胃脾经经络腧穴s

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,足阳明经络与腧穴,(Meridian,Collateral and Acupoints of Foot-Yangming),Meridian and Collateral of Foot-Yangming,经脉循行:鼻旁-上齿-口唇-下颌-耳前-头角-咽喉-颈-胸-胃脾-腹部-下肢前-脚2趾,联系的脏腑器官:,眼,口,上齿,鼻,咽喉,胃脾,特点:,十二经中,分支最多,的经脉.,胃足阳明之脉：起于,鼻,，交,頞,中旁约太阳之脉，下循鼻外，入,上齿,中，还出,挟口，环唇,，下交承浆，却循,颐,后下廉，出大迎，循颊车，上耳前，,过客主人,，循发际，至,额颅,。,頞:,指鼻根的凹陷处。,颐:,音夷。指下颌部。,客主人：,即上关穴。,额颅：,此指前额正中部。,其支者：从大迎前，下人迎，循喉咙，入缺盆，下膈，属胃，络脾。,其直者：从缺盆下乳内廉，下挟脐，入,气街,中。,气街:,腹股沟动脉处，穴名气冲,其支者：起于,胃口,，下循腹里，下至气街中而合。以下髀关，抵伏兔，下膝髌中，下循胫外廉，下,足跗,，入中指内间。,其支者，下三寸而别，下入中指外间。,其支者：别跗上，入,大指间，,出其端。,胃口：,指胃之下口，即幽门部。,足跗：,即足背。,大指间：,指大趾与次趾之间,病变(Disease):,热病,神志病,胃肠病,皮肤病,头面五官病及循行部位病.,是动,则病，洒洒振寒,善伸,数欠,颜黑,病至则恶人与火,闻木声则惕然而惊,心欲动,独闭户塞,牖,而处,甚则欲,上,高而歌,弃衣而走,贲响,腹胀,是为,骭厥.,牖：,音友，指窗口。,上,：素问阳明脉解作“登”，,贲响,：当指胸膈肠胃部作响。肠鸣之症均属此。,骭厥：,指足胫部气血阻逆,是,主血所生,病,狂,疟,温淫,汗出,鼽,衄,口喎,唇胗,颈肿,喉痹,大腹水肿,膝膑肿痛;循膺,乳,气街,股,伏兔,骭外廉,足跗上皆痛,中指不用。,气盛，则身以前皆热，其有余于胃，则消谷善饥，溺色黄；气不足，则身以前皆寒粟，胃中寒则胀满。,主血,：胃为水谷之海，化生精微之气而为血，其经脉多气多血，故主血所生病。,温淫,：指热性病症。,唇胗：,胗与疹通，指唇疡,Collateral of Foot-Yangming,足阳明之别，,名曰丰隆。去踝八寸，别走太阴；其别者，循胫骨外廉，上络头顶，合诸经之气，下络喉嗌。,主病:,气逆则喉痹卒瘖。,实，狂癫；,虚，足不收胫枯,卒瘖,：卒，通作猝，突然；瘖，失音，音哑。,足不收、胫枯：,足不收，指下肢弛缓、松软无力，胫部肌肉萎缩，气血亏虚的见症。,足阳明之正(,Divergent Meridian of Foot-Yangming,),上至髀，入于腹里，属胃，散之脾，上通于心，上循咽，出于口，上,頞,（出页）。,还系目系，合于阳明也。,頞:,鼻根；,(出页）:,眼眶下部,特点：,离：,在在大腿前面从足阳明正经分出,入：,入腹腔之内，属于胃腑，散布到脾脏，向上通连心脏,出：,沿着食道浅出于口腔，上达于鼻根和眼眶下部，回过来联系到眼后与脑相连的组织（目系）,合：,脉气仍会合于面部足阳明本经经脉,足阳明之筋,(Muscle Region of Foot-yangming),起于中三指，,结,于跗上，邪（斜）外加于辅骨，上,结,于膝外廉，直上,结,于髀枢，上循胁，属脊。其直者，上循骭，,结,于膝；其支者，,结,于外辅骨，合少阳。其直者，上循伏兔，上,结,于髀，,聚,于阴器，上腹而布，至缺盆而结，上颈，上挟口，合于（九页），下,结于,鼻，上合于太阳。太阳为目上纲，阳明为,目下纲,。其之者，从颊,结,于耳前。,特点：,结聚:,中三指，跗，辅骨，膝外廉，髀枢，胁，脊。,骭，膝；外辅骨，伏兔，髀，阴器，腹,缺盆，颈，口，（九页），鼻，上合于太阳。,太阳为目上纲，阳明为目下纲。,颊,耳。,散络:,其病：,足中指支，胫转筋，,脚跳坚,，伏兔转筋，髀前肿，,疝,，腹筋急，引缺盆及颊，卒,口僻，,急者目不合，热则筋纵，目不开。颊筋有寒则急，引颊移口；有热则筋弛纵，缓不胜收，故僻。,脚跳坚：,下肢跳动，感觉僵硬不舒适。,疒贵疝,：疒贵，音颓tui。又作“隤”。因疝气下颓，故名。,口僻：,指口角歪斜,腧穴(,Acupoints of Foot-Yangming,):,45穴 1.大体分布: 头面部8,颈部4,胸腹部18,下肢15 2.起止穴 : 承泣厉兑 3.治疗作用:调理脾胃,调和气血,清泻阳明,祛痰除湿,活血通络,补益气血,强壮身体,腧穴详解,承泣ST-1,Container of Tears,体位Position:,定位Location : 在面部，眼球与眶下缘之间，瞳孔直下。,承泣ST-1,主治(Indications)配伍和临床应用:,散风清热,疏邪明目止泪,目赤肿痛(风池,合谷,睛明),青光眼(风池,太冲,睛明),视神经萎缩(足三里,肝肾俞),流泪(肝经虚寒或肝肾不足,肝经风热或虚热,.),2.