《石学敏痛症》PPT课件.ppt

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1、1,石学敏 教授 Shi Xue Min Professor,针刺治疗痛证 Acupuncture Analgesia,针 法 特 点Characteristic of the theraphy,强 调 调 神，治 病 求 本 Regulate the vitality 刺 络 疗 法，祛 瘀 通 络 Blood-letting puncture 临 证 加 减，辨 证 论 治 Select the points according to differential diagnosis,止 痛 要 穴,4,1.头 面 躯 体 痛 证1.Painful disease of cephalofaci

2、al and somatic region 1.1头痛1.1 Headache血管性头痛 1.1.1 Vascular headache 治则：疏解少阳、活血化瘀。Principle:Regulate Shaoyang meridian,Activate blood flow and dispel blood stasis 配方：风池、完骨、太阳、头维透率谷、中封、阳辅。Prescription:Fengchi(GB20),Wangu(GB12),Taiyang(EX-HN5),Touwei(ST8)to Shuaigu(GB8)，Zhongfeng(LR4)Yangfu(GB38),1.1.

3、2 神经性头痛 1.1.2 Nervous headache 治则：调神理气、通络止痛。Principle:Regulate the Vitality and Qi,Activate the collaterals and relieve pain 配方：内关、人中、太冲、百会、四神聪、风池、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 眼性头痛 1.1.3 Ocul

4、ar headache 治则：通络止痛。Principle:Activate the collaterals and relieve pain 配方：风池、太阳、睛明、球后、四白。Prescription:Fengchi(GB20),Taiyang(EX-HN5),Jingming(BL1),Qiuhou(EX-HN7),Sibai(ST2),1.1.4 颈性头痛 1.1.4 Cervical headache 治则：通络止痛。Principle:Activate the collaterals and relieve pain 配方：风池、完骨、天柱、颈椎夹脊刺。Prescription:F

5、engchi(GB20),Wangu(GB12),Tianzhu(BL10),cervical Jiaji(EX-B2)1.1.5 高颅压性头痛 1.1.5 Ocular headache 治则：醒神开窍、滋阴潜阳、通络止痛。Principle:XNKQ,Nourish yin and yang,Activate the collaterals and relieve pain 配方：上星透百会、太阳、风池、完骨、三阴交、合谷、太冲。Prescription:Shangxing(DU23)to Baihui(DU20),Taiyang(EX-HN5),Fengchi(GB20),Wangu(G

6、B12),Sanyinjiao(SP6),Hegu(LI4),Taichong(LR3),1.2 面颊痛（三叉神经痛）1.2 Prosopalgia 治则：活血化瘀、通络止痛。Principle:Activate blood flow and dispel blood stasis,Clear the collaterals to relieve pain 主方：下关、四白、风池、翳风，痛点刺络拔罐。Prescription:Xiaguan(ST7),Sibai(ST2),Fengchi(GB20),Yifeng(SJ17)And blood-cuping on Ashipoint 配穴：第一

7、支痛加攒竹、太阳。Associated points:To the frist branch:Cuanzhu(BL2),Taiyang(EX-HN5)第二支痛加颧髎。To the second branch:Quanliao(SI18)第三支痛加颊车、迎香。To the third branch:Jianche(ST6),Yingxiang(LI20),1.3 落枕（斜方肌痉挛）1.3 Stiff neck 治则：调气活血、疏通经络。Principle:Regulate Qi and activate blood,Regulate and clear the meridian 配方：风池、完骨

8、、天柱、颈椎夹脊刺、绝骨、后溪。Prescription:Fengchi(GB20),Wangu(GB12),Tianzhu(BL10),cervical Jiaji(EX-B2),Juegu(GB39),Houxi(SI3)1.4 颈痛（颈椎病）1.4 Cervical spondylopathy 治则：活血通络、祛风止痛。Principle:Activate blood and clear the meridian,Dispel wind to relieve pain 配方：风池、完骨、天柱、颈椎夹脊刺。Prescription:Fengchi(GB20),Wangu(GB12),Tia

