胁痛多属少阳，厥阴伤寒胁痛，皆在少阳胆经，以胁居少阳之部耳。杂症胁痛皆属太阴
肺经，以肺脉布于肝络耳。
胁与肋属肝胆部，肝主藏血又主怒。凝血成瘀疼痛加，郁怒不舒痛则布。怒痛且膨得嗳
宽，血痛不臌无时住。痛连胃脘挟宿食，右胁气滞湿痰注。逍遥四物小柴胡，朴果青砂二苏
（叶梗）附。热须黛（青黛）胆（胆星）痰芥星，健脾二陈亦可付。
肝郁胁痛
川楝子 山栀 橘叶 川连 茯苓 降香末 半夏 川斛 牡蛎 香附 夏枯花 白芥子
湿热壅滞胁痛
小温中丸
金不制木，咳血后胁痛
川贝母 杏仁 白蔻仁 枇杷叶 橘红 降香末
营络虚寒（重按得缓属阴络虚也）
桂 干姜 小茴香 大枣 归身 茯苓 炙甘草
寒入络脉，气滞胁痛（口吐涎沫，身发寒栗）
半夏 川楝子 吴萸 高良姜 茯苓 延胡索 蒲黄 荜茇
血络瘀痹（用辛泄宣瘀法）
陈参曰∶进食痛加大便燥结，久病已入血络。
桃仁泥 川楝皮 郁金 新绛 当归须 延胡索 丹皮 五加皮 山栀皮 柏子仁 冬桑叶 左牡蛎
肝肾阴亏（五心热，咽痛，左胁疼）
陈参曰∶宜甘缓理虚，温柔通补方法。
生地 天冬 柏子仁 人参 麦冬 生白芍
肝胃皆虚，胁痛
人参 枣仁 柏子仁 桂元 茯神 当归 花龙骨 金箔
胁痛兼痰饮
半夏 白蒺藜 钩藤 广皮 茯苓 白芥子 甘草
风入络胁痛（易饥吐涎）
生地 白芍 天冬 杞子 桃仁 阿胶 柏仁 丹皮 泽兰
胆络血滞胁痛（上吐下泻，春深寒热不止）
青蒿 郁金 元红花 丹皮 归须 泽兰叶
陈参曰∶治胁痛症不外仲景旋复花汤，河间金铃子散，以及辛温通络、甘缓理虚、温柔
通补、辛泄宣瘀等法。《内经》肝病三法，治虚
亦主甘缓，况病必伤阳明胃络，渐归及右，肝肾同病矣。当用甘味（人参、茯苓、甘草、大
枣）佐镇摄（金箔、龙骨）治之。
胁痛多归属于少阳经，厥阴伤寒引起的胁痛，也都属于少阳胆经的范畴，因为胁部位于少阳经所主的区域。杂病中的胁痛多归属于太阴肺经，因为肺脉分布于肝络之中。
胁部与肋部属于肝胆所主的部位，肝主藏血又主怒。血液凝滞形成瘀血则疼痛加剧，郁结愤怒导致气机不畅则疼痛扩散。因怒气引发的疼痛且伴有胀满，通过嗳气后可得缓解；因血瘀引发的疼痛则无胀满感，且疼痛持续不停。若疼痛牵连胃脘部并夹杂宿食停滞，多为右胁气机阻滞、湿痰注聚所致。治疗可选用逍遥散、四物汤或小柴胡汤，并辅以厚朴、枳实、青皮、砂仁及二苏（紫苏叶、紫苏梗）。若有热象需加用青黛、胆南星化痰清热，健脾祛痰也可使用二陈汤。
肝郁胁痛：川楝子、山栀、橘叶、川连、茯苓、降香末、半夏、川斛、牡蛎、香附、夏枯花、白芥子。
金不制木，咳血后出现的胁痛：川贝母、杏仁、白蔻仁、枇杷叶、橘红、降香末。
营络虚寒（重按后疼痛缓解，属于阴络虚损）：桂枝、干姜、小茴香、大枣、当归身、茯苓、炙甘草。
寒邪侵入络脉，气机阻滞导致的胁痛（口吐涎沫，身体发冷颤抖）：半夏、川楝子、吴茱萸、高良姜、茯苓、延胡索、蒲黄、荜茇。
血络瘀痹（采用辛散泄浊、宣通瘀血的方法）：
陈参说：进食后疼痛加重且大便干燥结硬，说明久病已深入血络。
桃仁泥、川楝皮、郁金、新绛、当归须、延胡索、丹皮、五加皮、山栀皮、柏子仁、冬桑叶、左牡蛎。
肝肾阴亏（五心烦热，咽痛，左侧胁痛）：
陈参说：宜用甘缓理虚、温柔通补的方法。
生地、天冬、柏子仁、人参、麦冬、生白芍。
肝胃皆虚导致的胁痛：人参、枣仁、柏子仁、桂圆、茯神、当归、花龙骨、金箔。
胁痛兼有痰饮：半夏、白蒺藜、钩藤、广皮、茯苓、白芥子、甘草。
风邪入络导致的胁痛（容易饥饿、吐涎沫）：生地、白芍、天冬、杞子、桃仁、阿胶、柏仁、丹皮、泽兰。
胆络血滞导致的胁痛（上吐下泻，春深时节寒热不止）：青蒿、郁金、元红花、丹皮、归须、泽兰叶。
陈参说：治疗胁痛症，不外乎张仲景的旋复花汤、刘河间的金铃子散，以及辛温通络、甘缓理虚、温柔通补、辛泄宣瘀等方法。《内经》中治疗肝病有三法，治疗虚证也主张甘缓之法，况且疾病必然损伤阳明胃络，逐渐波及右侧，导致肝肾同病。应当使用甘味药（人参、茯苓、甘草、大枣）配合镇摄药（金箔、龙骨）进行治疗。
Pain in the hypochondrium mostly belongs to the Shaoyang (Lesser Yang) channel. Hypochondriac pain caused by Jueyin (Terminal Yin) cold damage also falls under the Shaoyang Gallbladder channel, as the hypochondrium is located in the region governed by the Shaoyang. Hypochondriac pain from miscellaneous diseases mostly belongs to the Taiyin Lung channel, because the Lung meridian distributes into the Liver collaterals.