面部:,口眼歪斜(wry face):(合谷,攒竹,足三里,颊车,地仓),modern disease categories:,acute and chronic conjunctivitis(,结膜炎,),myopia(,近视,),astigmatism(,散光,),colour blindness,neuritis of the optic nerve(,视神经炎,),keratitis(,角膜炎,),blepharospasm,(睑痉挛,).,Caution:,1. the needle should be inserted slowly without,lifting, thrusting or rotating;,2. immediately on withdrawal of the needle, press firmly with a cotton wool ball for about a minute to prevent haematoma;,3. this needling method should not be attempted by those who have not had appropriate clinical supervision.,操作:,嘱患者闭目，医者押手拇指向上轻推眼球固定，刺手持针紧靠眶缘缓慢直刺寸。不宜提插捻转，以防刺破血管引起血肿；出针时按压,以防出血.,禁灸。,四白（ST 2）,体位Position:,定位Location,在面部，眶下孔处。,With the eyes looking directly forwards, this point is located 1 cun directly below the pupil, in the depression at the infraorbital foramen,眶下孔,.,LOCATION NOTE,The infraorbital foramen,眶下孔,can be felt by palpating downwards from the edge of the orbital bone, about 0.3 cun below the edge.,四白,主治(Indications)配伍和临床应用:,散风清热明目,1.目疾:,目赤肿痛(风池,睛明);,目翳.青光眼(光明,太冲,丰隆),近视(肝肾俞),2.面部疾病:,口眼歪斜(合谷,攒竹,太阳,阳白);,面痛(上关,下关,鱼腰,地仓),胆道蛔虫症,3.头痛目眩(涌泉,百会,太溪),4.其他:胆道蛔虫症,操作,直刺寸；或沿皮透刺睛明；或向外上方斜刺寸入眶下孔。,慎灸。,巨髎 (ST3),体位Position:,定位Location:,在面部,横平鼻翼下缘,瞳孔直下。,Eliminates wind, dissipates swelling and alleviates pain,主治:,面瘫,面痛,目疾,操作:,直刺,地仓ST-4,体位Position:,定位Location,:在面部,口角旁开寸(指寸)。,注:口角旁，在鼻唇沟或鼻唇沟延长线上。,Regional Anatomy:,地仓ST-4,主治(Indications)配伍和临床应用: 祛风止痛,舒筋活络,1.口眼歪斜(合谷,人中,颊车,承泣),口噤不开(承浆,合谷,颊车,下关),流涎 2.齿痛(合谷,颊车),NEEDLING,斜刺或平刺寸。,Transverse insertion to join with such points as Jiache ST-6, Yingxiang L.I.-20, Chengjiang REN-24 etc.,寸,慎灸。,大迎 (ST5),体位Position:,定位Location :,在面部,下颌角前方,咬肌附着部的前缘凹陷中,面动脉搏动处。,治疗:,基本同,颊车,操作:,避开动脉或向地仓方向刺,颊车(ST6),Sun Si-miao Ghost point,体位Position:,定位Location:,在面部,下颌角前上方一横指(中指)。,注：沿下颌角角平分线上一横指,闭口咬紧牙时咬肌隆起,放松时按之有凹陷处。,Regional Anatomy:,颊车(ST6,),主治(Indications)配伍和临床应用:,散风清热,开关通络止痛,1.口眼歪斜(合谷,颧髎,巨髎,地仓),颊肿(合谷,翳风),口噤不语(承浆,合谷,人中,百会),2.齿痛(胃火:合谷,内庭;肾虚:太溪.或局部注射鱼腥草注射液).,NEEDLING,Perpendicular insertion 0.5 cun;,Transverse insertion to join with such points as Dicang ST-4, Daying寸,寸,慎灸。,下关 (ST7),Meeting point of the Stomach and Gall Bladder channels,体位Position:,定位Location :,在面部,颧弓下缘,中央与下颌切迹之间凹陷中。,注;闭口,上关 ( GB3 )直下,颧弓下缘凹陷中。,下关ST-7,主治(Indications)配伍和临床应用:,消肿止痛,聪耳通络,1.面部:,面痛(三叉神经痛,穴位注射),面瘫(大迎,颊车,巨髎),牙关紧闭(合谷,颊车,外关,翳风),颞颌关节炎(合谷,耳门,翳风,听宫;或温针灸),2.耳疾:,耳鸣,耳聋(中耳炎,阳溪,关冲,液门,阳谷,耳门,翳风,听宫),3.