1、七、足太阳膀胱经(一)经脉循行 体表:起于目内眦,上额,循头顶,夹督脉下项,分成两支,沿脊柱旁开1.5寸及3寸、大腿后侧下行,汇合于腘窝正中,沿小腿后侧、足外侧下行,在小趾外侧端与足少阴肾经相接。体内:络肾,属膀胱,联络脑。(二)主要病候 小便不通,遗尿,癫狂,疟疾,目痛,迎风流泪,鼻塞多涕,鼻衄,头痛,以及项、背、股、臀部和下肢后侧疼痛等证。(三)主治概要 外经病外经病:头痛,目疾,项强,背腰痛,下肢痿痹。脏腑病脏腑病:背俞穴主治所属脏腑的病证。神志病神志病:癫狂,痫证,失眠。(四)腧穴 本经共67穴:重点掌掌握握睛明、攒竹、天柱、睛明、攒竹、天柱、风门、肺俞、心俞、膈风门、肺俞、心俞、膈俞
2、、肝俞、胆俞、脾俞、俞、肝俞、胆俞、脾俞、胃俞、肾俞、大肠俞、胃俞、肾俞、大肠俞、膀胱俞、次髎、膀胱俞、次髎、承扶、承扶、委中、委中、膏肓、志室、膏肓、志室、承承山、昆仑、申脉、至阴山、昆仑、申脉、至阴23穴的定位、归经、特定位、归经、特定穴类别、操作。定穴类别、操作。睛明睛明 BL1BL1【定位】在面部,目内眦角稍上方凹陷处。【功效】散风清热,明目退翳。【主治】各种眼病,如近视、目赤肿痛,迎风流泪,夜盲。【操作】嘱患者闭目,左手将眼球推向外侧固定,针沿眼眶边缘缓缓刺入0.30.5寸,不宜作大幅度提插,捻转;(出针后按压35分钟,防止出血。若皮下出血,24小时内冷敷,24小时后热敷。)禁灸。攒
3、竹攒竹 BL2BL2【定位】在面部,当眉头陷中,眶上切迹处。【功效】散风镇痉,清热明目。【主治】1.视物不明,目赤肿痛,迎风流泪,眼睑跳动。2.头痛,眉棱骨痛,面瘫,呃逆。【操作】治疗眼病,可向下斜刺0.30.5寸;治疗头痛,面瘫,可平刺透鱼腰;可灸。天柱天柱 BL10BL10【定位】在项部,大筋(斜方肌)外缘之后发际凹陷中,约当后发际正中旁开1.3寸。【功效】熄风宁神,祛风散寒。【主治】1.头痛,眩晕。2.项背强急,肩背痛。3.目赤肿痛,鼻塞。【操作】直刺或向下斜刺向下斜刺0.50.50.80.8寸,不可向内上方寸,不可向内上方深刺,以免伤及延髓深刺,以免伤及延髓;可灸。风门 BL12【定位
4、】在背部,当第二胸椎棘突下,旁开1.5寸。【功效】解表宣肺,护卫固表。【主治】1.发热,咳嗽,鼻塞,多涕。2.头痛,颈项强痛,肩背痛。【操作】向内斜刺0.50.8寸;可灸。【应用】1.风门为祛风要穴之一,治一切外感中风之证。2.玉龙歌:“腠理不密咳嗽频,鼻流清涕气昏沉,须知喷嚏风门穴,咳嗽宜加艾火深。”肺俞肺俞 BL13BL13(肺背俞穴)(肺背俞穴)【定位】在背部,当第三胸椎棘突下,旁开1.5寸。【功效】宣肺平喘,化痰止咳,清热理气。【主治】1.咳嗽,气喘,胸满,鼻塞。2.骨蒸,潮热,盗汗。3.喉痹,吐血,咯血。4.风疹,痤疮,腰背痛,癫狂。【操作】向内斜刺0.50.8寸;可灸。心俞心俞 B
5、L15BL15(心背俞穴)(心背俞穴)【定位】在背部,当第五胸椎棘突下,旁开1.5寸。【功效】宽胸降气,宁心止痛。【主治】1.心痛,心悸,胸闷。2.咳嗽,气喘。【操作】向内斜刺0.50.8寸;可灸。膈俞膈俞 BL17(BL17(八会穴之血会八会穴之血会)【定位】在背部,当第七胸椎棘突下,旁开1.5寸。【功效】活血止血,宽胸降逆。【主治】1.胃脘胀痛,呕吐,呃逆,饮食不下。2.咳嗽,气喘,吐血,咯血,便血。3.潮热,盗汗。4.风疹,荨麻疹。【操作】向内斜刺0.50.8寸;可灸。肝俞、胆俞肝俞、胆俞 BL18BL18BL19 BL19(背俞穴)(背俞穴)肝俞:肝俞:在背部,当第九胸椎棘突下,旁开1
