Prescription
Main formula
Qiang huo sheng shi tang
Alternative formulas
Jiu wei qiang huo tang
Ma huang jia zhu tang
Ma xing yi gan tang
Juan bi tang
Fang ji huang qi tang
Modifications
Patent remedy
Main points
Explanations
Alternative points
Modifications
Diagnosis
Principle of treatment
Acupuncture treatment
Explanations
Invasion of Wind-Damp-Heat
Symptoms and signs
Principle of treatment
Prescription
Main formula
Jia wei xuan bi tang
Alternative formulas
Xiao feng san
Xuan bi tang
Modifications
Patent remedies
Main points
Explanations
Alternative points
Modifications
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Scapular pain
Notopterygium Dispelling Dampness Decoction. Although this formula can be used to treat the scapular pain due invasion of Wind, Cold and Damp, it is more often used to treat the headache or neck pain, especially headache. Xi Xin Herba Asari 5g, Yu Jin Tuber Curcumae 10g, Gui Zhi Ramulus Cinnamomi Cassiae 10g and Ji Xue Teng Caulis Milletiae Reticulatae 10g could be added into this formula to strengthen the effect of pain-relief.
Nine-herb Decoction with Notopterygium from the Analytic Collection. This formula could be used to treat pain due invasion of Wind, Cold and Damp with accumulation of Heat in the Interior, i.e. mixture of External Wind, Cold and Damp with Internal Heat. There is usually pain with no sweating, fever, painful body and joints, thirst, bitter taste in the mouth, white and greasy coating, superficial pulse.
Ephedra Decoction plus Atractylodes. This formula could be used to treat mild case of pain due to invasion of Wind, Cold and Damp.
Ephedra Apricot Kernel, Coicis and Licorice Decoction. This formula could be used to treat scapular body pain and joint pain at beginning stage due to invasion of Wind, Cold and Damp resulting from improper daily life, such as catching a rain and stand in wind after heavy sweating, etc.
Remove Painful Obstruction Decoction. This formula is indicated in either acute or chronic scapular pain and joint pain due to invasion of Wind, Cold and Damp with deficiency of Qi and Blood. Chuan Xiong Radix Ligustici Chuanxiong 10g, Hai Feng Teng Caulis Piperis Futokadsurae 10g and Sang Zhi Fructus Gardeniae 10g should be added to relieve the pain.
Stephania and Astragalus Decoction. This formula has properties which dispel Wind-Cold, eliminate Damp, promote the urination and subside the swelling. It is indicated invasion of Wind-Cold and Damp to the superficial layer of the body in beginning stage. Chuan Xiong Radix Ligustici Chuanxiong 10g, Hai Feng Teng Caulis Piperis Futokadsurae 10g and Sang Zhi Fructus Gardeniae 10g should be added to relieve the pain.
1. If there is extreme aversion to cold in the shoulder and scapular region, add Zhi Fu Zi Radix Aconiti Lateralis Praeparata 6g and Gan Jiang Rhizoma Zingiberis 10g to warm the channels and dispel Cold
2. If there is swelling in the scapular region, add Han Fang Ji Radix Stephania Tetrandrae 10g to dispel Damp and reduce the swelling
3. If there is severe limitation of shoulder movement, add Lu Lu Tong Fructus Liquidambaris 10g and Luo Shi Teng Caulis Trachelospermi 15g to harmonise the collateral and improve the shoulder movement
4. If there is severe scapular pain or aggravation of the pain at night, add Ru Xiang Resina Olibani 5g to promote the circulation of Blood and relieve the pain
5. If there is a very runny nose and cough, add Ma Huang Herba Ephedrae 10g and Zi Su Ye Folium Perillae 10g to dispel Wind-Cold and disperse the Lung-Qi.
Han Shi Bi Chong Ji Cold-Damp Bi Syndrome Infusion.
GB-20 Fengchi, LI-4 Hegu, TE-5 Waiguan, SI-4 Wangu, SI-10 Naoshu, SI-11 Tianzong, SI-14 Jianwaishu and BL-58 Feiyang. Reducing method is used on these points. Moxibustion should be applied on the local points and also on LI-4 and TE-5.
