肺大肠经络腧穴A

经络腧穴各论,手太阴经络与腧穴,(CHANNELS, COLLATERALS and Acupoints of hand-taiyin)CHANNELS of hand-taiyin手太阴经脉: 循行：起于中焦大肠胃膈肌肺上肢内侧前缘-大指端联系的脏腑器官:大肠,胃,膈肌,肺,Pathway肺手太阴之脉，起于中焦,下络大肠，还循胃口，上膈属肺。还：回来；循：顺沿；还循：意为顺着走。胃口：指贲门部。属：归属，隶属，统属；,从肺系，横出腋下，下循臑内行少阴、心主之前，下肘中，循臂内上骨下廉，入寸口，上鱼，循鱼际，出大指之端。其支者：从腕后，直出次指内廉，出其端。,肺系：指气管、喉咙。系，系带、悬系的意思。臑：音no(同闹)，指上臂部。少阴、心主：指手少阴、手厥阴二经。臂内上骨下廉：臂内上骨，指桡骨；廉，指边缘。上边称“上廉”，下边称“下廉”。寸口：桡动脉搏动处。,病变(Disease):肺系病,及循行部位病.是动则病，肺胀满，膨膨而喘咳，缺盆中痛，甚则交两手而瞀 ，此为臂厥。是主肺所生病者，咳，上气，喘喝，烦心，胸满，臑臂内前廉痛厥，掌中热。瞀：音mo(同茂)，指心胸闷乱，视力模糊。臂厥：指前臂经脉所过处发生气血阻逆的见症。,手太阴络脉COLLATERALS of Hand-taiyin手太阴之别，名曰列缺。起于腕上分间，并太阴之经，直入掌中，散入于鱼际。其病实则手锐掌热，虚则欠 ，小便遗数，取之去腕一寸半，别走阳明也。,手太阴经别THE DIVERGENT CHANNELS of Hand-taiyin手太阴之正，别入渊腋少阴之前，入走肺，散之大肠，上出缺盆，循喉咙，复合阳明。,特点：离：从太阴（正）经分出入：进入体腔（肺部，大肠）出：浅出体表（缺盆）合：合于面部手阳明经脉。,手太阴经筋THE SINEW CHANNELS of Hand-taiyin 手太阴之筋，起于大指之上，循指上行，结于鱼后，行寸口外侧，上循臂，结肘中，上臑内廉，入腋下，出缺盆，结肩前髃，上结缺盆，下结胸里，散贯赉，合赉下，抵季胁。其病：所过者支转筋痛(支撑不适、拘挛掣痛)，其成息赉者，胁急(胁肋拘急)、吐血(上逆吐血)。,主治概要主治咳、喘、咯血、咽喉痛等肺系疾患经脉循行部位的其他病证。,手太阴腧穴Acupoints of hand-taiyin :11穴大体分布 :上肢内侧 起止穴 :中府-少商重点穴:中府,尺泽,孔最,列缺,太渊,少商.治疗作用:疏风解表,宣肺化痰,止咳平喘,清热利咽,凉血止血,宁心安神,通经活络,腧穴详解中府ZHONGFU,LU-1体位Position:定位Location:On the lateral spect of the chest, in the first intercostal space, 6 cun lateral to the midline, 1 cun inferior toYunmen LU-2.,定位Location:在胸部，横平第1肋间隙，锁骨下窝外侧，前正中线旁开6寸。注1：先确定云门，中府即在云门下1寸。,中府LU-1主治(Indications)配伍和临床应用:肺募Front-Mu point of the Lung1.宣肺理气和胃,止咳平喘Disseminates and descends Lung qi and Descends Stomach qi,Alleviates cough and wheezing:咳嗽,气喘,胸满痛等.,2.通经活络,止痛:肩背痛.操作: 向外斜刺或平刺0.5-0.8,不能深刺.可灸。 Caution: deep perpendicular or oblique insertion carries a substantial risk of causing a pneumothorax.,云门(LU2)体位Position:定位Location:在胸部,锁骨下窝凹陷中,肩胛骨喙突内缘,前正中线旁开6寸。,中府-云门(LU2)共同:位置:胸部主治:咳嗽,气喘,胸痛,肩痛.操作:向外斜刺或平刺0.5-0.8,不能深刺.,天府(LU3)体位Position:定位Location:在臂前区,腋前纹头下3寸,肱二头肌桡侧缘处。侠白 ( LU4 )体位Position:定位Location:在臂前区,腋前纹头下4寸,肱二头肌桡侧缘处。,共同点:位置:上肢主治:咳嗽,气喘,上肢内侧痛,操作:直刺0.5-1,尺泽CHIZE,LU-5体位Position :定位Location:On the cubital crease of the elbow, in the depression at the radial side of the tendon of biceps brachii.在肘区,肘横纹上,肱二头肌腱桡侧缘凹陷中。,主治Indications配伍和临床应用: 合穴 1.宣肺止咳,清热利咽,凉血止血Clears heat from the Lung and descends rebellious qi:咳嗽，喘息，(配肺俞、孔最、合谷、鱼际).