6、.5寸。胆俞:胆俞:在背部,当第十胸椎棘突下,旁开1.5寸。【功效】清热化湿,疏肝利胆。共同主治:肝胆疾病,尤其是黄疸病。【操作】均向内斜刺0.50.8寸;可灸。脾俞、胃俞脾俞、胃俞 BL20BL20BL21 BL21(背俞穴)(背俞穴)脾俞:脾俞:在背部,当第十一胸椎棘突下,旁开1.5寸。胃俞:胃俞:在背部,当第十二胸椎棘突下,旁开1.5寸。【功效】健脾和胃,理中降逆。共同主治:脾胃疾患。【操作】均向内斜刺0.50.8寸;可灸。肾俞肾俞 BL23 BL23(肾背俞穴)【定位】在腰部,当第二腰椎棘突下,旁开1.5寸。【功效】益肾助阳,纳气利水,强腰聪耳。【主治】1.生育疾患:遗精,阳痿。2小溲
7、疾患:遗尿,小便频数,小便不利。3妇科疾患:月经不调,白带。4.耳鸣耳聋,腰膝痠痛。5.洞泄不化,五更泄泻。6.咳喘少气。【操作】直刺0.51寸;可灸。大肠俞 BL25(大肠背俞穴)【定位】在腰部,当第四腰椎棘突下,旁开1.5寸。【功效】调理肠胃,理气化滞。【主治】腰痛,泌尿系统疾患,肠道疾患。【操作】直刺0.51寸;可灸。膀胱俞膀胱俞 BL28BL28(膀胱背俞穴)(膀胱背俞穴)【定位】在骶部,当骶正中嵴旁1.5寸,平第二骶后孔。【功效】培补下元,强腰健膝。【主治】1.遗尿,遗精,小便不利。2.泄泻,便秘。3.腰骶疼痛。【操作】直刺0.81.2寸;可灸。次髎次髎 BL32BL32【定位】在骶
8、部,当髂后上棘内下方,适对第二骶后孔处。【功效】调理下焦,清利湿热。【主治】1.月经不调,痛经,带下,小便不利,遗尿,遗精。2.腰痛,下技痿痹。【操作】直刺11.5寸;可灸。承扶承扶 BL36BL36【定位】在大腿后面,臀下横纹的中点。【功效】消痔通便,舒筋活络。【主治】1.腰腿疼痛,下肢瘫痪。2.痔疾。【操作】直刺1.52.5寸;可灸。委中委中 BL40BL40(合穴,膀胱下合穴)(合穴,膀胱下合穴)【定位】在腘窝横纹中点,当股二头肌腱与半腱肌肌腱的中间。【功效】清热醒脑,理血消肿,祛风利湿,强健腰膝。【主治】1.腰痛,四总穴歌载:“腰背委中求”,髋关节屈伸不利,腘肌挛急,下肢痿痹。2.丹毒
9、,疔疮,腹痛,吐泻,中暑。3.衄血不止(又名“血郄”)4.遗尿,小便不利。【操作】直刺0.51寸,或用三棱针点刺出血;可灸。膏肓膏肓 BL43BL43【定位】在背部,当第4胸椎棘突下,旁开3寸。【功效】益气补虚,调理肺气。【主治】1.咳喘,盗汗,肺痨。肩背痛。2.健忘,遗精。3.羸瘦,虚劳。【操作】斜刺0.50.8寸;可灸。志室志室 BL52BL52【定位】在腰部,当第二腰椎棘突下,旁开3寸。【功效】益肾固精,壮腰强身。【主治】1.遗精,阳痿。2.遗尿,小便不利,水肿。3.腰脊强痛。【操作】直刺0.81寸;可灸。承山承山 BL57BL57【定位】在小腿后面正中,委中与昆仑之间,当伸直小腿或足跟