慢性鼻炎(温针灸).,NEEDLING,1,Perpendicular insertion slightly inferiorly 0.5 to 1 cun;,2Transverse insertion to join with such points as Tinggong SI-19, Jiache ST-6, Quanliao SI-18 etc. for diseases of the ear, teeth, face and jaw.,头维 (ST8),足阳明、足少阳、阳维脉交会穴,体位Position:,定位:在头部,额角发际直上寸,头正中线旁开寸,Regional Anatomy:,头维 (ST8),主治(Indications)配伍和临床应用: 息风镇静,止痛明目,1.偏正头痛(风池,百会,太阳,率谷,合谷,列缺),2.目赤肿痛(风池,角孙,睛明),3.面瘫(阳白,丝竹空,上关,合谷),4.过敏性鼻炎(上星,印堂,太阳),操作:平刺,NEEDLING,Transverse insertion 0.5 to 1 cun.,Note,: according to several classical texts, this point is contraindicated to moxibustion.,人迎 (ST9),体位Position:,定位LOCATION,在颈部,横平喉结,胸锁乳突肌前缘,颈总动脉搏动处。,注;取一侧穴,令病人头转向对侧以显露胸锁乳突肌,抗阻力转动时则肌肉显露更明显。,Note: the carotid artery lies just deep to, and can be readily palpated at, the anterior border of the sternocleidomastoid muscle. This point therefore lies between the carotid artery and the lateral border of the thyroid cartilage,(甲状软骨).,NEEDLING,Perpendicular insertion 0.5 to 1 cun.,Note,: according to most classical texts, this point is contraindicated to moxibustion.,Caution:,care should be taken to avoid puncturing the carotid artery which must be palpated and then held,laterally during needling, by using the index finger and thumb of one hand, above and below the point. This,needling method should not be attempted by those who have not had appropriate clinical supervision.,水突（STIO),体位Position:,定位Location :,在颈部,横平环状软骨,胸锁乳突肌前缘。,气舍(STll),体位Position:,定位Location :,在胸锁乳突肌区,锁骨上小窝,锁骨胸骨端上缘,胸锁乳突肌胸骨头与锁骨头中间的凹陷中。,注;人迎直下,在锁骨的上缘外。,缺盆 (STl2),体位Position:,定位Location :,在颈外侧区,锁骨上大窝,锁骨上缘凹陷中,前正中线旁开4寸。,人迎-缺盆,共同点:,位置:颈部(除缺盆在锁骨上大窝),主治:咳嗽,哮喘,咽喉肿痛,瘿气,瘰疬,操作:直刺0.3-0.5(人迎避开动脉直刺0.3-0.8,慎灸),气户(STl3),体位Position:,定位Location :,在胸部,锁骨下缘,前正中线旁开4寸。,NEEDLING,Transverse-oblique insertion laterally or medially, 0.5 to 0.8 cun, or transverse insertion inferiorly along the channel.,Caution:,deep or perpendicular insertion carries a substantial risk of puncturing the lung or injuring the subclavian vessels.,库房 (STl4),体位Position:,定位Location :,在胸部,第1肋间隙,前正中线旁开4寸。,屋翳(STl5),体位Position:,定位Location :,在胸部,第2肋间隙,前正中线旁开4寸。,注:先于胸骨角水平确定第2肋,其下为第2肋间隙;男性可以乳头定第4肋间隙,再向上2肋为第2肋间隙。,膺窗 (STl6),体位Position:,定位Location :,在胸部,第3肋间隙,前正中线旁开4寸。,乳中 (STl7),体位Position:,定位Location :,在胸部,乳头中央。,乳根 (STI8),体位Position:,定位Location :,在胸部,第5肋间隙,前正中线旁开4寸。,注:男性在乳头下1肋,即乳中线与第5肋间隙的相交处。女性在乳房根部弧线中点处。,气户-乳根,共同点:,位置:胸部,主治:咳嗽,哮喘,胸胁胀痛,操作:斜刺或平刺0.5-0.8(乳中不针不灸),不容 (STl9),体位Position:,定位Location :,在上腹部,脐中上6寸,前正中线旁开2寸。