天柱華佗夾脊刺課件

石學敏教授

ShiXueMinProfessor

針刺治療痛證

AcupunctureAnalgesia

1石學敏教授1

針法特點Characteristicofthetheraphy

強調調神，治病求本

Regulatethevitality

刺絡療法，祛瘀通絡

Blood-lettingpuncture

臨證加減，辨證論治

Selectthepointsaccordingtodifferentialdiagnosis

2針法特點強

止痛要穴上肢：外關

Arm:Waiguan(SJ5)下肢：飛揚

Leg:Feiyang(BL58)腰部：大腸俞

Lumbus:Dachangshu(BL25)全身：人中

TheWholebody:Renzhong(DU26)3止痛要穴上肢：外1.頭面軀體痛證1.Painfuldiseaseofcephalofacialandsomaticregion

1.1頭痛

1.1Headache1.1.1血管性頭痛

1.1.1Vascularheadache

治則：疏解少陽、活血化瘀。

Principle:RegulateShaoyangmeridian,Activatebloodflowanddispelbloodstasis

配方：風池、完骨、太陽、頭維透率谷、中封、陽輔。Prescription:Fengchi(GB20),Wangu(GB12),Taiyang(EX-HN5),Touwei(ST8)toShuaigu(GB8)，Zhongfeng(LR4)Yangfu(GB38)41.頭面軀體痛證41.1.2神經性頭痛

1.1.2Nervousheadache

治則：調神理氣、通絡止痛。Principle:RegulatetheVitalityandQi,Activatethecollateralsandrelievepain

配方：內關、人中、太沖、百會、四神聰、風池、完骨、天柱。Prescription:Neiguan(PC6),Renzhong(DU26),Taichong(LR3),Baihui(DU20),Sishencong(EX-HN1),Fengchi(GB20),Wangu(GB12),Tianzhu(BL10)1.1.3眼性頭痛

1.1.3Ocularheadache

治則：通絡止痛。

Principle:Activatethecollateralsandrelievepain配方：風池、太陽、睛明、球后、四白。Prescription:Fengchi(GB20),Taiyang(EX-HN5),Jingming(BL1),Qiuhou(EX-HN7),Sibai(ST2)

51.1.2神經性頭痛51.1.4頸性頭痛

1.1.4Cervicalheadache

治則：通絡止痛。Principle:Activatethecollateralsandrelievepain

配方：風池、完骨、天柱、頸椎夾脊刺。

Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervicalJiaji(EX-B2)1.1.5高顱壓性頭痛

1.1.5Ocularheadache

治則：醒神開竅、滋陰潛陽、通絡止痛。Principle:XNKQ,Nourishyinandyang,Activatethecollateralsandrelievepain

配方：上星透百會、太陽、風池、完骨、三陰交、合谷、太沖。

Prescription:Shangxing(DU23)toBaihui(DU20),Taiyang(EX-HN5),Fengchi(GB20),Wangu(GB12),Sanyinjiao(SP6),Hegu(LI4),Taichong(LR3)

61.1.4頸性頭痛61.2面頰痛（三叉神經痛）

1.2Prosopalgia

治則：活血化瘀、通絡止痛。

Principle:Activatebloodflowanddispelbloodstasis,Clearthecollateralstorelievepain主方：下關、四白、風池、翳風，痛點刺絡拔罐。Prescription:Xiaguan(ST7),Sibai(ST2),Fengchi(GB20),Yifeng(SJ17)

Andblood-cupingonAshipoint

配穴：第一支痛加攢竹、太陽。

Associatedpoints:Tothefristbranch:Cuanzhu(BL2),Taiyang(EX-HN5)第二支痛加顴髎。Tothesecondbranch:Quanliao(SI18)

第三支痛加頰車、迎香。

Tothethirdbranch:Jianche(ST6),Yingxiang(LI20)

71.2面頰痛（三叉神經痛）71.3落枕（斜方肌痙攣）1.3Stiffneck治則：調氣活血、疏通經絡。Principle:RegulateQiandactivateblood,Regulateandclearthemeridian配方：風池、完骨、天柱、頸椎夾脊刺、絕骨、后溪。Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervicalJiaji(EX-B2),Juegu(GB39),Houxi(SI3)

1.4頸痛（頸椎?。?.4

Cervicalspondylopathy治則：活血通絡、祛風止痛。Principle:Activatebloodandclearthemeridian,Dispelwindtorelievepain配方：風池、完骨、天柱、頸椎夾脊刺。Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervicalJiaji(EX-B2)

81.3落枕（斜方肌痙攣）81.5脊痛（退行性脊柱炎）

1.5

Retrogressivespondylitis治則：祛瘀通絡、通調督脈、膀胱經氣。Principle:Dispelbloodstasisandclearthemeridian,RegulateQIofDuandbladderchannel