10、上提时,腓肠肌肌腹下出现尖角凹陷处。【功效】理肠疗痔,舒筋活络。【主治】1.痔疾,便秘。2.腰腿痛。【操作】直刺0.51寸;可灸。昆仑昆仑 BL60 BL60(经穴)(经穴)【定位】在足部外踝后方,当外踝尖与跟腱之间的凹陷处。【功效】舒筋活络,清利头目,镇痉止痫。【主治】1.头痛,项强,肩背拘急,目眩,鼻衄。2.癫痫,难产。3.腰骶疼痛,足跟肿痛。【操作】直刺0.51寸;可灸。(孕妇禁针刺)(孕妇禁针刺)申脉申脉 BL62 BL62(八脉交会穴,通阳跷)(八脉交会穴,通阳跷)【定位】在足外侧部,外踝直下方凹陷中。【功效】镇静止痫,宁心安神。【主治】1.头痛,眩晕,失眠,癫狂,痫证。2腰腿痛,项
11、强,足背痛。【操作】直刺0.30.5寸;可灸。至阴 BL67(井穴)【定位】在足小趾末节外侧,距趾甲根角0.1寸。【功效】疏风清热,矫正胎位。【主治】1.胎位不正,难产,胞衣不下。(矫正胎位(矫正胎位用灸法)用灸法)2.头痛,鼻塞,鼻衄,目痛。【操作】浅刺0.10.2寸;或用三棱针点刺放血;可灸。(孕妇及习惯性流产者禁针刺)(孕妇及习惯性流产者禁针刺)足太阳膀胱经小结1、经脉循行、经脉循行 起于目内眦,上额,循头顶,夹督脉下项,分成两支,沿脊柱旁开1.5寸及3寸、大腿后侧下行,汇合于腘窝正中,再沿小腿后侧、足外侧下行,止于小趾外侧端。体内路径:络肾,属膀胱,联络脑。2、取穴要点、取穴要点 目内
12、眦上方取睛明。眶上切迹取攒竹。背部第一侧线取风门、肺俞、心俞、膈俞、肝俞、脾俞、胃俞、肾俞、大肠俞。背部第二侧线取膏肓、志室、秩边。第二骶后孔取次髎。腘横纹中央取委中,委中外1寸取委阳。腓肠肌人字沟顶点取承山。外踝尖与跟腱之间的凹陷处取昆仑。外踝直下方凹陷中取申脉。小趾外侧趾甲角旁取至阴。3、主治要点、主治要点 外经病:睛明攒竹治目疾,天柱治头项病,背腰腧穴治背腰痛,腰骶下肢腧穴治腰骶下肢病。脏腑病:背俞穴主治所属脏腑的病证。腰骶腧穴治前阴病。委阳治三焦病。神志病:癫狂痫,不寐。4、特殊作用、特殊作用 膈俞治血虚、血证。委中治热证。膏肓治虚证。承山治大肠病。昆仑、至阴治难产,至阴治胎位不正。5
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24、yk5!Nyk6!Nzk6$Nzl6$Ozl6$Ozl7$OAl7%OAm7%PAm8%PAm8%PBm8&PBn8&QBn9&QBn9&QCn9*QCo9*RCoa*RDoa*RDoa(RDpa(SDpb(SEpb(SEpb)SEqb)TEqc)TFqc)TFqc-TFrc-UFrd-UGrd+UGrd+UGsd+VGse+VHse0VHse0VHte0WHtf0WItf1WIuf1WIuf1XIug1XJug2XJvg2XJvg2YJvh2YKvh3YKwh3YKwh3ZKwi3ZLwi4ZLxi4#Lxi4#Lxj4#Mxj5#Myj5!Myj5!Myk5!Nyk6!Nzk6$Nzk6$