The hypochondrium and ribs belong to the regions of the Liver and Gallbladder. The Liver stores blood and governs anger. When blood coagulates and forms stasis, pain intensifies; when depression and anger cause Qi stagnation, pain spreads. Pain caused by anger accompanied by distension is relieved by belching; pain caused by blood stasis presents without distension and persists intermittently. If pain radiates to the epigastrium and is complicated by retained food, it indicates Qi stagnation and damp-phlegm accumulation in the right hypochondrium. Treatments may include Xiaoyao San (Free and Easy Wanderer Powder), Siwu Tang (Four Substance Decoction), or Xiao Chaihu Tang (Minor Bupleurum Decoction), supplemented with Houpo (Magnolia Bark), Zhishi (Immature Bitter Orange), Qingpi (Green Tangerine Peel), Sharen (Amomum Fruit), and Er Su Ye/Geng (Perilla Leaf/Stem). If heat is present, add Qingdai (Indigo Naturalis) and Danshenxing (Arisaema with Bile) to resolve phlegm and clear heat; for strengthening the Spleen and resolving phlegm, Erchen Tang (Two Aged Substances Decoction) may also be used.
Liver Qi Stagnation Hypochondriac Pain: Chuanlianzi (Toosendan Fruit), Shanzhi (Gardenia Fruit), Jiuye (Tangerine Leaf), Chuanlian (Coptis Rhizome), Fuling (Poria), Jiangxiang Mo (Sappan Wood Powder), Banxia (Pinellia Tuber), Chuanhu (Dendrobium Stem), Muli (Oyster Shell), Xiangfu (Cyperus Rhizome), Xiaku Hua (Prunella Flower), Baijiezi (White Mustard Seed).
Damp-Heat Obstruction Hypochondriac Pain: Xiaowenzhong Wan (Minor Warming the Middle Pill).
Metal Failing to Control Wood, Hypochondriac Pain after Hemoptysis: Chuanbeimu (Fritillaria Bulb), Xingren (Apricot Seed), Baokouren (Cardamom Seed), Pipaye (Loquat Leaf), Juhong (Aged Tangerine Peel), Jiangxiang Mo (Sappan Wood Powder).
