摘要
本文重点介绍了广西名中医、全国老中医药学术经验传承工作指导老师王力宁教授在临床诊疗工作中,针对小儿“哑科”特点,综合应用中医“望闻问切”各种诊查方法的经验。王力宁教授临证强调传统中医理论与现代临床实践相结合。根据小儿临床特点,在诊法层面,强调详询病史,通过规范化的病史采集模式,动态把握病程演变,确保信息及时、客观、准确。重视望诊,创新提出“下眼睑瘀黑征”作为特禀体质表型标志,结合咽喉色泽辨寒热、舌象变化析病因,形成多维度望诊模式,将体表表征与脏腑病理深度关联。针对小儿脉诊局限性,引入《内经》虚里理论,将中医虚里诊法与现代听诊技术结合,通过心肺听诊评估宗气盛衰与疾病传变趋势;并强调脉证结合,当脉象与实际病候不符,当“舍脉从证”。这种守正创新的诊查模式,不仅提升儿科四诊客观性,更推动中医儿科诊断学向标准化、精准化发展,对完善儿童疾病防治策略具有重要学术价值。
This article focuses on the clinical experience of Professor Wang Lining,a renowned traditional Chinese medicine(TCM)practitioner in Guangxi and a national instructor for inheriting the academic expertise of senior TCM doctors.Professor Wang comprehensively applies various diagnostic methods of TCM to the clinical practice,including inspection,listening/smelling,inquiry,and palpation(wang-wen-wen-qie),specifically tailored to the characteristics of pediatrics,which are often referred to as the"silent specialty"due to children's limited ability to express symptoms.Professor Wang emphasizes the integration of TCM theory with modern clinical practice.Based on the clinical features of children,she stresses detailed history taking at the diagnostic level.Through a standardized model of history collection,she dynamically tracks the evolution of the disease to ensure that the information is prompt,objective,and accurate.She places significant importance on inspection,innovatively proposing"infraorbital ecchymosis"(dark circles under the eyes)as a phenotypic marker for atopic constitution.She formulated multi-dimensional mode of inspection by differing the cold from the hot based on the throat color and analyzing the cause of disease according to the changes in tongue,which deeply correlates the signs on body surface with visceral pathology.Considering the limitations of pulse diagnosis in children,she introduces the theory of"xuli"(the area of the apex beat)from the Huangdi Neijing,integrating the TCM diagnostic approach of"xuli"with modern auscultation techniques.and she uses cardiopulmonary auscultation to assess the state of pectoral qi(zongqi)and the trend of disease change.Professor Wang also emphasizes the combination of pulse findings with clinical manifestations(syndrome differentiation),advocating to"discard the pulse and focus on the syndrome"(shemai congzheng),when the pulse signs are not in accordance with the actual clinical presentation.This diagnostic model,characterized by upholding integrity and pursuing innovation,not only improves the objectivity of the four diagnostic methods in pediatrics but also promotes the standardization and precision of TCM pediatric diagnostics,holding significant academic value for improving strategies for the prevention and treatment of childhood diseases.
作者
李志峰
王力宁
王广青
姚勇志
刘含
LI Zhifeng;WANG Lining;WANG Guangqing;YAO Yongzhi;LIU Han(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Guangxi University of Chinese Medicine,Nanning 530200,China)
出处
《中国中西医结合儿科学》
2025年第5期437-441,共5页
Chinese Pediatrics of Integrated Traditional and Western Medicine
基金
国家中医药管理局2022年全国名老中医药专家传承工作室建设项目(2023001-01)。
关键词
小儿诊法
诊法经验
王力宁
Pediatric diagnostic methods
Diagnostic experience
Wang Lining