配方：1.雙側環(huán)跳、大腸俞、委中、陽陵泉刺絡拔罐。Prescription:Ⅰ:Huantiao(GB30),Dachangshu(BL25),Weizhong(BL40),Yanglingquan(GB34)Ashipointwithblood-cuping2.人中、腎俞、大腸俞、環(huán)跳、腰陽關、委中、養(yǎng)老、阿是穴。

Ⅱ:Renzhong(DU26),Shenshu(BL23),Dachangshu(BL25),Huantiao(GB30),Yaoyanghguan(DU3),Weizhong(BL40),Yanglao(SI6),Ashipoints

91.5脊痛（退行性脊柱炎）91.6肩臂痛（臂叢神經痛）

1.6Brachialplexusneuralgia治則：行氣散瘀、通經止痛。Principle:CirculateQianddispelbloodstasis,Clearthemeridiantorelievepain配方：頸夾脊刺、肩外俞、阿是穴刺絡療法Prescription:cervicalJiaji(EX-B2),Jianwaishu(SI14),Ashipointwithblood-lettingpuncture

101.6肩臂痛（臂叢神經痛）101.7肩凝癥（肩關節(jié)周圍炎）1.7Periarthritisofshoulder治則：活血化瘀、通絡止痛。Principle:Activatebloodanddispelbloodstasis,Clearthecollateralstorelievepain配方：1.患側肩髃、肩貞、臑俞、天宗、曲垣、肩外俞或以痛為俞刺絡拔罐。Prescription:Ⅰ:IllnesssidepointsofJianyu(LI15),Jianzhen(SI9),Naoshu(SI10),Tianzong(SI11),Quyuan(SI13),Jianwaishu(SI14)Andblood-cupingonAshipoint2.患側肩髃、肩貞、臑俞、天宗、秉風、曲垣、肩外俞、肩中俞、條口。

Ⅱ:IllnesssidepointsofJianyu(LI15),Jianzhen(SI9),Naoshu(SI10),Tianzong(SI11),Bingfeng(SI12),Quyuan(SI13),Jianwaishu(SI14),Jianzhongshu(SI15),Tiaokou(ST38)

111.7肩凝癥（肩關節(jié)周圍炎）111.8肘勞（肱骨外上髁炎）1.8Externalhumeralepicomdylitis治則：治則：舒筋活血、通絡止痛。Principle:Relaxtendonsandpromotebloodcirculation,Clearthecollateralstorelievepain配方：曲池、肘髎、手三里、合谷、阿是穴（施阻力針法）。Prescription:Quchi(LI11),Zhouliao(LI12),Shousanli(LI10),Hegu(LI4),Ashipointwithspecialmanipulation

121.8肘勞（肱骨外上髁炎）121.9脅痛（肋間神經痛）1.9Intercostalneuralgia治則：疏肝理氣、通絡止痛。Principle:RegulateQiofliver,Clearthecollateralstorelievepain配方：支溝、陽陵泉、太沖、三陰交、期門、日月、膈俞、丘墟。Prescription:Zhigou(SJ6),Yanglingquan(GB34),Taichong(LR3),Sanyinjiao(SP6),Qimen(LR14),Riyue(GB24),Geshu(BL17),Qiuxu(GB40)

131.9脅痛（肋間神經痛）131.10腰痛10Lumbago1.10.1急性腰扭傷1.10.1Acutelumbarsprain治則：行氣活血、通絡止痛。Principle:PromoteQiandblood,Clearthecollateralstorelievepain

配方：以局部俞穴和循經取穴為主，采用后溪、委中、大腸俞、腎俞。疼痛甚者，取內關、人中、痛點施阻力針法。Prescription:Houxi(SI3),Weizhong(BL40),Dachangshu(BL25),Shenshu(BL23).AndNeiguan(PC6),Renzhong(DU26),AshipointwithspecialmanipulationifSeriouspain

141.10腰痛141.10.2腰椎間盤突出癥1.10.2Prolapseoflumbarintervertebraldisc治則：活血化瘀、消腫止痛。Principle:Promotebloodanddispelstasis,Repercussiontorelievepain配方：取患側阿是穴、環(huán)跳、殷門、陽陵泉、足三里、委中、承山、懸鐘。Prescription:IllnesssidepointsofAshi,Huantiao(GB30),Yinmen(BL37),Yanglingquan(GB34),Zusanli(ST36),Weizhong(BL40),Chengshan(BL57),Xuanzhong(GB39)

151.10.2腰椎間盤突出癥151.10.3腰肌勞損1.10.3Lumbarmusculestrain治則：舒筋活血、通經活絡、祛寒止痛。Principle:Relaxtendonsandpromotebloodcirculation,Dispelcoldtorelievepain

配方：以局部俞穴和阿是穴為主，重點采用腎俞、關元俞、膀胱俞等。Prescription:Ashipoint,Shenshu(BL23),Guanyuanshu(BL26),Pangguangshu(BL28)etc.