▪ GB-20 is the meeting point of the Gallbladder channel and the Yang Linking Vessel; TE-5 is the Connecting point of the Triple Burner channel and the point that connects with the Yang Linking Vessel. This vessel connects with all the Yang channels and dominates the superficial level of the body. Needling at GB-20 and TE-5 dispels Wind, eliminates Cold, promotes the function of the Triple Burner and eliminates Damp.
▪ LI-4, the Source point of the Large Intestine channel, dispels Wind and Cold, promotes sweating and eliminates Damp. LI-4 is also a very good point for promoting the circulation of Qi and Blood and relieving the pain.
▪ SI-4 and SI-7, the Source point and the Connecting point from the Small Intestine channel respectively, harmonise the collateral around the scapular regions and relieve the pain.
▪ SI-10, SI-11 and SI-14, all the local points, promote the circulation of Qi and Blood in the locality and relieve the scapular pain.
▪ BL-58, the Connecting point of the Bladder channel, harmonises the collateral and dispels Wind, Cold and Damp. This point is also very good for relieving the pain on the back.
▪ Moxibustion could warm the channels and collaterals, dispel the Cold, eliminate Damp and relieve the pain.
SI-3 Houxi, TE-14 Jianliao, TE15 Tianliao, BL15 Xinshu, BL-16 Dushu, BL-17 Geshu and BL-63 Jinmen, etc.
1. If there is much pain between the scapular regions, add BL-59, the Accumulation point of the Yang Heel Vessel, BL-40, the Sea point of the Bladder channel, and some local Ah Shi points, to harmonise the collateral, promote the circulation of Qi and Blood and relieve the pain
2. If the neck is stiff, add SI-3 and LU-7 to dispel External pathogenic factors and relieve the stiffness.
3. If there is tension and cramp in the scapular region, add Huahuojiaji points level with C5–C7 to relax the muscles and sedate the pain
4. If the pain worsens at night, add SP-6 and BL-17 to promote the circulation of Blood and alleviate the pain
5. If there is neck pain, add GB-21 to relieve the pain.
6. If there is a headache, add Extra Taiyang and Extra Yintang to harmonise the collateral and relieve the headache.
7. If there is a cough, add BL-13, the Back Transporting point of the Lung, to dispel Wind-Cold and relieve the cough.
A 58-year-old woman had been suffering from scapular pain for 3 weeks. At first she had a cold, infection, and was mainly suffering from throat pain, headache and generalised body pain together with a runny nose, a slight cough and a mild scapular pain on both sides of the body. She was given some herbs for her cold. Two days later, the general cold symptoms improved, but her scapular pain remained. Gradually this worsened over the next 2 weeks, and she often woke up at night.
When she arrived at the clinic, she had scapular pain mainly on the right side, which radiated along the Triple Burner channel with limitation of shoulder movement and was sensitive to cold and humidity, accompanied by a slight aversion to cold, headache in the occipital region, a stiff neck, a feeling of heaviness in the body generally, a thin, white and slightly greasy tongue coating and a superficial and tight pulse.
Scapular pain due to invasion of Wind-Cold-Damp.
Dispel Wind, eliminate Cold, dry Damp and circulate the collateral and sedate the pain.
GB-20, LI-4, TE-4, TE-5, TE-7, TE-14, SI-4, SI-7, SI-11 and SP-6. Reducing method was used on these points. The acupuncture treatment was given once every other day in order to achieve a quick result.
▪ Needling at GB-20 and TE-5 dispels Wind, eliminate Cold and promotes the Triple Burner’s function of eliminating Damp.
▪ LI-4, the Source, dispels Wind and Cold, promotes sweating and eliminates Damp. It is also a very good point for promoting the circulation of Qi and Blood and relieving pain.
▪ SI-4, the Source point, SI-7, the Connecting point, and TE-14 harmonise the collateral around the scapular regions and relieve the shoulder pain.
▪ SI-11, the local point, promotes the circulation of Qi and Blood in the locality and relieves the pain.