,承满 (ST20),体位Position:,定位Location :,在上腹部,脐中上5寸,前正中线旁开2寸。,梁门 (ST21),体位Position:,定位Location :,在上腹部,脐中上4寸,前正中线旁开2寸。,Regional Anatomy:,梁门 (ST21),主治(Indications)配伍和临床应用: 调气止痛,和胃降逆,消积化滞,益气止泻,胃痛,呕吐,纳呆;胃溃疡,NEEDLING,Perpendicular insertion 1 to 1.5 cun.,Caution:,deep needling at right Liangmen ST-21 may penetrate an enlarged liver.,不容-,梁门,共同点:,位置:上腹部,脐上6,5,4,主治:胃痛,纳呆,腹胀,操作:直刺,关门 (ST22),体位Position:,定位Location :,在上腹部,脐中上3寸,前正中线旁开2寸。,太乙(ST2 3),体位Position:,定位Location :,在上腹部,脐中上2寸,前正中线旁开2寸。,滑肉门 (ST24),体位Position:,定位Location :,在上腹部,脐中上1寸,前正中线旁开2寸。,共同点:,上腹部,胃肠道疾病,天枢( ST25 ),Front-Mu point of the Large Intestine,体位Position:,定位:,在腹部,横平脐中,前正中线旁开2寸。,.,Regional Anatomy:,天枢( ST25 ),主治(Indications)配伍和临床应用:大肠募穴,1.,调理肠腑,升降气机:,腹痛,(术后肠麻痹,配合足三里,上脘),腹泻(足三里),.(隔姜灸治疗慢性腹泻，双天枢每次7壮;治疗慢性结肠炎，足三里中脘关元留针30分,TDP 以神阙为中心照射30分),肠痈(上巨虚,阑尾穴),痢疾(上巨虚,三阴交),便秘(支沟,大肠俞,上巨虚,足三里),蛔虫痛,2.调经止带:,带下,月经不调,痛经(中极,三阴交,太冲,次髎.,NEEDLING,Perpendicular insertion 1 to 1.5 cun;,oblique inferior insertion towards the uterus for diseases of the uterus,(子宫).,Caution:,in thin subjects, deep needling may penetrate the peritoneal cavity(腹腔).,外陵 (ST26),体位Position:,定位Location :,在下腹部，脐中下1寸，前正中线旁开2寸。,大 巨 (ST27),体位Position:,定位Location :,在下腹部，脐中下2寸，前正中线旁开2寸。,水 道(ST28),体位Position:,定位Location :,在下腹部，脐中下3寸，前正中线旁开2寸。,归来（ST 29）,体位Position:,定位Location,:在下腹部，脐中下4寸，前正中线旁开2寸。,归来（ST 29）,主治(Indications)配伍和临床应用:,1.行气疏肝:,小腹痛,疝气(太冲),2.调经止带:,月经不调(中极,三阴交,曲骨),3.益气升提:,子宫下垂(三阴交,气海,维胞),NEEDLING,Perpendicular insertion 1 to 1.5 cun.,Caution:,deep insertion may penetrate the peritoneal cavity in thin patients or may penetrate a full bladder; the patient should therefore be asked to empty the bladder before needling.,气 冲（ST 30）,体位Position:,定位Location :,在腹股沟区，耻骨联合上缘，前正中线旁开2寸，动脉搏动处。,外陵-气 冲,共同点:,位置:下腹部,脐下1,2,3,4,5,主治:腹痛,妇科,男科疾病,操作:直刺1-1.5(,气 冲,),髀 关（ST 31）,体位Position:,定位Location :,在股前区，股直肌近端、缝匠肌与阔筋膜张肌3条肌肉之间凹陷中。,注：约相当于髂前上嵴、髌底外侧端连线与耻骨联合下缘水平线的交点处,伏兔（ST 32）,体位Position:,定位Location :,在股前区，髌底上6寸，髂前上棘与髌底外侧端的连线上。,伏兔（ST 32）,主治(Indications)配伍和临床应用:,1.行气疏肝:,疝气,2.散寒化湿,疏通经络:,下肢瘫痪(环跳,肾俞,委中,阳陵泉,三阴交) ;,腿膝酸痛(环跳,犊鼻) ;,股外侧皮神经炎(扬刺加灸,罐),NEEDLING,Perpendicular or oblique insertion 1 to 2 cun.,可灸,阴 市 （ST 33）,体位Position:,定位Location :,在股前区，髌底上3寸，股直肌肌腱外侧缘。,梁丘 （ST34）,体位Position:,定位Location :,在股前区，髌底上2寸，股外侧肌与股直肌肌腱之间。