9、nzhu(BL10),cervical Jiaji(EX-B2),1.5 脊痛（退行性脊柱炎）1.5 Retrogressive spondylitis 治则：祛瘀通络、通调督脉、膀胱经气。Principle:Dispel blood stasis and clear the meridian,Regulate QI of Du and bladder channel 配方：1.双侧环跳、大肠俞、委中、阳陵泉刺络拔罐。Prescription:Huantiao(GB30),Dachangshu(BL25),Weizhong(BL40),Yanglingquan(GB34)Ashipoint w

10、ith blood-cuping 2.人中、肾俞、大肠俞、环跳、腰阳关、委中、养老、阿是穴。:Renzhong(DU26),Shenshu(BL23),Dachangshu(BL25),Huantiao(GB30),Yaoyanghguan(DU3),Weizhong(BL40),Yanglao(SI6),Ashipoints,1.6肩臂痛（臂丛神经痛）1.6 Brachial plexus neuralgia 治则：行气散瘀、通经止痛。Principle:Circulate Qi and dispel blood stasis,Clear the meridian to relieve pa

11、in 配方：颈夹脊刺、肩外俞、阿是穴刺络疗法 Prescription:cervical Jiaji(EX-B2),Jianwaishu(SI14),Ashi point with blood-letting puncture,1.7 肩凝症（肩关节周围炎）1.7 Periarthritis of shoulder治则：活血化瘀、通络止痛。Principle:Activate blood and dispel blood stasis,Clear the collaterals to relieve pain 配方：1.患侧肩髃、肩贞、臑俞、天宗、曲垣、肩外俞 或以痛为俞刺络拔罐。Prescr

12、iption:Illness side points of Jianyu(LI15),Jianzhen(SI9),Naoshu(SI10),Tianzong(SI11),Quyuan(SI13),Jianwaishu(SI14)And blood-cuping on Ashi point 2.患侧肩髃、肩贞、臑俞、天宗、秉风、曲垣、肩外俞、肩中俞、条口。:Illness side points of Jianyu(LI15),Jianzhen(SI9),Naoshu(SI10),Tianzong(SI11),Bingfeng(SI12),Quyuan(SI13),Jianwaishu(SI14

13、),Jianzhongshu(SI15),Tiaokou(ST38),1.8 肘劳（肱骨外上髁炎）1.8 External humeral epicomdylitis 治则：治则：舒筋活血、通络止痛。Principle:Relax tendons and promote blood circulation,Clear the collaterals to relieve pain 配方：曲池、肘髎、手三里、合谷、阿是穴（施阻力针法）。Prescription:Quchi(LI11),Zhouliao(LI12),Shousanli(LI10),Hegu(LI4),Ashipoint with

14、special manipulation,1.9 胁痛（肋间神经痛）1.9 Intercostal neuralgia 治则：疏肝理气、通络止痛。Principle:Regulate Qi of liver,Clear the collaterals to relieve pain 配方：支沟、阳陵泉、太冲、三阴交、期门、日月、膈俞、丘墟。Prescription:Zhigou(SJ6),Yanglingquan(GB34),Taichong(LR3),Sanyinjiao(SP6),Qimen(LR14),Riyue(GB24),Geshu(BL17),Qiuxu(GB40),1.10 腰痛

15、 10 Lumbago 1.10.1 急性腰扭伤 1.10.1 Acute lumbar sprain 治则：行气活血、通络止痛。Principle:Promote Qi and blood,Clear the collaterals to relieve pain 配方：以局部俞穴和循经取穴为主，采用后溪、委中、大肠俞、肾俞。疼痛甚者，取内关、人中、痛点施阻力针法。Prescription:Houxi(SI3),Weizhong(BL40),Dachangshu(BL25),Shenshu(BL23).And Neiguan(PC6),Renzhong(DU26),Ashi point wi

