32. Painful Obstructive Syndrome (Bi Zheng)
Definition
Localized discomforts in the muscles, joins and tendons caused by invasion of exterior pathogens such as wind, cold, dampness and heat.
Relevant Diseases Of Western Medicine
1. Rheumatic arthritis--- rheumatic: of, relating to, or suffering from rheumatism. Arthritis: inflammation of a joint or joints resulting in pain and swelling.
2. Rheumatoid arthritis---a chronic disease marked by stiffness and inflammation of the joints, weakness, loss of mobility, and deformity.
3. Degenerative arthritis
4. Osteoarthritis---a form of arthritis, occurring mainly in older persons, that is characterized by chronic degeneration of the cartilage of the joints.also called degenerative joint disease
5. Gout--- a disturbance of uric-acid metabolism occurring predominantly in males, characterized by painful inflammation of the joints, especially of the feet and hands, and arthritic attacks resulting from elevated levels of uric acid in the blood and the deposition of urate crystals around the joints. The condition can become chronic and result in deformity.
6. Sciatica---pain along the sciatic nerve usually caused by a herniated disk of the lumbar region of the spine and radiating to the buttocks and to the back of the thigh.
7. Subacromial bursitis肩峰下滑液囊炎
8. Olecranal bursitis 鹰嘴的滑液囊炎
9. Carpal tunnel syndrome 腕管综合征
10. fibromyalgia 肌痛---( fibro-: fiber, especially fibrous tissue. Myalgia: muscular pain or tenderness, especially when diffuse and nonspecific.)
Etiology & Pathogenesis
1. Exterior Invasion---Wind, Cold. Dampness And Heat
Differential Diagnosis
1. Identification of wind, cold. Damp and heat bi
2. Identification of complication
3. Differential diagnosis of painful obstruction (bi) and atrophy syndromes (wei)
Classification & Treatment
Treatment Principle---Expel Wind, Cold, Dampness, Clear Heat, Unblock Channels
A. Acute Episode:
1. Wind Bi---Expel Wind, Cold, Dampness, Unblock Channels
Moving pain in the joints and limbs, apin of indeterminate location, difficulty in flexion and extension of joints, aversion to cold and in some cases, fever. Thin white coating, wiry and floating pulse.
Fang Fen Tang
Fang Feng, Ma Huang, Qin Jiao--- Expel Wind, Cold, Dampness
Dang Gui, Ge Gen, Rou Gui--------Invigorate Blood, Warm And Unblock Channels
Fu Ling--------Strengthen Spleen And Drain Dampness
Bl 12, Bl 17, Sp 10
2. Cold Bi--- Warm Channels, Expel Wind, Cold And Dampness
Severe pain of the joints and limbs, apin of fixed location accompanied by sensatio of cold, decrease in pain with application of heat, increase in pain upon exposure to cold, without redness or feverishness of joints, with difficulty moving the affected parts. Thin white coating, tight, wiry pulse.
Wu Tou Tang
Wu Tou, Ma Huang--- Warm Channels, Disperse Cold And Dampness, Alleviate Pain
Shao Yao, Gan Cao--- Alleviate Pain
Huang Qi-------------Augment Qi
Bl 23, Cv4
3. Damp Bi--- Expel Dampness And Wind-Cold, Unblock Channels
Heaviness and pain of the joints and limbs, distention and swelling in some case, pain of fixed location, local numbness or loss of sensation, with symptoms often increasing during overcast or rainy weather. White slimy coating, soft tardy pulse.
Yi Yi Ren Tang
Yi Yi Ren, Cang Zhu---------------Strengthen Spleen, Expel Dampness
Fang Fen, Qiang Huo, Du Huo-----Expel Wind-Dampness
Chuan Wu, Ma Huang, Gui Zhi--- Warm Channels, Disperse Cold
Dang Gui, Chuan Xiong------------Nourish Blood
St 36, Bl20, Sp 5
4. Heat Bi--- Clear Heat, Unblock Channels, Expel Wind And Dampness
Severe pain, local heat, redness and swelling; difficulty of movement affecting one or more joints accompanied by fever, sore throat, thirst, irritability and dark scanty urine. Yellow coating, rapid and slippery pulse.
Bai Hu Jia Gui Zhi Tang
Bai Hu Tang--- Clear Heat And Eliminate Irritability
Gui Zhi-------- Expel Wind And Unblock Channels
Gv 14, Li 11
B. Chronic Active Episode:
1. Phlegm Accumulation And Blood Stasis---Transform Phlegm, Expel Stasis, And Unblock Channels
Swelling, stiffness and deformity of the joints, incessant pain and complete immobility. Dark or purple with white slimy coating, deep, rough or deep slippery pulse.