,髀 关-,梁丘,共同点:,位置:大腿前,主治:下肢痹痛,操作:直刺1-2或,梁丘 （ST34）,主治(Indications)配伍和临床应用:郄穴,1.和胃,止痛:,胃痛(中脘,内关;急性胃炎指按),急性腹泻(艾灸7-9壮).,2.疏经活络止痛:,膝关节痛(犊鼻,阴.阳陵泉,委中,委阳).,NEEDLING,Perpendicular or oblique insertion 1 to 1.5 cun.,犊鼻,Calfs Nose,（ST35）,体位Position:,定位Location :,在膝前区，髌韧带外侧凹陷中。,注：屈膝45，髌骨外下方的凹陷中。,ACTIONS,Dispels wind-damp and reduces swelling,Activates the channel and alleviates pain,主治:,膝肿痛,NEEDLING,With the knee flexed and supported by a rolled pillow,Perpendicular insertion, directed towards Weizhong BL-40, 1 to 2 cun;,Oblique insertion in a medial and superior direction, behind the patella 1 to 2 cun,Behind the patellar ligament to join with medial Xiyan (MN-LE-16).,足三里 （ST36）,体位Position:,定位Location :,在小腿外侧，犊鼻下3寸，犊鼻与解溪连线上。,注：在胫骨前肌上取穴。,Regional Anatomy:,足三里 （ST36）,主治(Indications)配伍和临床应用:,和胃健脾，通腑化痰，升降气机,:,胃下垂.,肾下垂(百会,气海,肾,脾俞.中脘),2.和胃健脾:,慢性腹泻(配气海,肾.脾俞,天枢);,胃痛,反胃,呕吐(配中脘,内关,公孙);,3.,nourishes blood and yin:,贫血虚弱(配大椎气海脾俞 肝俞 三阴交)。,4.,Clears firend resolves dampness,restores consciousness:,眩晕(配丰隆阴陵泉三阴交中脘内关治疗痰湿中阻型),心悸(配脾俞 三阴交神门心俞心脾不足型)。,5.调理气机:,乳痈(配梁丘肩井太冲合谷膻中)。,现代研究:,1.针刺治疗白细胞减少症，双穴,2.针刺镇痛作用观察，治疗各种原因引起的上腹疼痛，双穴，与吗啡类药物联合阿托品或莨菪碱肌注作用相当，对胃痉挛、胆痉挛效好，晚期癌症疼痛效果较差。,3.电针对癌症化疗病人胃肠功能的影响：采用电针足三里为主，治疗化疗药物引起的胃肠反应。实验性大鼠的研究发现电针大鼠足三立刻有效的减弱环磷酰胺的毒性作用，保护胃肠组织。,4.抗衰老作用研究：针刺足三里可延缓衰老的进程，预防一些老年疾病的发生。,操作,直刺寸。,可灸。,上巨虚 （ST37）,体位Position:,定位Location :,在小腿外侧，犊鼻下6寸，犊鼻与解溪连线上。,Regional Anatomy:,上巨虚 （ST37）,主治(Indications)配伍和临床应用:大肠下合穴,1.理气通腑,调理胃肠:,痢疾(天枢,三阴交,曲池),肠痈 (天枢,三阴交,足三里,曲池,阑尾穴),便秘(天枢,支沟,大肠俞),下肢痿痹,NEEDLING,Perpendicular or oblique insertion 1 to 1.5 cun.,可灸。,条口 （ST38）,体位Position:,定位Location,:在小腿外侧，犊鼻下8寸，犊鼻与解溪连线上。,主治:下肢痛,肩臂痛,操作:直刺1-2,透承山,下巨虚 (ST 39),体位Position:,定位Location :,在小腿外侧，犊鼻下9寸，犊鼻与解溪连线上。,Regional Anatomy:,下巨虚 (ST 39),主治(Indications)配伍和临床应用: 小肠下合穴 1. 清利湿热:,痢疾, 小腹痛,乳痈,2.活血通络止痛 :,下肢痿痹,操作:,直刺寸。,可灸。,丰隆 (ST 40),体位Position:,定位Location :,在小腿外侧，外踝尖上8寸，胫骨前肌的外缘。,Regional Anatomy:,丰隆 (ST 40),主治(Indications)配伍和临床应用:,化痰,宁心安神,1.眩晕(痰多配百会,脾俞) 2.痫症:神门,太冲 3.狂症:神门,太冲 ,冲阳,人中,化痰定喘,4.咳嗽,哮喘:肺俞,膻中,尺泽,天突,6.,Transforms phlegm and dampness:,梅核气,双侧穴,老年虚寒性便秘:隔姜灸,NEEDLING,Perpendicular or oblique insertion 1 to 1.5 cun.,The single most important acupuncture point to transform phlegm in the body, whatever its origin.,可灸。,解溪 (ST 41),体位Position:,定位Location :,在踝区，踝关节前面中央凹陷中，当拇长伸肌腱与趾长伸肌腱之间。