This study explores the diagnosis and treatment of needle knife therapy for ankylosing spondylitis (AS) at middle and advanced stage based on the theory of meridian tendons, from a holistic perspective and syndrome differentiation. The treatment strategy includes "harmonizing yin and yang" to address root causes and "tendons-based release" to harmonize qi and blood, with the "tendons nodule points" as the core acupoint selection criterion. Based on this approach, the study systematically elaborates on two needle knife methods for AS: "governor vessel bone-piercing technique" and "below-the-umbilicus release technique", covering indications, acupoint location, and procedures. Clinical case examples are provided to enrich needle knife therapy guided by the theory of meridian tendons, offering insights for clinical and research work on AS.
基于经筋理论，从整体观念及辨证论治的角度对针刀疏筋解结术治疗中晚期强直性脊柱炎（AS）的诊疗思路进行探讨。其诊治思路为“调和阴阳”以治病求本、“循经解结”以调和气血，将“结筋病灶点”作为循经辨点取穴的核心。以此为基础，系统阐述了AS的两大针刀治法，即“督脉经筋刺骨术”“脐下营解结术”的适应证、定点及操作，并举隅临床案例，以期丰富经筋理论指导下的针刀疗法，为AS的临床和科研工作提供思路。.
Keywords: ankylosing spondylitis; below-the-umbilicus; governor vessel; needle knife therapy; theory of meridian tendons.