中医目诊的诊断原理及常见诊病部位

Diagnosis principle and common diagnosis site of traditional Chinese medicine eye diagnosis

早在《黄帝内经》中就有关于中医目诊的论述,文章从历代中医古籍中总结出中医目诊的4点诊断原理,分别为:眼目为五脏六腑缩影,五脏六腑的病理变化可显现于眼目;根据生理病理不同,可将眼目分为五轮,内应五脏;眼分八廓,外应脏腑;眼与经络载气血上注于目的联系较为广泛,脏腑气血失调先见通过经络上走于面,注于目。因此眼目的病理变化可作为诊断疾病的依据。常见的目诊眼部不同的部位包含有不同的诊断信息,可诊断不同的疾病,如胞睑可有虚浮、赤肿、颜色变化(青色、黯黑、白色、黄白色等)、内表面黄白色或粟粒样颗粒、下垂、不自主跳动等病理信息,多诊断眼科疾病;两眦、白睛可有白睛颜色变化(红赤、混赤、蓝白色、苍白色、青色、黑色等)、白睛血络变化(颜色、形态、粗细等)等病理信息,多诊断眼科、内科、外科、妇科等疾病;眼内组织包含视网膜变化(血管、颜色)、视盘、黄斑变化(渗出、水肿)、玻璃体变化(颜色变化、液体混浊)等病理信息,可诊断眼科、糖尿病、高血压病等内科、外科、妇科等疾病。文章总结了中医目诊的基本原理,梳理了中医目诊常见的诊断部位及病理变化。

As early as in the Huangdi Neijing, there is a discussion about traditional Chinese medicine(TCM) eye diagnosis. The article summarizes the four diagnostic principles of TCM eye diagnosis from ancient TCM books in the past dynasties. The eyes are the epitome of the viscera and the six organs. The pathological changes of the viscera and the six organs can be seen in the eyes. The eyes are divided into five chakras, which correspond to the five zang viscera. The eyes are divided into eight contours, which correspond to the zang-fu viscera. The meridians carry qi and blood on the eyes, and the disorder of qi and blood of the zang-fu viscera is first seen in the eyes. Different parts of the eye contain different diagnostic information,and different diseases can be diagnosed. The eyelid may have eyelid floating, red and swollen eyelid, eyelid color change(cyan,dark black, white, yellow-white, etc.), yellow-white or miliary-like particles in the eyelid, ptosis, involuntary eyelid beating, etc.This pathological information are mostly diagnosed as ophthalmic diseases. White eyes can have white eye color changes(redred, mixed red, blue-white, pale, cyan, black, etc.), white-eye blood vessels(color, shape, thickness, etc.). This pathological information are mostly diagnosed as ophthalmology, internal medicine, surgery, gynecology and other diseases. The intraocular tissues include the retina(blood vessels, color), optic disc, macula(exudation, edema), vitreous(color change, fluid opacity), etc.This pathological information can be diagnosed as ophthalmic diseases, diabetes, hypertension and other internal diseases. This article summarized the basic principle of TCM eye diagnosis, organized common diagnosis sites and pathological change.