,注：令足趾上跷，显现足背部两肌腱，穴在两腱之间，相当于内、外踝尖连线的中点处。,Regional Anatomy:,解溪 (ST 41),主治(Indications)配伍和临床应用:,经穴,腹胀,便秘,:,头痛(眉棱骨痛,合谷),眩晕,癫狂,踝关节痿痹,NEEDLING,Perpendicular insertion 0.5 cun;,Oblique insertion beneath the tendons to join with Shangqiu SP-5 medially or Qiuxu GB-40 laterally.,Caution: the anterior tibial vessels and nerve,腓深神经和胫前动、静脉,lie deep to this point.,冲阳 （ST42）,体位Position:,定位Location :,在足背，第2跖骨基底部与中间楔状骨关节处，可触及足背动脉。,陷骨（ST43）,体位Position:,定位Location,:在足背，第2、3跖骨间，第2跖趾关节近端凹陷中。,冲阳-陷骨,共同点:,位置:足背,主治:足背肿痛,足痿无力,头面疾病,操作:直刺0.3-0.5(,冲阳避开动脉,),内庭 （ST 44）,体位Position:,定位Location :,在足背，第2、3趾间，趾蹼缘后方赤白肉际处。,Regional Anatomy:,内庭 （ST 44）,Ying-Spring and Water point of the Stomach channel,Ma Dan-yang Heavenly Star point,主治(Indications)配伍和临床应用:,1.清热,健脾和胃,胃热呕吐(中脘,足三里),湿热泄泻(内关,曲池,天枢),2.清热泻火:,咽喉肿痛,牙龈肿痛(合谷,三阴交),面瘫(地仓,颊车,颧髎),麦粒肿(双侧点刺出血),NEEDLING,Perpendicular insertion 0.5 cun;,Oblique insertion directed proximally, 0.5 to 1 cun.,可灸。,厉兑（ST 45）,体位Position:,定位Location :,在足趾，第2趾末节外侧，趾甲根角侧后方寸（指寸）。,注：足第2趾外侧甲根角侧后方（即沿角平分线方向）寸。相当于沿爪角外侧画一直线与爪甲基底缘水平线交点处,Regional Anatomy:,厉兑（ST 45）,主治(Indications)配伍和临床应用: 井穴,1.泻热,醒脑开窍,:,热病,癫狂,中风昏迷(百会,人中,隐白,中冲),咽喉肿痛,齿痛,口歪,:,足背肿痛,:,胃脘疼痛(内关,中脘,足三里),NEEDLING,Perpendicular or oblique insertion directed proximally 0.1 to 0.2 cun, or prick to bleed.,可灸。,小结,.经络：,：,共性：,特点：,.刺灸注意事项：,刺灸注意事项:,面部血管丰富，进针要慢，防止出血，引起血肿。,颈部深处有重要血管，不可深刺。,胸部内容心肺，应浅刺或沿皮刺，严防伤及心肺，造成不良后果。,腹部进针要慢，达到一定深度，要少提插，避免刺伤腹腔内器官。,面部、关节部各穴不宜用直接灸，避免引起瘢痕，有碍面部美观和关节活动。,思考题,1.试用灵枢经脉原文叙述足阳明经脉的循行分布？,2.足阳明经络系统联系的脏腑器官有哪些？,3.试述承泣、四白、地仓、颊车、下关、头维、梁门、天枢、归来、伏兔、梁丘、足三里、上巨虚、下巨虚、丰隆、解溪、内庭、厉兑18个常用腧穴的定位、归经、主治和操作。,4.试述足阳明经各类特定穴.,足太阴脾经络和腧穴,(Meridian,Collateral and Acupoints of Foot-Taiyin),Meridian and Collateral of Foot-Taiyin,经脉循行: 足大趾-下肢内侧-腹-脾胃-膈-咽-舌,联系的脏腑器官:胃,脾,心,咽喉,舌,脾足太阴之脉，起于大指之端，循指内侧白肉际，过核骨后，上内踝前廉，上踹内，循胫骨后，交出厥阴之前，上膝股内前廉，入腹，,属脾，络胃，上膈，挟咽，连舌本，散舌下。,白肉际：,指足底或手掌面的边界，又称赤白肉际。,核骨：,第一跖趾关节内侧的圆形突起。,内踝前廉：,内踝前边。,腨：通“踹”，,俗称小腿肚，即腓肠肌部。,厥阴：,足厥阴肝经。,咽：,食道。,舌本：,舌根部。,其支者：,复从,胃,，别上膈，注,心,中（脾之大络，名曰大包，出渊腋下三寸，布胸胁）。,病变(Disease):,脾胃病,妇科病,前阴病及循行部位病.,是动强,.食则呕.胃脘痛.腹胀善噫，得,后,与,气,.则,快然如衰.,身体皆重。,强:,强硬，舌根部活动不灵活。,得后与气：,后，指大便；气，指矢气。,快然如衰：,感到病情松解。,是主脾,所生,病者.舌本痛.体重不能动摇.食不下.烦心.,心下,急痛.黄疸.不能卧.,强立,（欠）.股膝内肿.厥.大指不能用。,心下：,指胃脘部，俗称心口窝。,溏、瘕、泄：,溏，指大便溏薄；瘕，指腹部忽聚忽散的痞块；泄，指水泻。,水闭：,指小便不利。,强立：,太素作“强欠”，指想打呵欠而气出不畅。,足太阴络脉Collateral of Foot-Yangming :,足太阴之别，名曰公孙。去本节后一寸，别走阳明；其别者入络肠胃。