16、th special manipulation if Serious pain,1.10.2 腰椎间盘突出症 1.10.2 Prolapse of lumbar intervertebral disc 治则：活血化瘀、消肿止痛。Principle:Promote blood and dispel stasis,Repercussion to relieve pain 配方：取患侧阿是穴、环跳、殷门、阳陵泉、足三里、委中、承山、悬钟。Prescription:Illness side points of Ashi,Huantiao(GB30),Yinmen(BL37),Yanglingquan(

17、GB34),Zusanli(ST36),Weizhong(BL40),Chengshan(BL57),Xuanzhong(GB39),1.10.3 腰肌劳损 1.10.3 Lumbar muscule strain 治则：舒筋活血、通经活络、祛寒止痛。Principle:Relax tendons and promote blood circulation,Dispel cold to relieve pain 配方：以局部俞穴和阿是穴为主，重点采用肾俞、关元俞、膀胱俞等。Prescription:Ashi point,Shenshu(BL23),Guanyuanshu(BL26),Pangg

18、uangshu(BL28)etc.,1.11 腰腿痛（坐骨神经痛）1.11 Sciatica 治则：活血止痛、疏通经络。Principle:Promote blood to relieve pain,Regulate meridian 配方:1.刺络法：分别于疼痛侧太阳经、少阳经经络所过之处的 大肠俞、环跳、风市、承山等部位刺络拔罐。Prescription:Blood-cuping on painful side of Dachangshu(BL25),Huantiao(GB30),Fengshi(GB31),Chengshan(BL57)etc.大肠俞、环跳、委中、阳陵泉、风市、飞扬、昆仑

19、、承山:Dachangshu(BL25),Huantiao(GB30),Weizhong(BL40),Yanglingquan(GB34),Fengshi(GB31),Feiyang(BL58),Kunlun(BL60),Chengshan(BL57).肾虚者加刺肾俞、太溪；If kidney deficiency associated with Shenshu(BL23),Taixi(KI3);血瘀者加刺血海、膈俞；If blood stasis associated with Xuehai(SP10),Geshu(BL17)风寒者加刺风池。If wind-cold associated w

20、ith Fengchi(GB20),1.12 膝痛（膝关节骨关节炎）1.12 Gonitis 治则：活血化瘀、通络止痛。Principle:Promote blood and remove stasis,Clear the collaterals to relieve pain 配方：膝眼、鹤顶、阳陵泉、阴陵泉、膝阳关、梁丘。Prescription:Xiyan(EX-LE4,5),Heding(EX-LE2),Yanglingquan(GB34),Yinglingquan(SP9),Xiyangguan(GB33),Liangqiu(ST34).1.13 足底痛（跖神经痛）1.13 Plan

21、talgia 治则：滋阴补肾、温养经络。Principle:Nourishing yin of kidney,Warming meridian 配方：太溪、三阴交、足底排刺。Prescription:Taixi(KI3),Sanyinjiao(SP6),Line puncture on planta,1.14 痹证（风湿性、类风湿性关节炎）1.14 Arthralgia syndrome 治则：舒筋活络、行气活血、散风蠲痹。Principle:Relax and activate tendons,Promote Qi and blood,Dispel wind to relieve pain

22、主穴:风池、曲池、血海、合谷、太冲、华佗夹脊刺。Main point:Fengchi(GB20),Quchi(LI11),Xuehai(SP10),Hegu(LI4),Taichong,Jiaji(LR3).配穴：Assist point:热痹：大椎Heat-type:Dazhui(DU14)颌关节：下关、翳风、合谷。Jaw:Xiaguan(ST7),Yifeng(SJ17),Hegu(LI4),颈、胸椎关节：完骨、天柱、华佗夹脊刺。Cervical and thoracic vertebrae:Wangu(GB12),Tianzhu(BL10),Jiaji(EX-B2)肩关节：肩髃、肩贞、肩

