刘培 蒋鹏飞 颜春薇 张宜帆 彭俊 彭清华

〔摘要〕 目为五脏六腑缩影，五脏六腑的病理变化可显现在眼目，根据眼目与五脏六腑的生理病理联系，发展成了独具中医学特色的中医目诊法。新中国成立后，对中医目诊法的研究不断加深，其中一些创新性研究极大地促进了中医目诊的发展。就诊断部位而言，眼底病理信息已较多的用于诊断疾病，中医目诊初步形成了内眼+外眼的诊断模式;中医目诊的辨证方法亦有较多发展，如以六经辨证理论指导辨证，以眼部证候、证素为主进行辨证等。对部分中医目诊的创新理论进行介绍，以期为中医目诊的研究提供帮助。

〔关键词〕 中医目诊;理论;六经辨证;五轮学说;八廓学说

〔中图分类号〕R276.7        〔文献标志码〕A       〔文章編号〕doi：10.3969/j.issn.1674-070X.2021.07.027

〔Abstract〕 The eyes are the epitome of the internal organs. The pathological changes of the internal organs can be seen in the eyes. According to the physiological and pathological relationship between the eyes and the internal organs， it has developed a unique traditional Chinese medicine （TCM） visual diagnosis method. After the founding of the People's Republic of China， the research on the visual diagnosis of TCM has been continuously deepened， and some of the innovative researches have greatly promoted the development of visual diagnosis of TCM. As far as the diagnosis site is concerned， more fundus pathological information has been used to diagnose diseases. TCM visual inspection has initially formed a diagnostic model of inner eye + outer eye; TCM visual inspection has also developed more syndrome differentiation methods， such as syndrome differentiation guided by the six channels of syndrome differentiation theory， focusing on eye syndromes and syndromes. This article introduces some innovative theories of visual inspection in TCM， hoping to provide help for the research of visual inspection in TCM.

〔Keywords〕 visual examination of TCM; theory; six channels of syndrome differentiation; five-round theory; eight regions theory

中医目诊历史悠久，在马王堆出土的医书《阴阳脉死候》中就有目诊的记载：“面黑，目寰，视衮，则气先死。”《黄帝内经》中也有较多关于目诊的论述，如《灵枢·论疾诊尺》曰：“目赤色者，病在心，白在肺，青在肝，黄在脾，黑在肾，黄色不可名者，病在胸中。此以目之五色，验五脏之病，以五脏之精气聚于目也。”眼目五色病理变化不仅可以诊断疾病所在脏腑，还能预测生死，如《灵枢·邪客》记载：“视目之五色，以知五藏而决死生。”又如《灵枢·四时气第十九》说：“睹其色，察其以，知其散复者，视其目色，以知病之存亡也。”《伤寒杂病论》中也十分重视目诊，将眼目的诸多病理变化作为诊断疾病的依据，如目黯、血从目出、直视不能瞤等。……