161.10.3腰肌勞損161.11腰腿痛（坐骨神經痛）

1.11Sciatica

治則：活血止痛、疏通經絡。Principle:Promotebloodtorelievepain,Regulatemeridian

配方:1.刺絡法：分別于疼痛側太陽經、少陽經經絡所過之處的大腸俞、環(huán)跳、風市、承山等部位刺絡拔罐。Prescription:Ⅰ:Blood-cupingonpainfulsideofDachangshu(BL25),Huantiao(GB30),Fengshi(GB31),Chengshan(BL57)etc.

２.大腸俞、環(huán)跳、委中、陽陵泉、風市、飛揚、昆侖、承山Ⅱ:Dachangshu(BL25),Huantiao(GB30),Weizhong(BL40),Yanglingquan(GB34),Fengshi(GB31),Feiyang(BL58),Kunlun(BL60),Chengshan(BL57).

腎虛者加刺腎俞、太溪；IfkidneydeficiencyassociatedwithShenshu(BL23),Taixi(KI3);

血瘀者加刺血海、膈俞；IfbloodstasisassociatedwithXuehai(SP10),Geshu(BL17)風寒者加刺風池。Ifwind-coldassociatedwithFengchi(GB20)

171.11腰腿痛（坐骨神經痛）171.12膝痛（膝關節(jié)骨關節(jié)炎）1.12Gonitis

治則：活血化瘀、通絡止痛。Principle:Promotebloodandremovestasis,Clearthecollateralstorelievepain配方：膝眼、鶴頂、陽陵泉、陰陵泉、膝陽關、梁丘。Prescription:Xiyan(EX-LE4,5),Heding(EX-LE2),Yanglingquan(GB34),Yinglingquan(SP9),Xiyangguan(GB33),Liangqiu(ST34).1.13足底痛（跖神經痛）1.13Plantalgia

治則：滋陰補腎、溫養(yǎng)經絡。Principle:Nourishingyinofkidney,Warmingmeridian

配方：太溪、三陰交、足底排刺。Prescription:Taixi(KI3),Sanyinjiao(SP6),Linepunctureonplanta

181.12膝痛（膝關節(jié)骨關節(jié)炎）181.14痹證（風濕性、類風濕性關節(jié)炎）1.14Arthralgiasyndrome

治則：舒筋活絡、行氣活血、散風蠲痹。Principle:Relaxandactivatetendons,PromoteQiandblood,Dispelwindtorelievepain

主穴:風池、曲池、血海、合谷、太沖、華佗夾脊刺。Mainpoint:Fengchi(GB20),Quchi(LI11),Xuehai(SP10),Hegu(LI4),Taichong,Jiaji(LR3).

配穴：Assistpoint:熱痹：大椎Heat-type:Dazhui(DU14)

頜關節(jié)：下關、翳風、合谷。Jaw:Xiaguan(ST7),Yifeng(SJ17),Hegu(LI4)

191.14痹證（風濕性、類風濕性關節(jié)炎）19頸、胸椎關節(jié)：完骨、天柱、華佗夾脊刺。

Cervicalandthoracicvertebrae:Wangu(GB12),Tianzhu(BL10),Jiaji(EX-B2)

肩關節(jié)：肩髃、肩貞、肩中俞、肩外俞、臂臑、天宗透肩峰。

Shoulderjoint:Jianyu(LI15),Jianzhen(SI9),Jianzhongshu(SI15),Jianwaishu(SI14),Binao(LI15),Tianzong(SI11)toJianfeng

肘關節(jié)：小海、肘髎、手三里。

Elbowjoint:Xiaohai(SI18),Zhouliao(LI12),Shousanli(LI10)腕關節(jié)：外關、陽池、陽谷、陽溪、腕骨。Wristjoint:Waiguan(SJ5),Yangchi(SJ4),Yanggu(SI5),Yangxi(LI5),Wangu(SI4).

2020掌指關節(jié)：八邪、后溪。Metacarpophalangealjoint:Baxie(EX-UE9),Houxi(SI3)腰椎關節(jié)：大腸俞、命門、八髎、委中。

Lumbarvertebrae:Dachangyu(BL25),Mingmen(DU4),Baliao(BL31-34),Weizhong(BL40).骶髂關節(jié)：關元俞、小腸俞、白環(huán)俞、環(huán)跳、秩邊。

Sacroiliacjoint:Guanyuanshu(BL26),Xiaochangshu(BL27),Baihuanshu(BL30),Huantiao(GB30),Zhibian(BL54)髖關節(jié)：環(huán)跳、陽陵泉、髖關節(jié)圍刺。Hipjoint:Huantiao(GB35),Yanglingquan(GB34),surroundingpuncture

