Hypochondriac pain

Star

Textbook Prescriptions Liver

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

GB34 Yanglingquan bilateral

Shaoyang He-Sea; regulates qi of the Shaoyang channels along the flank
- ⚠ Nerve
TE6 Zhigou bilateral

Hand Shaoyang point; regulates Shaoyang qi to relieve lateral pain
LV14 Qimen affected side or bilateral

Front-Mu of the Liver; soothes the liver and eases hypochondriac pain
- ⚠ Major vessel

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

GB34 Yanglingquan
- ⚠ Nerve injury has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 3 (Peripheral nerve injury)
LV14 Qimen
- ⚠ Vascular injury or haematoma has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 4 (Organ injury) and Table 8 (Hemorrhage)

Treatment Principle

Soothe the liver and clear obstruction from the collaterals, using reducing method.

Indications

Qi stagnation: distending pain in the ribs and hypochondrium, chest fullness, bitter taste, wiry pulse; severity follows the emotionsBlood stasis: fixed stabbing hypochondriac pain, worse with pressure and at night; purple spots on the tongue, wiry pulse

Method

Reducing method for both qi stagnation and blood stasis.

⚠ Cautions

LV14 is on the chest wall over the liver and lung base: needle obliquely along the intercostal space, never deep, to avoid pneumothorax or liver injury. Right-sided pain can come from gallbladder or liver disease, and chest-wall pain must be distinguished from cardiac or pulmonary causes; refer where indicated.

About

The colleges' prescription for pain in the ribs and hypochondrium, taken from the Liver and Shaoyang channels.

Rationale

The Shaoyang channels cover the side of the body, so TE6 and GB34 relieve the pain by regulating their qi from above and below. LV14, the Front-Mu of the liver, works locally to ease the liver and the hypochondrium.

Clinical Notes

Qi stagnation: add BL18 and GB40 to free the liver and move qi. Blood stasis: the prescription line adds BL17 and Xingjian (LV2), while the Explanation instead names BL17 with SP6 to move blood and remove stasis. The book relates this pain to liver and gallbladder disease, hypochondriac sprain, intercostal neuralgia and costal chondritis, and gives an ear-acupuncture option.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Hypochondriac pain, p. 361–362.

📝 Notes

Public notes from the community and your own private notes on Hypochondriac pain.

No notes yet.

Back to Point Combinations