咽痛，针刺治疗急慢性扁桃体炎及咽炎:以透天凉手法针刺尺泽.咯血, 治疗肺痨(配膏肓).,2.通经活络止痛Activates the channelRelaxes the sinews and alleviates pain:肘臂挛痛(配合谷、然谷). 3.理气和胃:急性吐泻,中暑等(委中),4.清肺泻热:肺热所致的湿疹、痤疮、酒渣鼻、荨麻疹、过敏性鼻炎等。 操作(NEEDLING)Perpendicular insertion 0.5 to 1 cun.或点刺出血 可灸。,孔最KONGZUILU-6体位Position:定位Location :在前臂前区,腕掌侧远端横纹上7寸,尺泽( LU5 )与太渊( LU9)连线上。On the flexor aspect of the forearm, 7 cun proximal to Taiyuan LU-9, on the line connecting Taiyuan LU-9 with Chize LU-5.,主治(Indications)配伍和临床应用:郄穴Xi-Cleft point 1.止咳平喘,清热利咽,凉血止血Clears heat and stops bleeding,Moderates acute conditions:咯血(支气管扩张,肺结核,肺脓肿引起,穴位注射),气喘(发作期,配鱼际强刺激,留针30-60分,缓解时出针,)咽喉肿痛(少商).,2.通经活络止痛:肘臂挛痛3.清热,凉血止血Clears heat and stops bleeding:痔血操作NEEDLINGPerpendicular or oblique insertion 0.5 to 1.5 cun.可灸。,列缺LIEQUE,LU-7体位Position定位Location :在前臂,腕掌侧远端横纹上1.5寸,拇短伸肌腱与拇长展肌腱之间,拇长展肌腱沟的凹陷中。,Luo-Connecting point of the Lung channelConfluent point of the Conception vesselCommand pointMa Dan-yang Heavenly Star point,列缺LU-7主治(Indications)配伍和临床应用: 络穴,八脉交会穴 ,四总穴 1.宣肺通络,通调任脉Benefits the head and nape ,Opens and regulates the Conception vessel,Activates the channel and alleviates pain :偏头痛,落枕,颈肩综合症(配肩髃),腕痛.,2.宣肺止咳,清热利咽Releases the exterior and expels wind,Promotes the descending function of the Lung,Pacifies wind and phlegm :感冒，咳嗽，喘息，咽痛(外感引起的声音嘶哑,配照海),3.开宣肺气,通利小便Regulates the water passages :遗尿(交替埋针)4.宁心安神:遗精(肺藏魄),NEEDLINGWith the fingers of one hand pinch up the skin over the point, and with the other hand needle transversely in a proximal or distal direction, 0.2 to 0.3 cun, avoiding the cephalic vein.向肘部平斜刺0.2-0.3寸，穴下有桡动脉，一般不主张艾灸，更不宜直接灸、化脓灸。,经渠(LU8)体位Position定位Location :在前臂前区,腕掌侧远端横纹上1寸,桡骨茎突与桡动脉之间。,经渠-太渊共同点:位置:腕关节附近主治:1.咳嗽,气喘,胸痛,咽痛,2.腕痛操作:避开桡动脉,直刺0.3-0.5,太渊TAIYUAN LU-9体位Position定位Location :在腕前区,桡骨茎突与舟状骨之间,拇长展肌腱尺侧凹陷中。注:在腕掌侧远端横纹桡侧,桡动脉搏动,太渊LU-9主治(Indications)配伍和临床应用: 输穴,原穴,脉会穴Shu-Stream, Yuan-Source and Earth point of the Lung channel，Hui-Meeting point of the Vessels1.宣肺化痰，平喘止咳Tonifies the Lung and transforms phlegm，Promotes the descending function of the Lung:咽干喉痛( 配鱼际),咳嗽,气喘( 配列缺),2.通脉理血Regulates and harmonises the one hundred vessels:心悸,无脉症(配人迎,内关)3.