Ying Collateral Deficiency-Cold (Pain relieved by deep pressure indicates deficiency of Yin collaterals): Guizhi (Cinnamon Twig), Ganjiang (Dried Ginger), Xiaohuixiang (Fennel Fruit), Dazao (Jujube), Guishen (Angelica Root Body), Fuling (Poria), Zhi Gancao (Honey-fried Licorice Root).
Cold Entering Collaterals with Qi Stagnation Hypochondriac Pain (Salivation, chills): Banxia (Pinellia Tuber), Chuanlianzi (Toosendan Fruit), Wuzhuyu (Evodia Fruit), Gaoliangjiang (Galangal Rhizome), Fuling (Poria), Yanhusuo (Corydalis Tuber), Puhuang (Pollen Typhae), Bibo (Long Pepper Fruit).
Blood Collateral Stasis and Obstruction (Use pungent methods to vent and promote blood circulation):
Chen Shen stated: Pain worsens after eating with dry stool, indicating that chronic disease has entered the blood collaterals.
Taoren Ni (Peach Kernel Paste), Chuanlian Pi (Toosendan Bark), Yujin (Curcuma Tuber), Xinjiang (New Crimson Silk/Dyed Fabric), Dangguixu (Angelica Sinensis Root Tip), Yanhusuo (Corydalis Tuber), Danpi (Moutan Cortex), Wujia Pi (Acanthopanax Bark), Shanzhi Pi (Gardenia Bark), Baiziren (Biota Seed), Dong Sangye (Mulberry Leaf), Zuo Muli (Left-sided Oyster Shell).
Liver and Kidney Yin Deficiency (Five-palm heat, sore throat, left hypochondriac pain):
Chen Shen stated: Sweet and mild methods to regulate deficiency and gentle tonification should be used.
Shengdi (Rehmannia Root), Tiandong (Asparagus Tuber), Baiziren (Biota Seed), Renshen (Ginseng Root), Maidong (Ophiopogon Tuber), Sheng Baishao (Raw White Peony Root).
Liver and Stomach Both Deficient Hypochondriac Pain: Renshen (Ginseng Root), Zaoren (Ziziphus Seed), Baiziren (Biota Seed), Guiyuan (Longan Aril), Fushen (Poria with Hostwood), Danggui (Angelica Sinensis Root), Hualonggu (Flower-coated Dragon Bone), Jinbo (Gold Foil).
Hypochondriac Pain Complicated by Phlegm-Fluid: Banxia (Pinellia Tuber), Baijili (Tribulus Fruit), Gouteng (Uncaria Ramulus cum Uncis), Guangpi (Tangerine Peel), Fuling (Poria), Baijiezi (White Mustard Seed), Gancao (Licorice Root).
Wind Entering Collaterals Hypochondriac Pain (Increased appetite, salivation): Shengdi (Rehmannia Root), Baishao (White Peony Root), Tiandong (Asparagus Tuber), Qizi (Goji Berry), Taoren (Peach Kernel), Ejiao (Donkey-hide Gelatin), Bairen (Biota Seed), Danpi (Moutan Cortex), Zelan (Lycopus Herb).
Gallbladder Collateral Blood Stasis Hypochondriac Pain (Vomiting and diarrhea, persistent alternating chills and fever in late spring): Qinghao (Artemisia Annua Herba), Yujin (Curcuma Tuber), Honghua (Carthamus Flower), Danpi (Moutan Cortex), Guixu (Angelica Sinensis Root Tip), Zelan Ye (Lycopus Leaf).
Chen Shen stated: Treatment of hypochondriac pain essentially involves Zhang Zhongjing's Xuanshouhua Tang (Inula Decoction), Liu Hejian's Jinlingzi San (Melianthus Powder), as well as pungent-warm methods to unblock collaterals, sweet-mild methods to regulate deficiency, gentle tonification methods, and pungent-vent methods to promote blood circulation. The *Neijing* outlines three methods for treating Liver diseases; for deficiency, it also advocates sweet-mild methods. Moreover, since the disease inevitably damages the Yangming Stomach collaterals and gradually affects the right side, leading to concurrent Liver and Kidney pathology, one should use sweet-flavored herbs (Renshen, Fuling, Gancao, Dazao) combined with sedating agents (Jinbo, Longgu) for treatment.