21掌指關節(jié)：八邪、后溪。21膝關節(jié)：鶴頂、犢鼻、膝眼、曲泉、委中。Kneejoint:Heding(EX-LE2),Dubi(ST35),Xiyan(EX-LE4,5),Ququan(LR8),Weizhong(BL40)踝關節(jié)：解溪、商丘、丘墟、昆侖、太溪、申脈、照海。Anklejoint:Jiexi(ST41),Shangqiu(SP5),Qiuxu(GB40),Kunlun(BL60),Taixi(KI13),Shenmai(BL62),Zhaohai(KI6)跖趾關節(jié)：公孫、太沖、足臨泣、八風。Metatarsophalangealjoint:Gongsun(SP4),Taichong(LR3),Zulinqi(GB41),Bafeng(EX-LE10)

22膝關節(jié)：鶴頂、犢鼻、膝眼、曲泉、委中。222.臟腑痛證

2.Visceralpain

2.1胸痹（心絞痛）2.1Anginapectoris治則：養(yǎng)心血、益心氣、通心陽。Principle:Nourishingbloodandqiofheart,Promoteyangofheart配方：內關、郗門、膻中、厥陰俞、心俞、膈俞。Prescription:Neiguan(PC6),Ximen(PC4),Tanzhong(RN17),Jueyinshu(BL14),Xinshu(BL15),Geshu(BL17)

232.臟腑痛證232.2脅肋痛（膽囊炎、膽石癥）2.2Cholecystitis,Gallstone治則：疏肝利膽、理氣止痛。Principle:Soothingliverandgallbladder,Regulateqitorelievepain配方：膈俞、膽俞、日月、陽陵泉、中脘。Prescription:Geshu(BL17),Danshu(BL19),Riyue(GB24),Yanglingquan(GB34),Zhongwan(RN12)

242.2脅肋痛（膽囊炎、膽石癥）242.3腰痛（腎結石）2.3Calculusofkindey治則：通淋排石、實則清熱、虛則補虛。Principle:Relievestranguriaandremovethestons,ExpelheatforexcesssyndromeReinforcingmethodfordeficiency配方：以足太陽膀胱經和足陽明經及背俞穴為主。重點取膀胱俞、腎俞、三焦俞、次髎、中極、秩邊透水道等。

Prescription:Pangguangshu(BL28),Shenshu(BL23),Sanjiaoshu(BL22),Ciliao(BL32),Zhongji(RN3),Zhibian(BL54)toShuidao(ST28)etc.

252.3腰痛（腎結石）252.4胃脘痛（慢性胃炎）2.4Gastralgia治則：健脾養(yǎng)胃、化瘀止痛。Principle:Nourishspleenandstomach,Removestasistorelievepain配方：足三里、左梁丘、左天樞、關元、中脘、血海；Prescription:

Zusanli(ST36),leftLiangqiu(ST34),leftTianshu(ST25),Guanyuan(RN4),Zhongwan(RN12),Xuehai(SP10);膈俞、肝俞、膽俞、脾俞、胃俞、夾脊刺。Geshu(BL17),Ganshu(BL18),Danshu(BL19),Pishu(BL20),Weishu(BL21),Jiaji(EX-B2)

26262.5腹痛（胃腸功能紊亂）2.5Abdominalgia治則：清熱利濕、健睥通腑。Principle:Dispersedampandheat,Reinforcingspleenandclearfuorgans配方：內關、足三里、天樞、上巨虛。Prescription:Neiguan(PC6),Zusanli(ST36),Tianshu(ST25),Shangjuxu(ST37).

272.5腹痛（胃腸功能紊亂）273.五官科痛證

3.Painoffivesenseorgans

3.1目赤腫痛（結膜炎）3.1Conjunctivitis治則：清熱降火、疏風明目。Principle:Removeheatandfire,Dispelwindeviltoimproveeyesight配方：臂臑、蠡溝、合谷、太沖、風池、睛明、太陽。Prescription:Binao(LI14),Ligou(LR5),Hegu(LI4),Taichong(LR3),Fengchi(GB20),Jingming(BL1),Taiyang(EX-HN5)

283.五官科痛證283.2咽喉腫痛（急性扁桃體炎、急慢性咽炎）3.2Sore-throat治則：疏風解表、清熱利咽；滋陰降火、生津潤燥。Principle:Disperswindtoexpelexogenouspathogen,Removeheattoclearthroat;Nourishingyinandexpelheat,Inducesalivatomoistendryness配方：實熱證取曲池、列缺、大椎、合谷、內庭；Prescription:ExcesstypewithQuchi(LI11),Lieque(LU7),Hegu(LI4),Dazhui(DU14),Neiting(ST44);

陰虛癥取列缺、照海、曲池、太溪、魚際。

DeficiencywithLieque(LU7),Zhaohai(KI6),Quchi(LI11),Taixi(KI3),Yuji(LU10).