通经活络止痛Activates the channel and alleviates pain:腕臂痛,NEEDLINGPerpendicular insertion 0.3 to 0.5 cun, avoiding the radial artery.操作: 直刺0.2-0.3寸，避开桡动脉。可灸，但不宜疤痕灸。,鱼际YUJI LU-10体位Position定位Location :在手外侧,第1掌骨桡侧中点赤白肉际处,主治(Indications)配伍和临床应用:荥穴Ying-Spring and Fire point1.平喘止咳Descends rebellious qi :咳嗽,气喘2.清热利咽Benefits the throat Clears Lung heat：咽喉肿痛,发热,操作:直刺0.5-0.8寸；可灸,少商SHAOSHANG LU-11 体位Position定位Location :在手指，拇指末节桡侧，指甲根角侧上方0.1寸（指寸）。注：拇指桡侧指甲根角侧上方（即沿角平分线方向）0.1寸。相当于沿爪角桡侧画一直线与爪角基底缘水平线交点处取穴。,少商LU-11主治(Indications)配伍和临床应用:井穴Jing-Well and Wood point of the Lung channel，Sun Si-miao Ghost point1.泻热,醒脑开窍Revives consciousness and Clears heat:高热,昏迷,癫狂.(点刺治疗中风后的痴呆麻木).,2.清热利咽,凉血止血Clears heat and benefits the throat咽喉肿痛,鼻衄. 3.点刺治疗呃逆.,操作:向腕平刺0.2-0.3寸；或点刺出血；可灸，但不宜疤痕灸。NEEDLINGPerpendicular or oblique insertion directed proximally0.1 to 0.2 cun, prick to bleed.,小结,.经络：.主治：共性：特点：.刺灸注意事项：4.思考题,思考题1.试用灵枢经脉原文叙述手太阴经脉的循行分布？2.手太阴经络系统联系的脏腑器官有哪些？3.试述常用腧穴的定位、归经、主治和操作。4.试述手太阴经的各类特定穴.,手阳明经络与腧穴(Meridian,Collateral and Acupoints of hand-Yangming)Meridian and Collateral of hand-Yangming手阳明经脉: 循行：食指-上肢外侧-肩-颈-口-下齿-鼻旁 联系的脏腑器官:大肠,肺,口,下齿,鼻,Pathway,大肠手阳明之脉，起于大指次指之端，循指上廉，出合谷两骨之间，上入两筋之中，循臂上廉，入肘外廉，大指次指：大指侧的次指，即食指。指上廉：食指的桡侧边。按屈肘立拳位描述，故称上廉。,上臑外前廉，上肩，出髃骨之前廉，上出于柱骨之会上，下入缺盆，络肺，下膈，属大肠。髃骨：肩胛骨肩峰部。柱骨之会：指大椎穴处。柱骨即颈椎骨。缺盆：锁骨上窝部。缺盆骨即锁骨，其上有缺盆穴。,其支者：从缺盆上颈，贯颊 ，入下齿中；还出挟口，交人中 左之右、右之左，上挟鼻孔。交人中：经脉在人中穴处左右交叉。,病变: 热病,皮肤病,肠胃病,神志病,头面五官病.,是动则病，齿痛颈肿。是主津所生病者，目黄，口干，鼽衄，喉痹，肩前臑痛，大指次指痛不用。气有余，则当脉所过者热肿；虚，则寒栗不复。,目黄：指眼睛昏黄，不同于黄疸。鼽衄：鼽，为鼻流清涕。衄，指鼻出血。喉痹：指咽喉肿痛，壅闭不通。脉所过者：指本经脉外行所过之处。寒栗不复：发冷颤抖，难以回温。,手阳明络脉:Collateral of hand-Yangming手阳明之别，名曰偏历。去腕三寸，别走太阴，其别者，上循臂，乘肩髃，上曲颊偏齿 （上行到曲颊，偏络于齿根） ；其别者，入耳合于宗脉 （指总脉、大脉，耳中为手、足少阳、手太阳、足阳明四脉所总会。实，龋聋；虚，齿寒痹隔。,手阳明经别: Divergent Meridian of hand-Yangming手阳明之正，从手循膺乳(侧胸和乳之间 ),别于肩髃,入柱骨(颈椎。一释作锁骨 ),下走大肠，属于肺，上循喉咙，出缺盆，合于阳明也。,特点：离：在肩上部肩髃穴处从正经分出入：从第七颈椎处进入体腔（大肠,肺部）出：浅出体表（缺盆）合：合于面部手阳明本经经脉,手阳明经筋: Muscle Region of hand-yangming 起于大指次指之端，结于腕，上循臂，上结于肘外，上臑，结于肩髃；其支者，绕肩胛，挟脊；其直者从肩髃上颈；其支者上颊，结于(九页）；直者上出于手太阳之前，上左角，络头，下右颔。,其病：当所过者支痛及转筋，肩不举，颈不可左右视。特点： 结聚:结于腕,上臑，结于肩髃；其支者，绕肩胛，挟脊；其直者从肩髃上颈；其支者上颊，结于(九页）；散络:络头，下右颔。,腧穴Acupoints : 20 1.