,其病,：厥气上逆则霍乱。,实，腹中切痛；,虚，鼓胀。,足太阴之正,(Divergent Meridian of Foot-taiyin),上至髀，合于阳明。与别俱行，上结于咽，贯舌本。,特点：,离：,从足太阴经脉分出,入：,和足阳明经的经别相合并行入腹腔之内，属于 脾脏,络于胃腑,出：,向上结于咽喉，贯通到舌本。,合：,脉气仍会合于面部足阳明经经脉,足太阴之筋,(Muscle Region of Foot-taiyin),起于大指之端内侧，上,结,于内踝；其直者，,结,于膝内辅骨，上循阴股,结,于髀，,聚,于阴器。上腹，,结,于脐，循腹里，,结,于肋，,散于胸中；,其内者着于脊。,特点：,结聚:,结,于内踝；膝内辅骨，,结,于髀，,聚,于阴器。,结,于脐，循腹里，,结,于肋，,散络:,散于胸中；其内者着于脊。,其病：足大趾支，内踝痛，转筋痛，膝内辅骨痛，阴股引髀而痛，阴器纽痛，,上引,脐,与,两胁痛，引膺中，脊内痛。,上：,原作“下”，据太素改。,与：,原缺，据甲乙、太素补,腧穴详解,腧穴(,Acupoints of Foot-Yangming,):,21穴 1.大体分布: 腹部5,胸胁部5,大小腿部6,踝关节以下5 2.起止穴 : 隐白 大包 3.重点穴:,治疗作用:调理脾胃,补益气血,健脾除湿,益气摄血,升阳举陷,活血通络.,腧穴详解,隐白SP-1,体位Position,定位Location :,在足趾，大趾末节内侧，趾甲根角侧后方寸（指寸）,Regional Anatomy:,隐白SP-1,Jing-Well and Wood point of the Spleen channel,Sun Si-miao Ghost point,主治(Indications)配伍和临床应用:井穴,1.健脾宁神,心神疾患:,癫狂(depression and mania),梦魇(厉兑);,慢惊风等灸双少商治疗,2.血证:,崩漏,月经过多(麦粒灸,或点刺出血);,大便下血(足三里);,吐血(脾俞,肝俞,上脘),3.,脾胃疾病,腹胀,呕吐，食不下，暴泄。,足趾痛,NEEDLING,Perpendicular or oblique insertion directed proximally0.1 to 0.2 cun, or prick to bleed.,moxibustion (either by moxa stick or direct cones) at Yinbai SP-1 is frequently employed,大 都 （,SP 2）,体位Position,定位Location :,在足趾，第1跖趾关节远端赤白肉际凹陷中。,主治:荥穴,操作:,太白 (SP3),体位Position:,定位Location :,在跖区,第1跖趾关节近端赤白肉际凹陷中。,Regional Anatomy:,太白 (SP3),主治(Indications)配伍和临床应用:输穴,原穴,健脾化湿,理气和胃,1.,脾胃疾病,胃痛,腹泻(脾虚可加丰隆,灸),腹胀,便秘(公孙),小儿可悬灸,体重节痛,脚气,脚趾痛,NEEDLING,Perpendicular insertion 0.5 to 1 cun.,可灸。,公孙 (SP4),体位Position:,定位Location :,在跖区,第1跖骨底的前下缘赤白肉际处。,注:沿太白（SP3）向后推至一凹陷,即为本穴。,Regional Anatomy:,公孙 (SP4),主治(Indications)配伍和临床应用: 络穴,八脉交会穴,通冲脉.,1.健脾化湿,和胃理中,胃痛,吐泻(梁门,足三里),腹胀,腹痛,痢疾,胃痛,吐泻(梁门,足三里),腹胀,腹痛,痢疾,2. 养心通络,心痛,胸闷,脚趾肿痛,现代研究:,1.针健侧公孙,太白治疗腹股沟淋巴结炎,2.控制化疗引起的胃肠反应:内关,足三里,NEEDLING,Perpendicular insertion 0.5 to 1 cun,可灸。,商丘 (SP5),体位Position:,定位Location :,在踝区,内踝前下方,舟骨粗隆与内踝尖连线中点凹陷中。,注:内踝前缘直线与内踝下缘横线的交点处。,主治:经穴,操作:,三阴交 (SP6),体位Position:,定位Location,:在小腿内侧,内踝尖上3寸,胫骨内侧缘后际。,注:交信（KI8）上1寸。,Regional Anatomy:,三阴交 (SP6),Jing-River and Metal point of the Spleen channel,主治(Indications)配伍和临床应用:,泌尿系统 :,健脾利水,小儿遗尿,.睡前或午后4点灸,配中极三阴交合尿少尿闭。,配膀胱.肾俞 治疗产后,尿潴留,（功能外伤产后）,生殖系统：,补益肝肾,疏肝调经,男科疾病,配心俞，治疗,梦遗。,配命门肾俞.关元，治疗,阳萎、精冷不育。,疝气,等,妇科疾病(妇科要穴),配气海归来，治疗,月经不调,(irregular menstruation)。,配中极天枢治疗,痛经,(menorrhagia)（血瘀加合谷）。,经闭,等,消化系统(脾胃疾病)：,健脾益气,配气海，治疗,慢性腹泻,（单纯性消化不良）。,配天枢足三里治疗,急性菌痢。,配四缝足三里治疗,小儿疳积,。,配气海治疗气阴两虚,便秘。,配中脘神阙，治疗虚寒性,腹痛。