293.2咽喉腫痛（急性扁桃體炎、急慢性咽炎）293.3舌痛（舌炎）3.3Glossalgia治則：補益心脾、生津潤燥。Principle:Nourishingheartandspleen,Inducesalivatomoistendryness配方：心俞、脾俞、通里、三陰交、金津、玉液。Prescription:Xinshu(BL15),Pishu(BL20),Tongli(HT5),Sanyinjiao(SP6),Jinjin(EX-HN12),Yuye(EX-HN12).

303.3舌痛（舌炎）303.4牙痛3.4Toothache治則：補益心脾、生津潤燥。Principle:Removeheateviltorelievepain主穴：合谷、下關、頰車。Mainpoint:Hegu(LI4),Xiaguan(ST7),Jiache(ST6)配穴：風熱牙痛加風池、外關。

Assistpoint:wind-heattypeFengchi(GB20),Waiguan(SJ5)

胃火牙痛加內庭、足三里。

Stomach-firetypeNeiting(ST44),Zusanli(ST36)虛火牙痛加太溪、三陰交。AsthenicfiretypeTaixi(KI3),Sanyinjiao(SP6)

313.4牙痛314.痛經（原發(fā)性痛經）

4.Dysmenorrhea

治則：理氣化瘀、活血止痛；溫經散寒、除濕止痛；益氣補血、滋養(yǎng)胞脈。Principle:Regulateqianddispelstasis,PromotebloodtorelievepainWarmmeridiandispelcold,Removedamptorelievepain

Reinforcingqiandblood,Nourishinguterinecollaterals

配方：氣滯血瘀：氣海、氣穴、合谷、三陰交、太沖。Prescription:Withstagnationofqiandblood:Qihai(RN6),Qixue(KI13),Hegu(LI4),Sanyinjiao(SP6),Taichong(LR3)

寒濕凝滯：中極、水道、命門、陰陵泉。

Withstagnationofcoldanddamp:Zhongji(RN3),Shuidao(ST28),Mingmen(DU4),

Yinlingquan(SP9)

氣血虛弱：氣海、關元、腎俞、足三里。

Withweaknessofqiandblood:Qihai(RN6),Guanyuan(RN4),Shenshu(DU4),Zusanli(ST36)

324.痛經（原發(fā)性痛經）32謝謝

Thanks33謝謝

Thanks33石學敏教授

ShiXueMinProfessor

針刺治療痛證

AcupunctureAnalgesia

34石學敏教授1

針法特點Characteristicofthetheraphy

強調調神，治病求本

Regulatethevitality

刺絡療法，祛瘀通絡

Blood-lettingpuncture

臨證加減，辨證論治

Selectthepointsaccordingtodifferentialdiagnosis

35針法特點強

止痛要穴上肢：外關

Arm:Waiguan(SJ5)下肢：飛揚

Leg:Feiyang(BL58)腰部：大腸俞

Lumbus:Dachangshu(BL25)全身：人中

TheWholebody:Renzhong(DU26)36止痛要穴上肢：外1.頭面軀體痛證1.Painfuldiseaseofcephalofacialandsomaticregion

1.1頭痛

1.1Headache1.1.1血管性頭痛

1.1.1Vascularheadache

治則：疏解少陽、活血化瘀。

Principle:RegulateShaoyangmeridian,Activatebloodflowanddispelbloodstasis

配方：風池、完骨、太陽、頭維透率谷、中封、陽輔。Prescription:Fengchi(GB20),Wangu(GB12),Taiyang(EX-HN5),Touwei(ST8)toShuaigu(GB8)，Zhongfeng(LR4)Yangfu(GB38)371.頭面軀體痛證41.1.2神經性頭痛

1.1.2Nervousheadache

治則：調神理氣、通絡止痛。Principle:RegulatetheVitalityandQi,Activatethecollateralsandrelievepain

配方：內關、人中、太沖、百會、四神聰、風池、完骨、天柱。Prescription:Neiguan(PC6),Renzhong(DU26),Taichong(LR3),Baihui(DU20),Sishencong(EX-HN1),Fengchi(GB20),Wangu(GB12),Tianzhu(BL10)1.1.3眼性頭痛

1.1.3Ocularheadache

治則：通絡止痛。

Principle:Activatethecollateralsandrelievepain配方：風池、太陽、睛明、球后、四白。Prescription:Fengchi(GB20),Taiyang(EX-HN5),Jingming(BL1),Qiuhou(EX-HN7),Sibai(ST2)

381.1.2神經性頭痛51.1.4頸性頭痛

1.1.4Cervicalheadache

治則：通絡止痛。Principle:Activatethecollateralsandrelievepain

配方：風池、完骨、天柱、頸椎夾脊刺。

Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervicalJiaji(EX-B2)1.1.5高顱壓性頭痛

1.1.5Ocularheadache

治則：醒神開竅、滋陰潛陽、通絡止痛。Principle:XNKQ,Nourishyinandyang,Activatethecollateralsandrelievepain