大体分布: 面部2,颈部2,肩至肘5,肘以下11 2.起止穴 : 商阳迎香 3.重点穴:治疗作用:疏风解表,清热利咽,清热解暑,清热息风,调理脾胃,清利湿热,活血通络,润肠通腑,主治概要主治头面五官疾患热病皮肤病肠胃病神志病经脉循行部位的其他病证。,商阳SHANGYANG LI1体位Position定位Location :在手指，食指末节桡侧，指甲根角侧上方0.1寸,商阳LI-1主治(Indications)配伍和临床应用:井穴1.清热消肿Clears heat, reduces swelling and alleviates pain:咽喉肿痛(少商,合谷);齿痛,耳聋,2.清热开窍醒神Revives consciousness:热病(少商);昏迷(少商,人中)3.活血通络:手指麻木,操作:浅刺0.1-0.2寸，或点刺出血。可灸。NEEDLINGPerpendicular or oblique insertion directed proximally 0.1 to 0.2 cun, or prick to bleed.,二 间 ERJIAN LI 2体位Position定位Location :在手指，第2掌指关节桡侧远端赤白肉际处。三间SANJIAN,LI-3体位Position定位Location :在手背，第2掌指关节桡侧近端凹陷中。,二 间-三间共同点:位置:掌指关节处主治:目痛,咽喉肿痛,齿痛,热病操作:直刺,三间LI-3主治(Indications)配伍和临床应用:输穴Shu-Stream and Wood point1.清热消肿Clears heat and benefits the throat and teeth:目痛(前谷,睛明),咽喉肿痛,齿痛2.清热Expels wind and heat:热病,3.活血通络,消肿止痛the shu-stream points are indicated for “heaviness of the body and pain of the joints”.:手背肿痛,落枕,肩周炎,操作:直刺0.3-0.5寸。可灸。NEEDLINGPerpendicular insertion 0.3-0.5 ,or0.5to 2 cun, directed towards Houxi SI-3.,合谷HEGU,LI-4体位Position定位Location :在手背，第二掌骨桡侧的中点处。,主治(Indications)配伍和临床应用:原穴,四总穴,四关穴 1.明目聪耳, 通络镇痛: Regulates the face, eyes, nose, mouth and ears,Activates the channel and alleviates pain,头痛(配外关,风池),面痛三叉神经痛(配翳风,颊车,下关),牙痛(配颊车,大迎),面瘫(配颊车,迎香).鼻衄 痄腮咽痛(少商),2.清热解表,Expels wind and releases the exterior, adjusts sweating外感发热头痛,热病,无汗，多汗 3.清热凉血,截疟(风池,大椎):皮肤病,疟疾,4.平肝息风,镇静安神:癫狂,眩晕(太冲),小儿惊风(配太冲.十二井.十宣.大椎.曲池).牙关紧闭,5.调理胃肠:胃切除术的肠胀气病人,(配足三里,胃肠减压,可提前20小时). 6.催产调经活血:滞产,月经不调,痛经,经闭.,操作:直刺0.5-1寸。可灸。注意：孕妇禁针NEEDLINGi. Perpendicular insertion 0.5 to 1 cun; ii. Oblique insertion directed proximally 1 to 1.5 cun.Caution: contraindicated in pregnancy.,阳溪YANGXI，LI-5体位Position定位Location :在腕区，腕背侧远端横纹桡侧，桡骨茎突远端，解剖学“鼻咽窝”凹陷中。,主治(Indications)配伍和临床应用:Jing-River and Fire point1.清热散风,明目利咽:Clears heat and alleviates pain，Clears yangming fire头痛,目赤肿痛,咽喉肿痛,齿痛(二间,阳谷)2.活血通络Benefits the wrist joint，alleviates pain手腕痛,踝关节扭伤,操作:直刺0.5-0.8寸。可灸。NEEDLINGPerpendicular insertion 0.5 to 1 cun.,偏历PIANLI LI 6体位Position定位Location :在前臂，腕背侧远端横纹上3寸，阳溪与曲池连线上。,主治(Indications)配伍和临床应用:Luo-Connecting point1. Expels wind and clears heat： 目赤，耳聋，鼻衄，喉痛。2. Opens and regulates the water passages： 水肿。