![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=1738845981-CvykBC9rDgwNWbL5uZYRPpkrogsZsClp-0-3e0fafb2fd9653cd8e759635d36f3397)
(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=1738845981-G1n69uJzy4GuSOEYRpduo1jFNLrXRdJi-0-5440661567be2a53ffa9c02dd21d8253)
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=1738845981-bbScfbSokfYRtBL8UZm4mcnue4G4U1Ot-0-3e08ca6d6046a413324a74f578fb959e)
赤色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0002.jpg?sign=1738845981-PuSk5aDAZ6hH0s58rgBCWvPEzapTIdZZ-0-817899c47d86585d45b96c127c887138)
青色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0003.jpg?sign=1738845981-BQ9aHMtvkoOsUXdesJ2JTsixtasnLn4m-0-80a07d7da6c8e427620d96bac94954e7)
黄色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0004.jpg?sign=1738845981-nXeULTFwg956l2ZoBszAgFFWn2b118WH-0-bd1bc23a333c60b454b2b4ea7e2d6a7f)
白色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0005.jpg?sign=1738845981-19g2arbuzrURAUnJEVoGV5RNBch1bgfW-0-cc7d431a77091582b7083fefa2b149b3)
黑色
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0006.jpg?sign=1738845981-pNY9qg8TYVZ9vi9bU7UtH4Lb05NBc7gH-0-6a9bff00ac0835d2fcd4ae6e605908c8)
指纹与病症的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0007.jpg?sign=1738845981-4LGJZ0pP4VzAAoe8uwV6OmohX0WVRRnJ-0-765c75b58de9faf9fa39886c823642a9)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0008.jpg?sign=1738845981-WyhBmyQlkOmqgLpBzBWxNVg505FQUvDy-0-e54ed68d23a3317364952e42b7b35670)
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0023_0009.jpg?sign=1738845981-IoAyp3GwbN58nLe6fLA76WnHnHaYMIMN-0-b8d5a1cab7374b82c4cf570b67618844)
(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=1738845981-nrgxXwX6sqXOk2Bb2QZ6Fspq4GDQ6Noa-0-aff9c8c37969fd216c645267913e6daf)
(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=1738845981-N4U8GO1z9mas4f8KVRWvubTvqbSMFdoz-0-58057803ade272caf3420100c2463e8d)
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=1738845981-VqnFvHDs8wcyFn2Ff0WwXng9UwZ8tdUX-0-e920d6bc269a6d50c31cc541dd26860b)
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=1738845981-6hrqbSTxWYOWLnJ4gAtMAMugg4HZV5kB-0-4a6d2c499b458a68d16593de0e565a7a)
耳朵与脏腑的关系
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0025_0003.jpg?sign=1738845981-FMjkjdIcao5EV5pp8NbPMvN6yu0I4Ewm-0-a9c727815b7674d72f8934c3922f0a5a)
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=1738845981-0RkrHsrwNdP0t5tYOCyQvNJSJkIBFLsN-0-c6c16adcf757542091a988759ece7f6b)
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=1738845981-KJoyMwq4VypOFLgvvWUGIOmzcrVHOrmv-0-8b0bf2e2143fd0a03342fcc19a8a94d2)
(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=1738845981-e3qLo1PaBkmVA3ezEakrGvSqivZfTt81-0-2093180197cc9488866d53221cff8c77)
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=1738845981-nMscaqor0nXtNJ3L86MSHRT4NrihTIFr-0-5fccb945a6dc2b86907a24818fbed352)
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=1738845981-RY2laaUOmlhiom9LnSPxW31osdzXbeMp-0-e98b106b35bc26741324780b71a34763)
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=1738845981-7HO8cw6dFELkC8dJRnLQyYC8eENMOnWk-0-ea96c3cae66712fd495b0bc1e4c34b83)
发声
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0002.jpg?sign=1738845981-CczxjwU4uMpt0Llgv0B6rcaPb0WyxwgN-0-a46932361a67ac283baf0a37440562f0)
呼吸
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0003.jpg?sign=1738845981-IxCxOIDQ8QCZioo30ghfrYsIK88WkL3g-0-4078e6d2cf6d4aa196d8a5e1c46c3688)
咳嗽
嗅气味
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0004.jpg?sign=1738845981-HEL959PWZYwZ15dZPej1Yv1QnhvwkFyr-0-11ee638f43e837fd524b6f9a4a67eb97)
口臭
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0005.jpg?sign=1738845981-VudVkhPUyFi16aNBDvmrtoXaHul9wGRT-0-b401eb6670cfabf5596e39f16109291a)
便便
问诊
知寒热
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0006.jpg?sign=1738845981-rwBA5VjsgRgzUncPIoec2wFVSYDBZVT8-0-2b3e615a862620e90ba855dca0f4de6b)
察二便
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0007.jpg?sign=1738845981-KWG7Uwz3ko6T1xGJb3omxVGTscGuScCi-0-892e4a169508b637d1fb5956ab4acf57)
看睡眠
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0008.jpg?sign=1738845981-lBxBQqSVwe7YQ4PnR31BfY9UEHTIDGDu-0-f69f9c6f57266e9ed1795a2b65b80fdb)
观饮食
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0009.jpg?sign=1738845981-rcr9CrpjSJxlblllLTLlhZL5y2XnFTmB-0-827973f7664cf2716eed1b4707a73a72)
脉诊
![](https://epubservercos.yuewen.com/44A2C3/15255317805968406/epubprivate/OEBPS/Images/figure_0027_0010.jpg?sign=1738845981-CIizseHIdoYj1ViNZ16FtG4oamKDenPX-0-a3b55268901e2294b36949109474d338)
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=1738845981-jlRkrnAZTY7JadR3y8w7feUVWE0b6lCd-0-1322d28e3e4523a58f42d8fc2e0dd377)
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=1738845981-lQrcEkixF0SBTzXXtX7baeGkYGHZ1E3I-0-7fc66e5017d795d35a6ce6c39ea56115)
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。