Tao Hong Yin
Tao Ren, Hong Hua, Dang Gui Wei-----------Invigorate Blood, Expel Stasis
Chuan Xiong------------Expel Wind, Alleviate Pain, Invigorate Blood, And Move Qi
Wei Ling Xian------------Expel Wind-Dampness And Unblock Channels
St 40, Sp10
2. Qi And Blood Deficiency---Expel Exterior Pathogen, Stop Pain, And Tonify Qi And Blood
Aching pain in the lower back and knees, difficulty in the flexion and extension of joints, numbness or loss of sensation in affected areas, palpitations and shortness of breath, in some cases aversion to cold and symptoms relieved by warmth, pale with white coating.
Weak thread pulse
Du Huo Ji Sheng Tang
Du Huo-------------Expel Wind-Dampness, Unblock Channels Andalleviate Pain
Xi Xin, Fang Fen, Qin Jiao--------Expel Wind, Cold, Dampness
Du Zhong, Niu Xi Sang Ji Sheng---Strengthen Sinews And Bones, Nourish Kidney And Liver
Dang Gui, Chuan Xiong, Di Huang, Bai Shao---Harmonize Blood
Ren Shen, Fu Ling----------------Tonify Qi And Spleen
Gui Zhi---------------------------Warm And Unblock Blood Circulation
St 36, Sp 6, Rn 6
3. Heart Bi---Augment Qi, Nourish Heart, Warm Yang, Restore Regular Pulse
Palpitations, Oppression In The Chest, Shortness Of Breath, Edema, Aggravation Of Symptoms With Physical Activity, Lusterless Complexion And, In Some Cases, Cyanosis.Tongue: Pale. Pulse: Rapid, Forceless Or Intermittent.
Zhi Gan Cao Tang
Zhi Gan Cao------------Augment Qi And Yang
Gui Zhi---------------- Warm Yang Qi
Ren Shen, Da Zhao---Augment Qi And Tonify Heart And Spleen
Di Huang, Er Jiao, Mai Men Dong, Huo Ma Ren--- Nourish Blood And Yin, Tonify Heart
Pc 6, Ub 15
Acupuncture Treatment For Deferent Joints
1. Shoulder-----Sj 14, Li 15, Si 10
2. Elbow-----Li 11, Li 4, Sj 10, Sj 5, Lu 5
3. Wrist-----Sj 4, Sj 5, Li 5, Si 5
4. Hip-----Gb30, Gb 29, Gb 39
5. Knee-----He Ding, Xi Yan, St 35, Sp 9, Gb 34
6. Ankle-----St 41, Sp 5, Gb 40, Ub 60, Ki 3
7. Lower Back And Spine-----Du 26, Du 3, Du 12
Localized discomforts in the muscles, joins and tendons caused by invasion of exterior pathogens such as wind, cold, dampness and heat.
Relevant Diseases Of Western Medicine
1. Rheumatic arthritis--- rheumatic: of, relating to, or suffering from rheumatism. Arthritis: inflammation of a joint or joints resulting in pain and swelling.
2. Rheumatoid arthritis---a chronic disease marked by stiffness and inflammation of the joints, weakness, loss of mobility, and deformity.
3. Degenerative arthritis
4. Osteoarthritis---a form of arthritis, occurring mainly in older persons, that is characterized by chronic degeneration of the cartilage of the joints.also called degenerative joint disease
5. Gout--- a disturbance of uric-acid metabolism occurring predominantly in males, characterized by painful inflammation of the joints, especially of the feet and hands, and arthritic attacks resulting from elevated levels of uric acid in the blood and the deposition of urate crystals around the joints. The condition can become chronic and result in deformity.
6. Sciatica---pain along the sciatic nerve usually caused by a herniated disk of the lumbar region of the spine and radiating to the buttocks and to the back of the thigh.
7. Subacromial bursitis肩峰下滑液囊炎
8. Olecranal bursitis 鹰嘴的滑液囊炎
9. Carpal tunnel syndrome 腕管综合征
10. fibromyalgia 肌痛---( fibro-: fiber, especially fibrous tissue. Myalgia: muscular pain or tenderness, especially when diffuse and nonspecific.)
Etiology & Pathogenesis
1. Exterior Invasion---Wind, Cold. Dampness And Heat
Differential Diagnosis
1. Identification of wind, cold. Damp and heat bi
2. Identification of complication
3. Differential diagnosis of painful obstruction (bi) and atrophy syndromes (wei)
Classification & Treatment
Treatment Principle---Expel Wind, Cold, Dampness, Clear Heat, Unblock Channels
A. Acute Episode:
1. Wind Bi---Expel Wind, Cold, Dampness, Unblock Channels
Moving pain in the joints and limbs, apin of indeterminate location, difficulty in flexion and extension of joints, aversion to cold and in some cases, fever. Thin white coating, wiry and floating pulse.
