日本漢方腹診臨床應用概說

Introduction to the Clinical Application of Belly Diagnosis in Japanese Oriental Medicine

腹診在疾病的診斷及治療上，具有不可取代的意義。清．俞根初云：「胸腹為五臟六腑之宮城，陰陽氣血之發源，若欲知其臟腑何如，則莫如按胸腹」，胸腹部和五臟六腑的關係最為密切，透過腹診可以得知體質的虛實、邪氣的病位病性，據此可知病因為氣、血、水病中的哪一類，而影響辨證論治的結果。白竹子在《診病奇侅》中提到：「外感病，切脈可知，而內傷病，非診腹不能知也。胸腹者，病之本位，診之於此，察其厚薄虛實，則可預知其一二年後之病。」尤其在內傷雜病的部分，病情複雜、虛實難辨時，腹診更具有診斷價值；依筆者臨床所見，有身形強壯但腹部無力寒冷者，亦有寸口脈及趺陽脈浮數但腹部寒冷脹滿無力者，當寒熱虛實難辨時，腹診佔有決定性的判斷；雖身熱脈數口渴而診腹冷者，若其足與鼻尖之溫度冷，小便色白，雖渴而不欲多飲，喜食熱者為真寒假熱。此外，腹診具有客觀性強、重覆性高的特色，可補四診之不足。但不應忽視其他診法的重要性，四診各有特色，相輔相成，才能提高中醫診斷疾病的準確率和治療效果。

The belly diagnosis has a significant meaning on the diagnosis and treatment of diseases. In Ching Dynasty, Yue Gan-Tsu said 'The chest and belly are the places for the vital organs of human body, and the sources of Ying, Yang, qi, and blood. If you want to know their condition, it is better to press the chest and belly.' The chest and belly have the closest relationship to the vital organs of human body. The insufficiency or surplus of physique and the actual location and situation of bad qi can be known through the belly diagnosis. It can be used to know the disease is caused by qi, blood, or water, and the result of syndrome will be influenced. In the 'Wonder of Disease Diagnosis', Bai Chu-Jeh pointed out 'The external diseases can be known by checking pulse. The internal injury and diseases should be examined by the belly diagnosis. The chest and belly are the places of the diseases. The thick, thin, insufficiency, or surplus can be known by it, and the disease at 1-2 years later can be foreseen.' Particularly for the part of internal injury and miscellaneous diseases, if the disease condition is complicated and the insufficiency or surplus is difficult to be distinguished, the belly diagnosis has better diagnosing value. According to the clinical finding of author, the belly diagnosis has the decisive judgment, when the insufficiency or surplus is difficult to be distinguished for the patient with strong body and cold belly. Although the body is hot, the mouth is thirsty, and the belly is cold, if the temperature is low at the feet and nose tip, the urine will be white. Although the patient feels thirsty but he likes to eat hot food instead of drinking more water, it is real cold and false heat. In addition, the belly diagnosis has strong objectivity and high repetition characteristics, which can make up the deficiency of other four diagnoses. But the importance of other diagnoses can not be neglected. Other four diagnoses have their own characteristics, respectively. They should be complemented each other to improve accurate rate and curative effect of diagnosing the diseases by Chinese medicine.