白色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0005.jpg?sign=1739352234-UgiQlxLOssoZlHMBQImU3Qzbd8kAo3D4-0-2dde693b8e59b0b46713dafbd196bf35)
黑色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0006.jpg?sign=1739352234-IX5Rmx9zgQtMQOtBlNKUzFTUzO2Qt0Lp-0-a14e46f87e4d56a89427a4a8f5217851)
指纹与病症的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0007.jpg?sign=1739352234-AsJdwvTUlMoztQZTscz3SJ6N9Y2YWVIg-0-0d4e9578d696da54f9aff66bce90b4b5)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0008.jpg?sign=1739352234-BEKzVreFsvyedWo041Qcmp652j1ZwBXS-0-31d1388b98420a4791ae290cd3e7546a)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0009.jpg?sign=1739352234-gMG1GFGHVGB7Ukmh8cVZr4jEwkpElAb5-0-cb85712a2100930cd100509710050fbf)
(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=1739352234-nY1QpRtMc5Ydvypd3QAeaVc38tYjsyKP-0-d8f4449b40b963043d5001b0ffe391d8)
(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=1739352234-wJNFL9xqFKRvtdT8iapnjzAWn6VovJlV-0-33df6b6026a61b920192a34013740baf)
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=1739352234-ijMscyqLLxYrdUqJSc77yIOzr7QvLUYr-0-3edaa7d781fd0166ac4a1ad25159a602)
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=1739352234-o4cf17A2DxRKmdPkeupdAo89V5mMR8VQ-0-db954c1b5124ad0b8b87fe0a5cd44115)
耳朵与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0003.jpg?sign=1739352234-79wuwvvSFka8JPuCAjj35yWtU4RoqzE3-0-d4b8f397fe2375d88d80e389021b0734)
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=1739352234-uDQVdI4YzUCqoS2zQm87WUNIPTsWwciS-0-ffbc35155e3d474ccfed450932f97b30)
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=1739352234-RomhcXKPRPakggWXJc2SMTfGrYlI1ZPr-0-2cc55c9234e74edd0e952cf3aded82b7)
(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=1739352234-aoPFuHYkCLB2KCZLEvTvfqZuMJR8kfnI-0-65711a4a62a8aac608e978e88e7f7de8)
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=1739352234-5YM6EC79EDANraWp9PqSh6UUZsbQCpwr-0-e6fb0f2b54f744b7bb77841e64a17e47)
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=1739352234-oiufcJSy2YxjqmylDeUREVEakxz53hLN-0-b5ce7c4ceabb8ae0180dea28d2a9f013)
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=1739352234-8mr6LN7hAbJlkcOysMaMOOKwb7nnkhMV-0-3cac14262d502da3bc32f62566d3c4b4)
发声
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0002.jpg?sign=1739352234-07GTPmNfPczm0pzIi15IWcli9aMmvn13-0-5f75acc35a662a57bfb1dfb2906249b3)
呼吸
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0003.jpg?sign=1739352234-u1r00nTrvxipCJe5I1StfObZhT3MQS0t-0-4e9001310bec3792e130b8f90e247058)
咳嗽
嗅气味
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0004.jpg?sign=1739352234-LTnQEz6UakbhHKNc2Hr7fQYxu5acX0dv-0-c78b2f5623571341f0d2c9f13ebafb87)
口臭
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0005.jpg?sign=1739352234-VvGghqtCgjNOotZMHMM4mVbKOSI6q0fN-0-b00f997ecc31991e3ab2f23203ec13ec)
便便
问诊
知寒热
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0006.jpg?sign=1739352234-SjeCb2vJLlVLyYHNphJT6zj3uVDEbKEU-0-2fde5a18b198d6b70db722edbaf7ec9b)
察二便
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0007.jpg?sign=1739352234-kyqeyYoZ6RobUViIOxwZGDzd8kxXdwlv-0-57ae10b3114833897bce5b51acd14643)
看睡眠
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0008.jpg?sign=1739352234-PKRwnkj4cn61p4KzRK3rDVpMZB2q9NNE-0-c2c416781b919ef849e233f0969a2348)
观饮食
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0009.jpg?sign=1739352234-70Y4vOa4hbOu81qvt53UsPwAp6N4lBHI-0-c80540b60d63d74634f252962b0f85c0)
脉诊
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0010.jpg?sign=1739352234-5PQHoJC7t0tsFSQCsq8Q526HNtTqsCCs-0-0a3532ac301a58c78700ba85f861e677)
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=1739352234-9s8DqheW6EZh7k1t6T4i3uZbIy8iV3Pw-0-7be6cf11d3b53a2ca8960fc161ff7986)
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=1739352234-09RfjSodC9XZ5fEkDVRzMEjo2PBWMRqw-0-4d6f453eee03f77bd0d6e0094712a846)
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。