顳下頜關節功能紊亂的針灸治療

Category: Head, Face & Limb Disorders｜頭面肢體病症

The temporomandibular joint, or TMJ, is one of the most active joints in the human body. It allows us to talk, eat, and express emotions — but because of its frequent movement, it is also easily strained or misaligned.

顳下頜關節（TMJ）是人體活動最頻繁的關節之一，主掌說話、咀嚼、吞嚥與表情動作，但因長期活動頻繁，也最容易受到壓力或結構錯位影響。

When the TMJ becomes tight or misaligned, patients may experience jaw pain, clicking sounds, stiffness, or difficulty opening the mouth.

當顳下頜關節緊繃或錯位時，患者常會出現下頜疼痛、彈響聲、肌肉僵硬或開口受限等問題。

From a Traditional Chinese Medicine (TCM) point of view, this condition is often related to stagnation of Qi and blood in the meridians around the jaw.

在中醫理論中，這屬於氣血運行不暢、經絡受阻的表現。

External cold, muscle fatigue, emotional tension, or old injuries may block these channels, leading to pain and restricted movement.

外感風寒、肌肉勞損、情志緊繃或舊傷未癒，都可能造成經絡受阻，引起疼痛與活動障礙。

Common Symptoms

常見症狀

• Limited mouth opening or jaw stiffness 張口受限或下頜僵硬
• Pain or clicking when chewing or talking 咀嚼或說話時疼痛、彈響
• Tight facial or neck muscles 面部或頸部肌肉緊繃
• Headache, dizziness, tinnitus, or ear discomfort 頭暈、頭痛、耳鳴或耳悶

In TCM, this disorder is sometimes called “Mouth lock” (口噤不開) or “Jaw pain” (頜痛), caused by wind-cold invasion or Qi stagnation.

中醫稱之為「口噤不開」或「頜痛」，多由風寒侵襲、氣血瘀滯所致。

Treatment Principles

治療原則

When treating TMJ disorders with acupuncture, the goal is to release stagnation, restore circulation, and relax the tendons around the jaw.

針灸治療此病的核心，是疏通氣血、放鬆筋脈、恢復關節靈活度。

“When the meridians are open, pain is gone.”

「經絡通則不痛。」

Practically, the treatment combines warming, unblocking, and harmonizing methods to help the body regain balance.

實際操作中，常結合溫通與補瀉並用，使身體自我修復機能得以發揮。

Key Acupuncture Points

主要取穴

1. Taiyang (EX-HN5)

Located one finger-width behind the outer corner of the eye, Taiyang is a classical point for headache, facial pain, and TMJ tension.

太陽穴位於眉梢與目外眥之間向後約一橫指凹陷處，是治療頭痛、顳部緊繃及顳下頜疼痛的重要穴位。

Gentle needling or light bleeding can relieve pressure and clear local stagnation.

可用輕刺或點刺放血，以疏通氣血、舒緩壓力。

2. Fire Main and Fire Hard (火主穴、火硬穴)

These two Tung’s points are on the dorsum of the foot between the first and second metatarsal bones.

這兩個董氏奇穴位於足背第一、第二跖骨之間。

Fire Hard is closer to the toe joint, and Fire Main is about one inch above it.

火硬穴靠近趾關節，火主穴在其上一寸。

They are particularly effective for joint tension and difficulty opening the mouth because they belong to the Liver channel, which governs the tendons.

屬於肝經（肝主筋），對關節緊繃與張口困難特別有效，可放鬆筋脈並改善協調。

3. Four Flowers Upper (四花上穴)

Located three cun below the knee, lateral to the tibia.

位於膝眼下三寸、脛骨外側陷中。

This point regulates Qi and blood and is often used in chronic or fatigue-type TMJ cases.

此穴能調理氣血，對慢性或虛弱型顳下頜關節病例尤為適用。

4. Spirit Bone and Door Golden (靈骨穴、門金穴)

Spirit Bone is on the dorsum of the hand near the second metacarpal, while Door Golden is on the dorsum of the foot between the second and third metatarsal bones.

靈骨穴位於手背第二掌骨附近，而門金穴位於足背第二、第三跖骨連接部之前方凹陷中。

Needle Door Golden 1–1.5 cun deep (or 0.5 cun with a fine needle for strong effect).

門金穴針深約一至一寸半，細針刺入五分時常有特效。

Traditionally, Door Golden is used for abdominal disorders such as gastritis and appendicitis, but when paired with Fire Main, it can relieve TMJ tension and facial tightness.

雖原用於腸胃疾患（如腸炎、盲腸炎），但臨床上與火主穴配合，對顳下頜關節紊亂與面部緊繃特別有效。

⚠️ Do not needle both feet simultaneously.

⚠️ 禁雙腳同時取穴。

Together, Spirit Bone and Door Golden harmonize Qi flow between the limbs and head, easing facial muscle tightness.

靈骨與門金合用，能通暢頭面部氣血，放鬆緊張肌肉。

Clinical Observation

臨床觀察

A case from Clinical Essence of Tung’s Extraordinary Points described a female patient who couldn’t open her mouth for months.

《董氏奇穴臨床治療精華》記載一名女性患者，張口受限數月。

After one treatment using Spirit Bone and Fire Main, her jaw loosened and pain subsided within minutes.

以靈骨穴與火主穴針治一次後，幾分鐘內疼痛緩解、開口幅度明顯增大。

This case reflects Tung’s principle of “treat bone with bone.”

此案體現董氏針法「以骨治骨」之理：

When the problem lies in the joints, distal bony points can mirror and rebalance the affected area.

當病位於骨或關節時，遠端骨旁取穴，可起到反射與調衡作用。

Practical Advice

臨床建議

• Avoid excessive mouth opening or chewing hard food. 避免過度張口與咀嚼堅硬食物。
• Relax the jaw and neck; don’t clench for long periods. 放鬆下頜與頸部肌肉，避免長時間緊咬。
• Keep the face warm, avoid cold wind. 注意面部保暖，防止風寒侵襲。
• Maintain correct posture while reading or working. 維持正確姿勢，避免長時間低頭。
• Good lifestyle habits enhance acupuncture results and prevent relapse.良好生活習慣能強化針灸療效並預防復發。

Reference｜參考文獻

Yang Chao-Tang & Yang Ya-Shui, Clinical Essence of Tung’s Extraordinary Points.

楊朝棠、楊雅冰．《董氏奇穴臨床治療精華》。

Written by / 撰文： Jade Wei-Yu Liao, R.Ac.

Jade Health Acupuncture — Registered Acupuncturist in Vancouver Downtown on Burrard

位於溫哥華市中心 Burrard 的註冊針灸師診所