《黄帝内经》四诊合参的中和意蕴与临床价值  

The Harmonizing Implications and Clinical Value of the Comprehensive Analysis of the Four Diagnostic Methods in Huangdi′s Internal Classic

作　　者：陈晓 贾梦真 黄岩杰 CHEN Xiao;JIA Mengzhen;HUANG Yanjie(Wancheng District Maternal and Child Health Hospital of Nanyang City,Nanyang,Henan,China,473000;Pediatric School of Henan University of Chinese Medicine,Zhengzhou,Henan,China,450000;Shanghai Children′s Hospital,Shanghai Children′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China,200062)

机构地区：[1]南阳市宛城区妇幼保健院,河南南阳473000 [2]河南中医药大学儿科医学院,河南郑州450000 [3]上海市儿童医院,上海交通大学医学院附属儿童医院,上海200062

出　　处：《河南中医》2025年第3期331-336,共6页Henan Traditional Chinese Medicine

基　　金：河南省中医药学科领军人才项目{豫卫中医函[2021]8号};2022年中原科技创新领军人才项目(234200510028)。

摘　　要：《黄帝内经》四诊合参遵循天地人整体观,以人与自然、人体自身的顺应、协调、中和为标准,对疾病进行全面、准确把握,从而达到主观与客观、现象与本质、整体与部分的辩证统一。望诊首先是望神,其次是望色,再次是综合望诊,将人体脏腑藏于内的功能与表现于外的征象内外相参,从其“和”与“不和”“应”与“不应”推导出内外相参相应的变化规律;闻诊立足于五行理论,对五脏与五音、五声及气味的相互关系进行综合判断,以诊察疾病的各种性质与变化规律;问诊的目的和意义在于全面把握疾病的根本所在,切中肯綮,明确病名或病证,为治疗提供准确的依据和前提;切诊一是强调脉应四时,二是强调脉以胃气为本,三是强调色脉互参,四是重视“平息以调之为法”。医者应充分融合四诊收集到的有效信息,精准诊疗,使“失中和”向“中和”转化。The comprehensive analysis of the four diagnostic methods in Huangdi′s Internal Classic adheres to the holistic view of heaven,earth,and human beings,utilizing harmony between humans and nature,as well as the internal equilibrium of the human body,as criteria for comprehensively and accurately diagnosing diseases.This approach achieves dialectical unity between subjectivity and objectivity,phenomena and essence,and the whole with its parts.Inspection prioritizes observing vitality,followed by complexion analysis and comprehensive visual assessment.It correlates internal visceral functions with external manifestations,deducing pathological patterns through the interplay of"harmony versus disharmony"and"correspondence versus non correspondence."Auscultation and Olfaction are grounded in the five-element theory,elaborating on the relationships among the five zang organs,five tones,five voices,and odors to discern disease characteristics and progression laws.Inquiry aims to identify the core pathogenesis,establish precise disease nomenclature or syndrome differentiation,and provide a foundation for treatment.Palpation emphasizes four principles:pulse correspondence with seasonal variations,pulse vitality rooted in stomach qi,integrative analysis of pulse and complexion,and"respiratory synchronization during pulse-taking".Clinicians must synthesize information from the above four methods to guide the transformation from"disharmony"to"harmony."

关 键 词：四诊合参 望诊 闻诊 问诊 切诊 《黄帝内经》 “中和” 

分 类 号：R221.09[医药卫生—中医基础理论]