25、Nzl6$Ozl7$OAl7%OAm7%OAm7%PAm8%PBm8&PBn8&PBn8&QBn9&QCn9*QCo9*RCo9*RCoa*RDoa(RDpa(SDpa(SDpb(SEpb)SEqb)TEqb)TEqc)TFqc-TFrc-UFrd-UFrd-UGrd+UGsd+VGse+VGse+VHse0VHte0WHtf0WItf0WItf1WIuf1XIug1XJug1XJug2XJvg2YJvh2YKvh2YKvh3YKwh3ZKwi3ZLwi4ZLwi4ZLxi4#Lxj4#Mxj5#Mxj5#Myj5!Myk5!Nyk6!Nzk6!Nzk6$Nzl6$Ozl7$OAl7$OAl7
26、%OAm7%PAm8%PBm8%PBm8&PBn8&QBn9&QCn9*QCn9*QCo9*RCoa*RDoa(RDoa(RDpa(SDpb(SEpb)SEqb)SEqb)TEqc)TFqc-TFrc-TFrc-UFrd-UGrd+UGsd+UGsd+VGse+VHse0VHte0WHte0WHtf0WItf)TFqc-TFrc-UFrd-UFrd-UGrd+UGsd+VGse+VGse+VHse0VHte0WHtf0WItf0WItf1WIuf1XIug1XJug1XJug2XJvg2YJvh2YKvh3YKvh3YKwh3ZKwi3ZLwi4ZLwi4ZLxi4#Lxj4#Mxj5#Mxj
27、5#Myj5!Myk5!Nyk6!Nzk6!Nzk6$Nzl6$Ozl7$OAl7$OAl7%OAm7%PAm8%PBm8&PBm8&PBn8&QBn9&QCn9*QCn9*QCo9*RCoa*RDoa(RDoa(RDpa(SDpb(SEpb)SEqb)SEqb)TEqc)TFqc-TFrc-TFrc-UFrd-UGrd+UGsd+VGsd+VGse+VHse0VHte0WHte0WHtf0WItf1WIuf1XIuf1XIug1XJug2XJvg2YJvh2YJvh2YKvh3YKwh3ZKwi3ZKwi3ZLwi4ZLxi4#Lxj4#Lxj4#Mxj5#Myj5!Myk5!Nyk5!Ny
28、k6!Nzk6$Nzl6$Ozl6$Ozl7$OAl7%OAm7%PAm8%PAm8%PBm8&PBn8&QBn9&QBn9&QCn9*QCo9*RCoa*Rzl7$OAl7$OAl7%OAm7%PAm8%PBm8&PBm8&PBn8&QBn9&QCn9*QCn9*QCo9*RCoa*RDoa(RDoa(RDpa(SDpb(SEpb)SEqb)SEqb)TEqc)TFqc-TFrc-TFrc-UFrd-UGrd+UGsd+VGsd+VGse+VHse0VHte0WHte0WHtf0WItf1WIuf1XIuf1XIug1XJug2XJvg2YJvh2YJvh2YKvh3YKwh3ZKwi3ZKwi3ZLwi4ZLxi4#Lxj4#Mxj4#Mxj5#Myj5!Myk5!Nyk5!Nyk6!Nzk6$Nzl6$Ozl6$Ozl7$OAl7%OAm7%PAm8%PAm8%PBm8&PBn8&QBn9&QBn9&QCn9*QCo9*RCoa*RDoa*RDoa(RDpa(SDpb(SEpb(SEpb)SEqb)TEqc)TFqc)TFqc-TFrc-UFrd-UGrd+UGrd+UGsd+VGse+VHse0VHse0VHte0WHtf0WItf1WIuf1WIuf1XIug1XJug2XJvg2XJvg2YJvh2YKvh3YKwh3YKwh3ZKwi3ZL