配方：上星透百會、太陽、風池、完骨、三陰交、合谷、太沖。

Prescription:Shangxing(DU23)toBaihui(DU20),Taiyang(EX-HN5),Fengchi(GB20),Wangu(GB12),Sanyinjiao(SP6),Hegu(LI4),Taichong(LR3)

391.1.4頸性頭痛61.2面頰痛（三叉神經痛）

1.2Prosopalgia

治則：活血化瘀、通絡止痛。

Principle:Activatebloodflowanddispelbloodstasis,Clearthecollateralstorelievepain主方：下關、四白、風池、翳風，痛點刺絡拔罐。Prescription:Xiaguan(ST7),Sibai(ST2),Fengchi(GB20),Yifeng(SJ17)

Andblood-cupingonAshipoint

配穴：第一支痛加攢竹、太陽。

Associatedpoints:Tothefristbranch:Cuanzhu(BL2),Taiyang(EX-HN5)第二支痛加顴髎。Tothesecondbranch:Quanliao(SI18)

第三支痛加頰車、迎香。

Tothethirdbranch:Jianche(ST6),Yingxiang(LI20)

401.2面頰痛（三叉神經痛）71.3落枕（斜方肌痙攣）1.3Stiffneck治則：調氣活血、疏通經絡。Principle:RegulateQiandactivateblood,Regulateandclearthemeridian配方：風池、完骨、天柱、頸椎夾脊刺、絕骨、后溪。Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervicalJiaji(EX-B2),Juegu(GB39),Houxi(SI3)

1.4頸痛（頸椎?。?.4

Cervicalspondylopathy治則：活血通絡、祛風止痛。Principle:Activatebloodandclearthemeridian,Dispelwindtorelievepain配方：風池、完骨、天柱、頸椎夾脊刺。Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervicalJiaji(EX-B2)

411.3落枕（斜方肌痙攣）81.5脊痛（退行性脊柱炎）

1.5

Retrogressivespondylitis治則：祛瘀通絡、通調督脈、膀胱經氣。Principle:Dispelbloodstasisandclearthemeridian,RegulateQIofDuandbladderchannel

配方：1.雙側環(huán)跳、大腸俞、委中、陽陵泉刺絡拔罐。Prescription:Ⅰ:Huantiao(GB30),Dachangshu(BL25),Weizhong(BL40),Yanglingquan(GB34)Ashipointwithblood-cuping2.人中、腎俞、大腸俞、環(huán)跳、腰陽關、委中、養(yǎng)老、阿是穴。

Ⅱ:Renzhong(DU26),Shenshu(BL23),Dachangshu(BL25),Huantiao(GB30),Yaoyanghguan(DU3),Weizhong(BL40),Yanglao(SI6),Ashipoints

421.5脊痛（退行性脊柱炎）91.6肩臂痛（臂叢神經痛）

1.6Brachialplexusneuralgia治則：行氣散瘀、通經止痛。Principle:CirculateQianddispelbloodstasis,Clearthemeridiantorelievepain配方：頸夾脊刺、肩外俞、阿是穴刺絡療法Prescription:cervicalJiaji(EX-B2),Jianwaishu(SI14),Ashipointwithblood-lettingpuncture

431.6肩臂痛（臂叢神經痛）101.7肩凝癥（肩關節(jié)周圍炎）1.7Periarthritisofshoulder治則：活血化瘀、通絡止痛。Principle:Activatebloodanddispelbloodstasis,Clearthecollateralstorelievepain配方：1.患側肩髃、肩貞、臑俞、天宗、曲垣、肩外俞或以痛為俞刺絡拔罐。Prescription:Ⅰ:IllnesssidepointsofJianyu(LI15),Jianzhen(SI9),Naoshu(SI10),Tianzong(SI11),Quyuan(SI13),Jianwaishu(SI14)Andblood-cupingonAshipoint2.患側肩髃、肩貞、臑俞、天宗、秉風、曲垣、肩外俞、肩中俞、條口。

Ⅱ:IllnesssidepointsofJianyu(LI15),Jianzhen(SI9),Naoshu(SI10),Tianzong(SI11),Bingfeng(SI12),Quyuan(SI13),Jianwaishu(SI14),Jianzhongshu(SI15),Tiaokou(ST38)

441.7肩凝癥（肩關節(jié)周圍炎）111.8肘勞（肱骨外上髁炎）1.8Externalhumeralepicomdylitis治則：治則：舒筋活血、通絡止痛。Principle:Relaxtendonsandpromotebloodcirculation,Clearthecollateralstorelievepain配方：曲池、肘髎、手三里、合谷、阿是穴（施阻力針法）。Prescription:Quchi(LI11),Zhouliao(LI12),Shousanli(LI10),Hegu(LI4),Ashipointwithspecialmanipulation

