問診單（Medical consultation form）

如有以下問題可詳細(xì)說(shuō)明，以便醫(yī)生能知曉病情，合理用藥。
（The following questions can be explained in detail, so that doctors can understand the condition and use medication reasonably.）
1. 姓名
Name
2. 性別
Sex
3. 年齡
Age
4. 身高
Height
5. 體重
Weight
6. 主要有什么不舒服?
What's the main discomfort?
7. 如有以下問題可詳細(xì)說(shuō)明，以便醫(yī)生能知曉病情，合理用藥。
The following questions can be explained in detail, so that doctors can understand the condition and use medication reasonably.
8. 白天容易犯困嗎?
Do you feel sleepy during the day?
9. 頭重腳輕嗎?
Top-heavy?
10. 身體沉重嗎?
Is the body heavy?
11. 眼睛有沒有不舒服?（比如眼睛干澀發(fā)癢、眼屎多、視力下降）
Are your eyes uncomfortable? (For example, dry and itchy eyes, excessive eye discharge, decreased vision)
12. 耳朵有沒有不舒服?（比如耳朵塞、耳鳴、聽力下降等）
Are your ears uncomfortable? (such as ear plugs, tinnitus, hearing loss, etc.)
13. 早上口苦嗎?
Is it bitter in the morning?
14. 嗓子干不干?
Is your throat dry?
15. 肋骨下方一圈有沒有壓痛點(diǎn)?
Is there any tenderness in the circle below the rib?
16. 平時(shí)口渴嗎?（如果口渴的話喝水能解渴嗎，喜歡熱水還是冷水?）
Are you usually thirsty? (If you are thirsty, can drinking water quench your thirst? Do you prefer hot water or cold water?)
17. 怕不怕風(fēng)吹?
Afraid of the wind?
18. 怕冷還是怕熱?
Is it cold or hot?
19. 平時(shí)容易出汗嗎?
Do you sweat easily?
20. 小腿有沒有魚鱗狀皮膚、掉白皮屑?
Does the calf have fish-scaled skin or white scales?
21. 大便多久一次、干還是稀、臭不臭、有沒有未消化食物?拉完會(huì)不會(huì)感覺沒排干凈?
How often do you have a bowel movement, dry or thin, smelly, and whether there is any undigested food? Does it feel like it's not clean?
22. 小便費(fèi)不費(fèi)勁、顏色如何、一天幾次?有沒有泡沫?渾濁嗎?
Is it easy to urinate, what is the color, how many times a day? Is there any foam? Is it cloudy?
23. 睡眠情況?夢(mèng)多嗎?容易醒嗎?
How about your sleep? Do you dream a lot? Is it easy to wake up?
24. 容易受到驚嚇嗎?
Are you easily scared?
25. 煩躁嗎?
Are you upset?
26. 食欲和飯量怎么樣，有沒有惡心嘔吐?
How is your appetite ? Are you feeling nauseous or vomiting?
27. 有沒有口腔潰瘍?
Do you have oral ulcers?
28. 每天會(huì)不會(huì)固定時(shí)間發(fā)熱?
Do you have a fixed time of fever every day?
29. 黃昏會(huì)發(fā)熱或覺得特別累或困嗎?
Do you feel hot or tired or sleepy at dusk?
30. 有沒有皮膚病?
Do you have any skin diseases?
31. 手腳溫度如何?
What is the temperature of the hands and feet?
32. 睡覺流口水嗎?（有沒有夢(mèng)游、磨牙、盜汗、鬼壓床等）
Do you drool when you sleep? (Are there any sleepwalking, teeth grinding, night sweats, etc.)
33. 手指和腳趾溫度會(huì)不會(huì)比手腳其它位置更涼?
Are your fingers and toes colder than the rest of your hands and feet?
34. 癥狀在白天和夜晚有沒有不同表現(xiàn)?
Are symptoms different during the day and at night?
35. 后背有沒有巴掌大一塊發(fā)涼，或者整個(gè)后背發(fā)涼?
Does the back feel cold in a palm-sized area, or the entire back?
36. 是否一直吃什么都不胖?會(huì)脫發(fā)嗎?
Do you always eat anything without getting fat? Will it lose hair?
37. 腹部側(cè)面有沒有脹痛?
Is there any bloating pain on the side of the abdomen?
38. 有沒有胸悶氣短心悸?
Do you have chest tightness, shortness of breath, palpitations?
39. 皮膚有沒有發(fā)黃?
Does the skin turn yellow?
40. 胳膊肘痛不痛?
Does the elbow hurt?
41. 會(huì)胃脹嗎?
Will you have stomach bloating?
42. 臉發(fā)黑嗎?
Does your face turn black?
43. 嘴唇干燥嗎、有沒有干裂或起皮?
Are the lips dry, cracked, or peeled?
44. 身上有沒有哪里疼痛?
Is there any pain in your body?
45. 坐著到站起有沒有頭暈?
Do you feel dizzy from sitting to standing up?
46. 有沒有偏頭痛史?
Any history of migraines?
47. 平時(shí)容不容易嘆氣?
Do you usually sigh easily?
48. 冬天有沒有凍瘡
Is there frostbite in winter?
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