鍼灸學（世界中醫學專業核心課程教材）

Luo Zhen (Stiff Neck) Luo Zhen is a condition characterized by sudden pain and restricted movement in the neck, primarily referring to acute simple neck stiffness and pain. It falls within the category of neck soft tissue injuries and is also known as "lost pillow" or "lost neck." In Western medicine, Luo Zhen is often seen in individuals with a history of cervical spondylosis or those who have experienced muscle protective contraction due to certain neck injuries and joint sprains. The occurrence of Luo Zhen is commonly associated with improper sleeping posture, inappropriate pillow height, excessive neck load, and invasion of wind-cold pathogenic factors into the neck and back. The underlying pathogenesis is damage to the sinews, acute contraction of the meridians, and obstruction of the flow of qi and blood. Whether it is improper posture, excessive load, or invasion of wind-cold, all can lead to acute contraction of the neck meridians and obstruction of the flow of qi and blood. The affected area of this disease is the neck sinews, which are closely related to the Du Meridian, the hand and foot Taiyang meridians, and the foot Shaoyang meridian. Key Points for Syndrome Differentiation • Main Symptoms: Stiffness and pain in the neck, restricted movement, and obvious tenderness in the nape or neck and shoulder area. • Du Meridian and Taiyang Meridian Type: Severe pain in the nape and back, which worsens when bending the head forward, with obvious tenderness in the nape and back. • Shaoyang Meridian Type: Pain in the neck and shoulder area, with the head tilted to the affected side, and obvious tenderness in the neck and shoulder area. Treatment 1. Basic Treatment • Therapeutic Principle: To dredge the meridians, relax the sinews, and relieve pain. Acupuncture is mainly applied to local acupoints, combined with distal acupoints along the meridians. • Main Acupoints: Ah Shi points, Tianzhu (BL10), Houxi (SI3), Xuanzhong (GB39), and Wailaogong. • Supplementary Acupoints: For the Du Meridian and Taiyang Meridian type, add Dazhui (GV14) and Shugubone (BL11); for the Shaoyang Meridian type, add Fengchi (GB20) and Jianjing (GB21). • Formula Explanation: The foot Shaoyang and hand Taiyang meridians run through the neck area. Xuanzhong and Houxi belong to these two meridians respectively. Combined with local Tianzhu and Ah Shi points, the combination of local and distal acupoints can regulate the flow of qi and blood in the neck meridians, relax the sinews, and relieve pain. Wailaogong, also known as the "stiff neck point," is an empirical acupoint for treating this condition, with the functions of activating blood circulation, dredging the meridians, and relieving spasms and pain. • Manipulation: Insert the needle vertically into Tianzhu by 1 transverse finger width, Houxi by 0.5 transverse finger width, Xuanzhong by 0.5 transverse finger width, Wailaogong by 0.5 transverse finger width, and Ah Shi points by 1 transverse finger width. Use the twisting and discharging method. First, insert the distal acupoints and continue to twist the needle while instructing the patient to slowly move the neck. The pain can usually be relieved immediately. Then, insert the local acupoints and apply moxibustion or bloodletting if necessary. 2. Other Treatments • Digital Acupuncture: Select the Chengshan (BL57) on the affected side. The physician uses the thumb to press deeply until a local soreness and distension is felt. While pressing, instruct the patient to move the neck. This method is suitable for the initial stage of the disease. • Auricular Acupuncture: Select the neck, cervical vertebrae, and Shenmen points. Use moderate stimulation with filiform needles and instruct the patient to slowly move the neck area while continuously manipulating the needles. • Cupping Therapy: Select Dazhui (GV14), Jianjing (GB21), Tianzong (SI11), and Ah Shi points. For severe pain, bloodletting cupping or sliding cupping can be performed.

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