Fang Fen Tang
Fang Feng, Ma Huang, Qin Jiao--- Expel Wind, Cold, Dampness
Dang Gui, Ge Gen, Rou Gui--------Invigorate Blood, Warm And Unblock Channels
Fu Ling--------Strengthen Spleen And Drain Dampness
Bl 12, Bl 17, Sp 10
2. Cold Bi--- Warm Channels, Expel Wind, Cold And Dampness
Severe pain of the joints and limbs, apin of fixed location accompanied by sensatio of cold, decrease in pain with application of heat, increase in pain upon exposure to cold, without redness or feverishness of joints, with difficulty moving the affected parts. Thin white coating, tight, wiry pulse.
Wu Tou Tang
Wu Tou, Ma Huang--- Warm Channels, Disperse Cold And Dampness, Alleviate Pain
Shao Yao, Gan Cao--- Alleviate Pain
Huang Qi-------------Augment Qi
Bl 23, Cv4
3. Damp Bi--- Expel Dampness And Wind-Cold, Unblock Channels
Heaviness and pain of the joints and limbs, distention and swelling in some case, pain of fixed location, local numbness or loss of sensation, with symptoms often increasing during overcast or rainy weather. White slimy coating, soft tardy pulse.
Yi Yi Ren Tang
Yi Yi Ren, Cang Zhu---------------Strengthen Spleen, Expel Dampness
Fang Fen, Qiang Huo, Du Huo-----Expel Wind-Dampness
Chuan Wu, Ma Huang, Gui Zhi--- Warm Channels, Disperse Cold
Dang Gui, Chuan Xiong------------Nourish Blood
St 36, Bl20, Sp 5
4. Heat Bi--- Clear Heat, Unblock Channels, Expel Wind And Dampness
Severe pain, local heat, redness and swelling; difficulty of movement affecting one or more joints accompanied by fever, sore throat, thirst, irritability and dark scanty urine. Yellow coating, rapid and slippery pulse.
Bai Hu Jia Gui Zhi Tang
Bai Hu Tang--- Clear Heat And Eliminate Irritability
Gui Zhi-------- Expel Wind And Unblock Channels
Gv 14, Li 11
B. Chronic Active Episode:
1. Phlegm Accumulation And Blood Stasis---Transform Phlegm, Expel Stasis, And Unblock Channels
Swelling, stiffness and deformity of the joints, incessant pain and complete immobility. Dark or purple with white slimy coating, deep, rough or deep slippery pulse.
Tao Hong Yin
Tao Ren, Hong Hua, Dang Gui Wei-----------Invigorate Blood, Expel Stasis
Chuan Xiong------------Expel Wind, Alleviate Pain, Invigorate Blood, And Move Qi
Wei Ling Xian------------Expel Wind-Dampness And Unblock Channels
St 40, Sp10
2. Qi And Blood Deficiency---Expel Exterior Pathogen, Stop Pain, And Tonify Qi And Blood
Aching pain in the lower back and knees, difficulty in the flexion and extension of joints, numbness or loss of sensation in affected areas, palpitations and shortness of breath, in some cases aversion to cold and symptoms relieved by warmth, pale with white coating.
Weak thread pulse
Du Huo Ji Sheng Tang
Du Huo-------------Expel Wind-Dampness, Unblock Channels Andalleviate Pain
Xi Xin, Fang Fen, Qin Jiao--------Expel Wind, Cold, Dampness
Du Zhong, Niu Xi Sang Ji Sheng---Strengthen Sinews And Bones, Nourish Kidney And Liver
Dang Gui, Chuan Xiong, Di Huang, Bai Shao---Harmonize Blood
Ren Shen, Fu Ling----------------Tonify Qi And Spleen
Gui Zhi---------------------------Warm And Unblock Blood Circulation
St 36, Sp 6, Rn 6
3. Heart Bi---Augment Qi, Nourish Heart, Warm Yang, Restore Regular Pulse
Palpitations, Oppression In The Chest, Shortness Of Breath, Edema, Aggravation Of Symptoms With Physical Activity, Lusterless Complexion And, In Some Cases, Cyanosis.Tongue: Pale. Pulse: Rapid, Forceless Or Intermittent.
Zhi Gan Cao Tang
Zhi Gan Cao------------Augment Qi And Yang
Gui Zhi---------------- Warm Yang Qi
Ren Shen, Da Zhao---Augment Qi And Tonify Heart And Spleen
Di Huang, Er Jiao, Mai Men Dong, Huo Ma Ren--- Nourish Blood And Yin, Tonify Heart
Pc 6, Ub 15
Acupuncture Treatment For Deferent Joints
1. Shoulder-----Sj 14, Li 15, Si 10
2. Elbow-----Li 11, Li 4, Sj 10, Sj 5, Lu 5
3. Wrist-----Sj 4, Sj 5, Li 5, Si 5
4. Hip-----Gb30, Gb 29, Gb 39
5. Knee-----He Ding, Xi Yan, St 35, Sp 9, Gb 34
6. Ankle-----St 41, Sp 5, Gb 40, Ub 60, Ki 3
7. Lower Back And Spine-----Du 26, Du 3, Du 12
