Disease and Condition Overview
Pruritus is characterized by itching of the skin. In Chinese medicine, it is caused by yin deficiency of liver and kidney, blood deficiency, wind dryness, malnourishment of the skin, wind dampness covering the skin, or the inability to disperse and reduce the qi. Clinically it is differentiated into general and local itching. Local itching is often related to irritation and allergic reactions. General pruritus is often related to chronic illness such as diabetes, liver and gallbladder diseases, uremia or malignant tumors. External causes can be related to work environment, changes in the weather or diet and medications. Clinically the disease should be differentiated from eczema, dermatitis, urticaria, scabies and seborrheic dermatitis.

Pair-point Treatment Combinations

(1) Wuyi (ST15), Zhiyin (BL67) (Fig 133)
Wuyi (ST15): on the chest, in the second intercostal space, 4 cun lateral to the anterior midline.
Zhiyin (BL67): on the lateral side of the distal segment of the little toe, 0.1 cun from the corner of the toenail.
Wuyi (ST15) dispels wind, stops itching, invigorates the luo-connecting channels and stops pain. Zhiyin (BL67) promotes, elevates and regulates qi. This pair point combination, one superior and one inferior, regulates qi and blood, clears heat, reduce fires, dispel wind and stops itching. This treatment is appropriate for all types of pruritus.

Needling techniques:
1. Wuyi (ST15) oblique insertion to a depth of 0.5 cun.
2. Zhiyin (BL67) oblique insertion to a depth of 0.1 cun.
3. Using moxa stick 15 minutes, or 5 sections.

(2) Hegu (LI4), Quehi (LI11) (Fig 7)
Hegu (LI4), the yuan-source point of the hand-yangming channel, dispels wind, clears heat and regulates qi and blood. Quchi (LI11), the he-sea point of the hand-yangming channel, dispels wind, releases the exterior, opens fu organs and stops itching. This pairing of the yuan-source point and he-sea point, working in synergy disperses and opens qi of the yangming channel and clears and disperses wind heat. This treatment is appropriate for genereal pruritus.

Needling techniques:
1. Hegu (LI4) perpendicular insertion to a depth of 1 cun.
2. Quchi (LI11) perpendicular insertion to a depth of 2 cun.
3. Needle reducing method.

(3) Jianyu (LI15), Quchi (LI11) (Fig 134)
Wuyi (ST15): on the chest, in the second intercostal space, 4 Cun lateral to the anterior midline.
Zhiyin (BL67): on the lateral side of the distal segment of the little toe, 0.1 cun from the corner of the toenail.
Jianyu (LI15): On the shoulder, in the depression anterior and inferior to the acromion when the arm is abducted.
Quchi (LI11): In the depression at the lateral end of the transverse cubital crease. Midway between Chize(LU5) and the lateral epicondyle of the humerus, when elbow is half flexed.
Jianyu (LI15) dispels wind, extinguishes pathogenic factors and regulates qi and blood. Quchi (LI11), the he-sea point of the hand-yangming channel, dispels wind, release the exterior, opens fu organs and stops itching. These two points promote qi and blood, dispel wind and stop itching. This treatment is appropriate for general pruritus caused by wind heat.

Needling techniques:
1. Jianyu (LI15) perpendicular insertion to a depth of 1.5 cun.
2. Quchi (LI11) perpendicular insertion to a depth of 2 cun.
3. Needle reducing method.

(4) Quchi (LI11), Xuehai (SP10) (Fig 135)
Quchi (LI11): In the depression at the lateral end of the transverse cubital crease, midway between Chize (LU5) and the lateral epicondyle of the humerus, when elbow is half flexed.
Xuehai (SP1O): with the knee flexed, on the medial side of the thigh, 2 cun above the superior medial corner of the patella, on the prominence of the medial head of the quadriceps muscle.
Quchi (LI11) dispels wind, releases the exterior and stops itching. Xuehai (SP10) invigorates blood, clears heat and cools blood. This pair point combination, one exterior and one interior, regulates qi and blood, dispels wind and stops itching. This treatment is appropriate for general pruritus caused by blood heat.

Needling techniques:
1. Quchi (LI11) perpendicular insertion to a depth of 2 cun.
2. Xuehai (SP1O) perpendicular insertion to a depth of 2 cun.

Commentaries
Acupuncture treatment of pruritus has excellent results.
Generally, it is important to select the appropriate pair-point combinations based on the syndromes.
For pruritus caused by wind heat, select Jianyu (LI15), Quchi (LI11).
For pruritus caused by blood heat, select Quchi (LI11), Xuehai (SP10).
The Wuyi (ST15), Zhivin (BL67) pair point combination is appropriate for all types of pruritus.
The Hegu (LI4), Quchi (LI11) pair point combination is appropriate for general pruritus.
In addition, it is crucial to advise patients against excessive scratching to prevent breaking the skin and causing infection.