451.8肘勞（肱骨外上髁炎）121.9脅痛（肋間神經痛）1.9Intercostalneuralgia治則：疏肝理氣、通絡止痛。Principle:RegulateQiofliver,Clearthecollateralstorelievepain配方：支溝、陽陵泉、太沖、三陰交、期門、日月、膈俞、丘墟。Prescription:Zhigou(SJ6),Yanglingquan(GB34),Taichong(LR3),Sanyinjiao(SP6),Qimen(LR14),Riyue(GB24),Geshu(BL17),Qiuxu(GB40)

461.9脅痛（肋間神經痛）131.10腰痛10Lumbago1.10.1急性腰扭傷1.10.1Acutelumbarsprain治則：行氣活血、通絡止痛。Principle:PromoteQiandblood,Clearthecollateralstorelievepain

配方：以局部俞穴和循經取穴為主，采用后溪、委中、大腸俞、腎俞。疼痛甚者，取內關、人中、痛點施阻力針法。Prescription:Houxi(SI3),Weizhong(BL40),Dachangshu(BL25),Shenshu(BL23).AndNeiguan(PC6),Renzhong(DU26),AshipointwithspecialmanipulationifSeriouspain

471.10腰痛141.10.2腰椎間盤突出癥1.10.2Prolapseoflumbarintervertebraldisc治則：活血化瘀、消腫止痛。Principle:Promotebloodanddispelstasis,Repercussiontorelievepain配方：取患側阿是穴、環(huán)跳、殷門、陽陵泉、足三里、委中、承山、懸鐘。Prescription:IllnesssidepointsofAshi,Huantiao(GB30),Yinmen(BL37),Yanglingquan(GB34),Zusanli(ST36),Weizhong(BL40),Chengshan(BL57),Xuanzhong(GB39)

481.10.2腰椎間盤突出癥151.10.3腰肌勞損1.10.3Lumbarmusculestrain治則：舒筋活血、通經活絡、祛寒止痛。Principle:Relaxtendonsandpromotebloodcirculation,Dispelcoldtorelievepain

配方：以局部俞穴和阿是穴為主，重點采用腎俞、關元俞、膀胱俞等。Prescription:Ashipoint,Shenshu(BL23),Guanyuanshu(BL26),Pangguangshu(BL28)etc.

491.10.3腰肌勞損161.11腰腿痛（坐骨神經痛）

1.11Sciatica

治則：活血止痛、疏通經絡。Principle:Promotebloodtorelievepain,Regulatemeridian

配方:1.刺絡法：分別于疼痛側太陽經、少陽經經絡所過之處的大腸俞、環(huán)跳、風市、承山等部位刺絡拔罐。Prescription:Ⅰ:Blood-cupingonpainfulsideofDachangshu(BL25),Huantiao(GB30),Fengshi(GB31),Chengshan(BL57)etc.

２.大腸俞、環(huán)跳、委中、陽陵泉、風市、飛揚、昆侖、承山Ⅱ:Dachangshu(BL25),Huantiao(GB30),Weizhong(BL40),Yanglingquan(GB34),Fengshi(GB31),Feiyang(BL58),Kunlun(BL60),Chengshan(BL57).

腎虛者加刺腎俞、太溪；IfkidneydeficiencyassociatedwithShenshu(BL23),Taixi(KI3);

血瘀者加刺血海、膈俞；IfbloodstasisassociatedwithXuehai(SP10),Geshu(BL17)風寒者加刺風池。Ifwind-coldassociatedwithFengchi(GB20)

501.11腰腿痛（坐骨神經痛）171.12膝痛（膝關節(jié)骨關節(jié)炎）1.12Gonitis

治則：活血化瘀、通絡止痛。Principle:Promotebloodandremovestasis,Clearthecollateralstorelievepain配方：膝眼、鶴頂、陽陵泉、陰陵泉、膝陽關、梁丘。Prescription:Xiyan(EX-LE4,5),Heding(EX-LE2),Yanglingquan(GB34),Yinglingquan(SP9),Xiyangguan(GB33),Liangqiu(ST34).1.13足底痛（跖神經痛）1.13Plantalgia

治則：滋陰補腎、溫養(yǎng)經絡。Principle:Nourishingyinofkidney,Warmingmeridian

配方：太溪、三陰交、足底排刺。Prescription:Taixi(KI3),Sanyinjiao(SP6),Linepunctureonplanta

511.12膝痛（膝關節(jié)骨關節(jié)炎）181.14痹證（風濕性、類風濕性關節(jié)炎）1.14Arthralgiasyndrome

治則：舒筋活絡、行氣活血、散風蠲痹。Principle:Relaxandactivatetendons,PromoteQiandblood,Dispelwindtorelievepain

主穴:風池、曲池、血海、合谷、太沖、華佗夾脊刺。Mainpoint:Fengchi(GB20),Quchi(LI11),Xuehai(SP10),Hegu(LI4),Taichong,Jiaji(LR3).

