中医四诊补遗与九诊探索  

Supplement on four diagnosis and exploration on the nine diagnosis of traditional Chinese medicine

作　　者：丁宁[1] 杨宇飞[2] 张浩琳[1] 李赛[1] 宋威江 李东[1] DING Ning;YANG Yu-fei;ZHANG Hao-lin;LI Sai;SONG Wei-jiang;LI Dong(Department of Traditional Chinese Medicine,Peking University Third Hospital,Beijing 100191,China;Xiyuan Hospital of China Academy of Traditional Chinese Sciences,Beijing 100091,China)

机构地区：[1]北京大学第三医院中医科,北京100191 [2]中国中医科学院西苑医院,北京100091

出　　处：《中华中医药杂志》2021年第12期6983-6987,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市自然科学基金项目(No.7174363);国家自然科学基金面上项目(No.82074193)。

摘　　要：在传统望闻问切四诊基础上,笔者补充了一些传统四诊中可能缺失的部分,又提出一些新四诊的假说,如肿瘤患者手掌之瘀斑,考虑其可能与肿瘤的恶性程度相关,是气血逆乱达到一定程度的病理产物,并可能与肿瘤发生的部位相关;也以假说提出了一些四诊的可能新内涵,如闻诊中的特殊气味、互联网问诊中的一些信息、脉诊中的特殊脉象等。另外结合临床和前人经验总结提出了触诊、体感诊、食茶气诊、祝由诊、易诊等可能具有临床意义的诊断手段,并提出新九诊假说。或为精准医学提供一种中医相对更加全面的诊断思路。On the basis of traditional four ways of diagnosis(look, listen, question and feel the pulse), this article supplements some missing parts in the traditional four diagnostic methods, and puts forward some new four diagnostic hypotheses, such as palmar ecchymosis of tumor patients. It is considered that may be related to the malignant degree of the tumor. It is also maybe the pathological product of the disorder of qi and blood on a certain extent. Its location on palm may be related to the location of the tumor. This article also puts forward some possible new connotations of the four diagnoses, such as the special smell in sniffing, some information in internet inquiry, special pulse in pulse diagnosis and so on. In addition, combined with clinical and previous experience, it summarizes and supplements some diagnostic methods that may have clinical significance, such as palpation, somatosensory examination, food and tea qi diagnosis, Zhuyou examination, and diagnosis based on The Book of Changes, and puts forward new nine diagnostic hypotheses. It may provide a relatively more comprehensive diagnostic thinking of traditional Chinese medicine for precision medicine.

关 键 词：九诊 手掌瘀斑 互联网问诊 体感诊 祝由诊 易诊 食茶气诊 

分 类 号：R241[医药卫生—中医诊断学]