23、中俞、肩外俞、臂臑、天宗透肩峰。Shoulder joint:Jianyu(LI15),Jianzhen(SI9),Jianzhongshu(SI15),Jianwaishu(SI14),Binao(LI15),Tianzong(SI11)to Jianfeng 肘关节：小海、肘髎、手三里。Elbow joint:Xiaohai(SI18),Zhouliao(LI12),Shousanli(LI10)腕关节：外关、阳池、阳谷、阳溪、腕骨。Wrist joint:Waiguan(SJ5),Yangchi(SJ4),Yanggu(SI5),Yangxi(LI5),Wangu(SI4).,掌指关节：

24、八邪、后溪。Metacarpophalangeal joint:Baxie(EX-UE9),Houxi(SI3)腰椎关节：大肠俞、命门、八髎、委中。Lumbar vertebrae:Dachangyu(BL25),Mingmen(DU4),Baliao(BL31-34),Weizhong(BL40).骶髂关节：关元俞、小肠俞、白环俞、环跳、秩边。Sacroiliac joint:Guanyuanshu(BL26),Xiaochangshu(BL27),Baihuanshu(BL30),Huantiao(GB30),Zhibian(BL54)髋关节：环跳、阳陵泉、髋关节围刺。Hip joint:

25、Huantiao(GB35),Yanglingquan(GB34),surrounding puncture,膝关节：鹤顶、犊鼻、膝眼、曲泉、委中。Knee joint:Heding(EX-LE2),Dubi(ST35),Xiyan(EX-LE4,5),Ququan(LR8),Weizhong(BL40)踝关节：解溪、商丘、丘墟、昆仑、太溪、申脉、照海。Ankle joint:Jiexi(ST41),Shangqiu(SP5),Qiuxu(GB40),Kunlun(BL60),Taixi(KI13),Shenmai(BL62),Zhaohai(KI6)跖趾关节：公孙、太冲、足临泣、八风。Met

26、atarsophalangeal joint:Gongsun(SP4),Taichong(LR3),Zulinqi(GB41),Bafeng(EX-LE10),2.脏腑痛证 2.Visceral pain 2.1 胸痹（心绞痛）2.1 Angina pectoris 治则：养心血、益心气、通心阳。Principle:Nourishing blood and qi of heart,Promote yang of heart 配方：内关、郗门、膻中、厥阴俞、心俞、膈俞。Prescription:Neiguan(PC6),Ximen(PC4),Tanzhong(RN17),Jueyinshu(BL

27、14),Xinshu(BL15),Geshu(BL17),2.2 胁肋痛（胆囊炎、胆石症）2.2 Cholecystitis,Gallstone 治则：疏肝利胆、理气止痛。Principle:Soothing liver and gallbladder,Regulate qi to relieve pain 配方：膈俞、胆俞、日月、阳陵泉、中脘。Prescription:Geshu(BL17),Danshu(BL19),Riyue(GB24),Yanglingquan(GB34),Zhongwan(RN12),2.3 腰痛（肾结石）2.3 Calculus of kindey 治则：通淋排石、

28、实则清热、虚则补虚。Principle:Relieve stranguria and remove the stons,Expel heat for excess syndrome Reinforcing method for deficiency配方：以足太阳膀胱经和足阳明经及背俞穴为主。重点取 膀胱俞、肾俞、三焦俞、次髎、中极、秩边透水道等。Prescription:Pangguangshu(BL28),Shenshu(BL23),Sanjiaoshu(BL22),Ciliao(BL32),Zhongji(RN3),Zhibian(BL54)to Shuidao(ST28)etc.,2.4

29、 胃脘痛（慢性胃炎）2.4 Gastralgia 治则：健脾养胃、化瘀止痛。Principle:Nourish spleen and stomach,Remove stasis to relieve pain 配方：足三里、左梁丘、左天枢、关元、中脘、血海；Prescription:Zusanli(ST36),left Liangqiu(ST34),left Tianshu(ST25),Guanyuan(RN4),Zhongwan(RN12),Xuehai(SP10);膈俞、肝俞、胆俞、脾俞、胃俞、夹脊刺。Geshu(BL17),Ganshu(BL18),Danshu(BL19),Pishu(