配穴：Assistpoint:熱痹：大椎Heat-type:Dazhui(DU14)

頜關節(jié)：下關、翳風、合谷。Jaw:Xiaguan(ST7),Yifeng(SJ17),Hegu(LI4)

521.14痹證（風濕性、類風濕性關節(jié)炎）19頸、胸椎關節(jié)：完骨、天柱、華佗夾脊刺。

Cervicalandthoracicvertebrae:Wangu(GB12),Tianzhu(BL10),Jiaji(EX-B2)

肩關節(jié)：肩髃、肩貞、肩中俞、肩外俞、臂臑、天宗透肩峰。

Shoulderjoint:Jianyu(LI15),Jianzhen(SI9),Jianzhongshu(SI15),Jianwaishu(SI14),Binao(LI15),Tianzong(SI11)toJianfeng

肘關節(jié)：小海、肘髎、手三里。

Elbowjoint:Xiaohai(SI18),Zhouliao(LI12),Shousanli(LI10)腕關節(jié)：外關、陽池、陽谷、陽溪、腕骨。Wristjoint:Waiguan(SJ5),Yangchi(SJ4),Yanggu(SI5),Yangxi(LI5),Wangu(SI4).

5320掌指關節(jié)：八邪、后溪。Metacarpophalangealjoint:Baxie(EX-UE9),Houxi(SI3)腰椎關節(jié)：大腸俞、命門、八髎、委中。

Lumbarvertebrae:Dachangyu(BL25),Mingmen(DU4),Baliao(BL31-34),Weizhong(BL40).骶髂關節(jié)：關元俞、小腸俞、白環(huán)俞、環(huán)跳、秩邊。

Sacroiliacjoint:Guanyuanshu(BL26),Xiaochangshu(BL27),Baihuanshu(BL30),Huantiao(GB30),Zhibian(BL54)髖關節(jié)：環(huán)跳、陽陵泉、髖關節(jié)圍刺。Hipjoint:Huantiao(GB35),Yanglingquan(GB34),surroundingpuncture

54掌指關節(jié)：八邪、后溪。21膝關節(jié)：鶴頂、犢鼻、膝眼、曲泉、委中。Kneejoint:Heding(EX-LE2),Dubi(ST35),Xiyan(EX-LE4,5),Ququan(LR8),Weizhong(BL40)踝關節(jié)：解溪、商丘、丘墟、昆侖、太溪、申脈、照海。Anklejoint:Jiexi(ST41),Shangqiu(SP5),Qiuxu(GB40),Kunlun(BL60),Taixi(KI13),Shenmai(BL62),Zhaohai(KI6)跖趾關節(jié)：公孫、太沖、足臨泣、八風。Metatarsophalangealjoint:Gongsun(SP4),Taichong(LR3),Zulinqi(GB41),Bafeng(EX-LE10)

55膝關節(jié)：鶴頂、犢鼻、膝眼、曲泉、委中。222.臟腑痛證

2.Visceralpain

2.1胸痹（心絞痛）2.1Anginapectoris治則：養(yǎng)心血、益心氣、通心陽。Principle:Nourishingbloodandqiofheart,Promoteyangofheart配方：內關、郗門、膻中、厥陰俞、心俞、膈俞。Prescription:Neiguan(PC6),Ximen(PC4),Tanzhong(RN17),Jueyinshu(BL14),Xinshu(BL15),Geshu(BL17)

562.臟腑痛證232.2脅肋痛（膽囊炎、膽石癥）2.2Cholecystitis,Gallstone治則：疏肝利膽、理氣止痛。Principle:Soothingliverandgallbladder,Regulateqitorelievepain配方：膈俞、膽俞、日月、陽陵泉、中脘。Prescription:Geshu(BL17),Danshu(BL19),Riyue(GB24),Yanglingquan(GB34),Zhongwan(RN12)

572.2脅肋痛（膽囊炎、膽石癥）242.3腰痛（腎結石）2.3Calculusofkindey治則：通淋排石、實則清熱、虛則補虛。Principle:Relievestranguriaandremovethestons,ExpelheatforexcesssyndromeReinforcingmethodfordeficiency配方：以足太陽膀胱經和足陽明經及背俞穴為主。重點取膀胱俞、腎俞、三焦俞、次髎、中極、秩邊透水道等。

Prescription:Pangguangshu(BL28),Shenshu(BL23),Sanjiaoshu(BL22),Ciliao(BL32),Zhongji(RN3),Zhibian(BL54)toShuidao(ST28)etc.

582.3腰痛（腎結石）252.4胃脘痛（慢性胃炎）2.4Gastralgia治則：健脾養(yǎng)胃、化瘀止痛。Principle:Nourishspleenandstomach,Removestasistorelievepain配方：足三里、左梁丘、左天樞、關元、中脘、血海；Prescription:

Zusanli(ST36),leftLiangqiu(ST34),leftTianshu(ST25),Guanyuan(RN4),Zhongwan(RN12),Xuehai(SP10);膈俞、肝俞、膽俞、脾俞、胃俞、夾脊刺。Geshu(BL17),Ganshu(