3.活血通络：手臂酸痛。,操作直刺或斜刺0.50.8寸。可灸。NEEDLINGTransverse-oblique insertion, 0.5 to 0.8 cun.,温 溜 LI 7体位Position定位Location :在前臂，腕背侧远端横纹上5寸，阳溪与曲池连线上。,下 廉 LI 8体位Position定位Location :在前臂，肘横纹下4寸，阳溪与曲池连线上。上 廉LI 9体位Position定位Location :在前臂，肘横纹下3寸，阳溪与曲池连线上。,偏历-上 廉共同点:位置:前臂主治:手臂痛,胃肠病(除偏历治水肿),头面五官病(除上廉)操作:直刺0.5-1(除偏历直刺或斜刺0.5-0.8),手三里SHOUSANLI LI-10体位Position定位Location :在前臂，肘横纹下2寸，阳溪与曲池连线上。,手三里LI-10,主治(Indications)配伍和临床应用:1.活血通络Regulates qi and blood, activates the channel andalleviates pain上肢不遂,手臂麻木,肩周炎,急性腰扭伤.,2.调理胃肠Harmonises the intestines and Stomach 腹痛,腹胀,腹泻(足三里) 3.清热,利咽:齿痛,咽喉肿痛(曲池,中渚),操作:直刺0.81.2寸。可灸。NEEDLINGPerpendicular or oblique insertion 0.8 to 1.2 cun.,曲池QUCHI LI-11体位Position定位Location :在肘区，尺泽（LU5）与肱骨外上髁连线的中点处。注：90屈肘，肘横纹外侧端外凹陷中；极度屈肘，肘横纹桡侧端凹陷中。,主治(Indications)配伍和临床应用: 合穴He-Sea and Earth point1.活血通络Regulates qi and blood ,Activates the channel and alleviates pain手臂痹痛, 上肢不遂(合谷,肩髃). 2.清热息风:癫狂,眩晕(高血压:配足三里,太冲或丰隆,太冲).,3.清热解表Clears heat, eliminates wind :感冒发热,热病(善治热病),咽喉肿痛(合谷,外关),齿痛,目赤肿痛.4.调理胃肠Harmonises the intestines and Stomach :腹痛,吐泻(足三里,天枢).,5.清热疏风,消肿止痒Clears heat,Cools the blood, eliminates wind, drains damp and alleviates itching:皮肤病(荨麻疹,配大椎,肩髃,血海或血海,合谷).如湿疹、痤疮、酒渣鼻、黄褐斑、神经性皮炎、口周皮炎、瘾疹、丹毒、皮肤过敏、干燥。,操作:直刺0.81.2寸。可灸。NEEDLINGPerpendicular insertion 1 to 1.5 cun, or joined by throughneedling to Shaohai HE-3.,肘 髎LI 12体位Position定位Location :在肘区，肱骨外上髁上缘，髁上嵴的前缘。手五里LI 13体位Position定位Location :在臂部，肘横纹上3寸，曲池与肩髃连线上。,共同点:位置:上臂主治:肘臂疼痛操作:直刺0.5-1,臂臑LI-14体位Position定位Location :在臂部，曲池上七寸，三角肌前缘处。注：曲池与肩髃连线上，横平臑会,臂臑LI-14主治(Indications)配伍和临床应用:1.疏经活络:颈项拘急,肩臂疼痛,肩周炎.2.理气消痰:瘰疬 ,颈淋巴结核(配曲池,手三里).,3.清热明目止痛:目疾(光明),目赤肿痛.操作:直刺或向上斜刺0.81.5寸。可灸。,肩髃JIANYU LI-15体位Position定位Location :在三角肌区，肩峰外侧缘前端与肱骨大结节两骨间凹陷中。注：屈臂外展，肩峰外侧缘前后端呈现两个凹陷，前一较深凹陷即本穴，后一凹陷为肩髎（TE14）,主治(Indications)配伍和临床应用: 1.清热疏风,消肿止痒Clears heat, eliminates wind, drains damp and alleviates itching :皮肤病(荨麻疹).痤疮、湿疹、神经性皮炎、疱疹、瘾疹、皮肤过敏。2.疏经活络Dispels wind-damp, alleviates pain and benefits theshoulder上肢不遂(曲池,合谷),肩臂疼痛,肩周炎等.,3.活血化瘀,降脂Regulates qi and blood ,dissipates phlegm nodules :瘰疬,高脂血症(曲池,合谷,足三里).,操作:直刺,向肩关节,治疗肩周炎. 斜刺向三角肌方向,治疗上肢不遂.NEEDLING With the arm abd