,精神系统,(疏肝理气,Calms the spirit,),使兴奋与抑制过程恢复平衡,配内关百会治疗,失眠。,配内关神门丰隆涌泉人中治疗,精神病,。,心血管系统(活血化瘀止痛,)：,配合谷内关百会治疗,高血压。,配内关 膻中治疗,心绞痛。,配内关神门大陵膻中治疗,风湿性心脏病。,其他,(清热除湿,),配大椎曲池治疗,瘾疹。,配合谷丰隆秩边治疗,风湿性紫班,NEEDLING,Perpendicular insertion 0.5 to 1 cun;,可灸。,Caution:,contraindicated in pregnancy.,孕妇禁针,漏谷( SP7),体位Position:,定位Location,在小腿内侧,内踝尖上6寸,胫骨内侧缘后际。,注:三阴交上3寸处。,地机(SP8)郄穴,体位Position:,定位Location,在小腿内侧,阴陵泉下3寸,胫骨内侧缘后际。,商丘-地机,共同点:,位置:在小腿内侧,膝下,主治:腹泻,腹胀,下肢痹痛,操作:直刺1-1.5(,商丘,),地机,主治(Indications)配伍和临床应用:,郄穴,1.健脾渗湿:,腹胀,腹痛,泄泻,水肿(水分),小便不利,2.调理月经:,月经不调,痛经(针刺或埋线;可配关元,三阴交),崩漏,:,腰痛,下肢痿痹,操作,直刺寸。可灸。,阴陵泉 (SP9),体位Position:,定位Location :,在小腿内侧,胫骨内侧髁下缘与胫骨内侧缘之间的凹陷中。,注:用拇指沿胫骨内缘由下往上推,至拇指抵膝关节下时,胫骨向内上弯曲的凹陷中即是本穴。,Regional Anatomy:,阴陵泉 (SP9),主治(Indications)配伍和临床应用:合穴,1.健脾渗湿:,水肿(水分),小便不利等(三阴交),:,膝关节肿痛,3.补益脾肾:妇科男科疾病:,痛经,遗精等,NEEDLING,Perpendicular insertion 1 to 1.5 cun.,可灸。,血海（SP10）,体位Position:,定位Location :,在股前区,髌底内侧端上2寸,股内侧肌隆起处。,Regional Anatomy:,血海（SP10）,主治(Indications)配伍和临床应用: 1.健脾渗湿,祛风活血,瘾疹(曲池,三阴交,穴位注射),慢性湿疹(曲池,三阴交,合谷,足三里,灸关元,再针脾.大肠.三焦俞),皮肤瘙痒症,:,月经不调,崩漏,经期头痛,3.活血通络:,膝关节痛(膝阳关,梁丘,阴陵泉),NEEDLING,Perpendicular or oblique insertion 1 to 1.5 cun.,可灸。,箕门 (SPIl),体位Position:,定位Location :,在股前区,髌底内侧端与冲门(SPI2)的连线上1/3与下2/3交点,长收肌和缝匠肌交角的动脉搏动处。,主治,1. 小便不利，遗尿。,2. 腹股沟肿痛。,操作,避开动脉，直刺寸。可灸。,冲 门 (SPI2),体位Position:,定位Location :,在腹股沟区,腹股沟斜纹中,髂外动脉搏动处的外侧。,府舍(SPl3),体位Position:,定位Location :,在下腹部,脐中下寸,前正中线旁开4寸。,腹结(SP14),体位Position:,定位Location :,在下腹部,脐中下寸,前正中线旁开4寸。,冲 门-腹结,共同点:,位置:下腹部,主治:腹痛,疝气,操作:直刺1-1.5(,冲 门,),大横 (SPl5),体位Position:,定位Location :,在腹部,脐中旁开4寸。,注:横平内侧的天枢（ST25) 、肓俞(KI16) 、神阙(CV8)。,Regional Anatomy:,大横 (SPl5),主治(Indications)配伍和临床应用: 理气止痛,通腑降气,1.腹痛,便秘,泻痢(中脘,足三里,三阴交),2.慢性胃痛(中脘,天枢,脾俞,三焦俞),3.肠道蛔虫(四缝,足三里),NEEDLING,Perpendicular insertion 0.5 to 1 cun.,可灸。,Caution:,in thin patients deep needling may penetrate the peritoneal cavity;,deep needling at this point may penetrate a substantially enlarged spleen or liver.,腹哀 (SPl6),体位Position:,定位Location :,在上腹部,脐中上3寸,前正中线旁开4寸。,主治:,主治,1. 腹痛，便秘，泄泻，痢疾，消化不良,2. 绕脐痛。,操作,直刺寸。可灸。,食窦 (SPl7),体位Position:,定位Location,:在胸部,第5肋间隙,前正中线旁开6寸。,天溪 (SPl8),体位Position:,定位Location :,在胸部,第4肋间隙,前正中线旁开6寸。,胸乡 (SPl9),体位Position:,定位Location,:在胸部,第3肋间隙,前正中线旁开6寸。,周荣 (SP20),体位Position:,定位Location :在,胸部,第2肋间隙,前正中线旁开6寸。,食窦-周荣,共同点:,位置:胸部,第5,4,3,2肋间隙,前正中线旁开6寸。,主治:胸胁痛,操作:斜刺或平刺,大包 (SP21),体位Position:,定位Location :,在胸外侧区,第