30、BL20),Weishu(BL21),Jiaji(EX-B2),2.5 腹痛（胃肠功能紊乱）2.5 Abdominalgia 治则：清热利湿、健睥通腑。Principle:Disperse damp and heat,Reinforcing spleen and clear fu organs 配方：内关、足三里、天枢、上巨虚。Prescription:Neiguan(PC6),Zusanli(ST36),Tianshu(ST25),Shangjuxu(ST37).,3.五官科痛证 3.Pain of five sense organs 3.1 目赤肿痛（结膜炎）3.1 Conjunctivi

31、tis 治则：清热降火、疏风明目。Principle:Remove heat and fire,Dispel wind evil to improve eyesight 配方：臂臑、蠡沟、合谷、太冲、风池、睛明、太阳。Prescription:Binao(LI14),Ligou(LR5),Hegu(LI4),Taichong(LR3),Fengchi(GB20),Jingming(BL1),Taiyang(EX-HN5),3.2 咽喉肿痛（急性扁桃体炎、急慢性咽炎）3.2 Sore-throat 治则：疏风解表、清热利咽；滋阴降火、生津润燥。Principle:Dispers wind to

32、expel exogenous pathogen,Remove heat to clear throat;Nourishing yin and expel heat,Induce saliva to moisten dryness 配方：实热证取曲池、列缺、大椎、合谷、内庭；Prescription:Excess type with Quchi(LI11),Lieque(LU7),Hegu(LI4),Dazhui(DU14),Neiting(ST44);阴虚症取列缺、照海、曲池、太溪、鱼际。Deficiency with Lieque(LU7),Zhaohai(KI6),Quchi(LI11)

33、,Taixi(KI3),Yuji(LU10).,3.3 舌痛（舌炎）3.3 Glossalgia 治则：补益心脾、生津润燥。Principle:Nourishing heart and spleen,Induce saliva to moisten dryness 配方：心俞、脾俞、通里、三阴交、金津、玉液。Prescription:Xinshu(BL15),Pishu(BL20),Tongli(HT5),Sanyinjiao(SP6),Jinjin(EX-HN12),Yuye(EX-HN12).,3.4 牙痛 3.4 Toothache 治则：补益心脾、生津润燥。Principle:Remo

34、ve heat evil to relieve pain 主穴：合谷、下关、颊车。Main point:Hegu(LI4),Xiaguan(ST7),Jiache(ST6)配穴：风热牙痛加风池、外关。Assist point:wind-heat type Fengchi(GB20),Waiguan(SJ5)胃火牙痛加内庭、足三里。Stomach-fire type Neiting(ST44),Zusanli(ST36)虚火牙痛加太溪、三阴交。Asthenic fire type Taixi(KI3),Sanyinjiao(SP6),4.痛经（原发性痛经）4.Dysmenorrhea 治则：理气

35、化瘀、活血止痛；温经散寒、除湿止痛；益气补血、滋养胞脉。Principle:Regulate qi and dispel stasis,Promote blood to relieve pain Warm meridian dispel cold,Remove damp to relieve pain Reinforcing qi and blood,Nourishing uterine collaterals 配方：气滞血瘀：气海、气穴、合谷、三阴交、太冲。Prescription:With stagnation of qi and blood:Qihai(RN6),Qixue(KI13),Hegu(LI4),Sanyinjiao(SP6),Taichong(LR3)寒湿凝滞：中极、水道、命门、阴陵泉。With stagnation of cold and damp:Zhongji(RN3),Shuidao(ST28),Mingmen(DU4),Yinlingquan(SP9)气血虚弱：气海、关元、肾俞、足三里。With weakness of qi and blood:Qihai(RN6),Guanyuan(RN4),Shenshu(DU4),Zusanli(ST36),33,谢 谢Thanks,