▪ SP-6, the crossing point of the three Yin channels of the foot, promotes the circulation of Blood and relieves the pain.
After two sessions of treatment, her scapular pain had much improved and she could sleep without waking up at night. Her general cold symptoms were also under control. After 2 weeks of treatment, the scapular pain had disappeared completely. During the treatment, she was advised to wear enough warm clothes. She did not take any painkillers during the treatment. Six months later, she was followed up by a letter and she replied that she had experienced no more pain since the acupuncture treatment.
Symptoms and signs are acute occurrence of sudden scapular pain with a burning sensation, or a pricking pain, or a sharp and constant pain, which is aggravated by exposure to warmth and damp, and alleviated by cold. Accompanying symptoms included sticky sweating, an aversion to cold, thirst, fever, a generalised feeling of heaviness in the body, a cough with expectoration of slightly yellow phlegm, dark and scanty urine, a red tip to the tongue and a thin and yellow coating, and a superficial and rapid pulse.
Dispel the Wind, dry the Damp, clear the Heat and arrest the pain.
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Disband Painful Obstruction Decoction. This formula clears the Heat, eliminates the Damp and relieves the pain, indicated in scapular pain due to invasion of Wind, Damp and Heat. However, its effect on pain relief is limited, so some other herbs should be added to the prescription, such as Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc.
Eliminate Wind Powder from True Lineage. This formula clears the Heat, eliminates the Damp and stops the itching. It is often used to treat itching; however, it can also be used to treat scapular pain by adding Jiang Huang Rhizoma Curcumae Longae 15g, Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc.
Disband Painful Obstruction Decoction. This formula has properties which dispel Wind, clear the Heat, eliminate the Damp, harmonise the collaterals and relieve the pain. Hai Tong Pi Cortex Erythrinae 15g and Sang Zhi Ramulus Mori 15g, etc., could be added to relieve the pain.
1. If there is severe scapular pain, add Chuan Xiong Rhizoma Ligustici Chuanxiong 10g to promote the circulation of Qi and Blood and relieve the pain
2. If there is a fever, add Huang Qin Radix Scutellariae 10g to clear the Heat and reduce the fever
3. If there is a burning feeling and swelling with formation of red spots or blisters in the scapular region, add Long Dan Cao Radix Gentianae 10g and Sheng Di Huang Radix Rehmanniae Recens 10g to dispel the Heat, remove the Toxin and reduce the swelling
4. If there is coughing with profuse phlegm, add Jie Geng Radix Platycodi 10g and Gua Lou Fructus Trichosanthis 12g to eliminate the Phlegm and relieve the cough
5. If there is a sore throat, add Da Qing Ye Folium Isatidis 10g to clear the Heat and relieve the throat pain.
Shi Re Bi Chong Ji Damp-Heat Bi Syndrome Infusion.
Feng Shi Xiao Tong Wan Wind-Damp Dispel Pain Pill.
GB-20 Fengchi, LI-4 Hegu, TE-6 Zhigou, SI-4 Wangu, SI-7 Zhizheng, SI-10 Naoshu, SI-11 Tianzong, SI-14 Jianwaishu, ST-40 Fenglong and SP-9 Yinlingquan. Reducing method is used on these points.
▪ GB-20, the meeting point of the Gallbladder channel and the Yang Linking Vessel, dispels Wind, clears Heat and relieves the External symptoms.
▪ LI-4 and TE-6 dispel the Wind and clear the Heat. They can also promote sweating so as to eliminate the Damp. LI-4 is also a very good point for promoting the circulation of Qi and Blood and relieving the pain.
▪ SI-4 and SI-7, the Source point and the Connecting point of the Small Intestine channel respectively, harmonise the collateral in the scapular region and relieve the pain.
▪ SI-10, SI-11 and SI-14, the local points, promote the circulation of Qi and Blood in the locality and relieve the pain.
▪ ST-40 and SP-9 dispel the Damp in the channels and in the body generally.
SI-2 Qiangu, SI-6 Yanglao, SI-12 Bingfeng, BL-60 Kunlun, BL-64 Jinggu and BL67 Zhiyin, etc.
