What is Zhi Gou (TE6) used for?

Zhi Gou is best known for treating constipation, especially the type driven by sluggish Qi movement rather than dryness. It is also a key point for rib-side (hypochondrial) pain and distension, intercostal neuralgia, and chest tightness. It is one of the most frequently used points on the Triple Energizer meridian.

How do I locate Zhi Gou?

Zhi Gou lies on the back of the forearm, on the line between the ulna and radius, about 4 cun (four finger-widths, measured with your own fingers) up from the wrist crease toward the elbow. Feel for a slight tender spot in the groove between the two bones. Pressing it gently often reproduces a mild ache or radiating sensation.

Zhi Gou (支沟 TE6): The Triple Energizer Point for Constipation and Rib-Side Pain

The “Branch Ditch” on the Triple Energizer Meridian

Zhi Gou (支沟, TE6), meaning “Branch Ditch,” sits on the Triple Energizer (San Jiao) meridian of the hand Shao Yang. Among the 361 classical acupuncture points, Zhi Gou holds a special reputation as the foremost point for constipation — and more broadly, for anywhere Qi is stuck and needs to be unblocked.

The Triple Energizer meridian governs the body’s fluid passages and the movement of Qi across the three burners (chest, middle abdomen, lower abdomen). Because constipation is often not a problem of “dry stool” but of stuck Qi failing to push, a point that mobilizes Triple Energizer Qi is precisely what is needed. This is why Zhi Gou works so well for the sluggish, Qi-stagnation type of constipation that affects stressed, busy people.

Location

Meridian: Triple Energizer (手少阳三焦经), TE6
Location: On the dorsal (back) forearm, on the line connecting the ulna and radius, 4 cun proximal to the dorsal wrist crease, in the groove between the two bones.
Method to find it: Lay your forearm palm-down. Measure four of your own finger-widths (cun) up from the wrist crease along the forearm. Feel in the valley between the radius (thumb side) and ulna (little-finger side) for a tender point — that is Zhi Gou.

Note: Cun (寸) is a proportional measurement based on your own finger width, so the measurement adapts to each body. Use the width of your own thumb (1 cun) or the four fingers held together (3 cun) plus a bit more.

Classical Actions

Action	Application
Regulates Qi and unblocks the intestines	Constipation (especially Qi-stagnation type)
Moves Qi and clears the channels	Rib-side (hypochondrial) pain, distension, intercostal neuralgia
Diffuses and descends Lung/Stomach Qi	Chest oppression, hiccup, tinnitus, deafness
Relaxes tendons	Stiffness and pain in the forearm and elbow

Why It Works So Well for Constipation

In TCM, constipation has several patterns — heat, dryness, deficiency, cold, and Qi stagnation. Zhi Gou targets the Qi-stagnation pattern, which is extremely common in modern life.

Signs of Qi-stagnation constipation:

Stools that are not necessarily dry or hard, but difficult to pass
A feeling of incomplete emptying
Abdominal distension and fullness, often worsening with stress
Symptoms that fluctuate with mood — worse when tense, better when relaxed
Frequent belching or sighing

This is the “stuck” type of constipation — the stool is there, but the Qi is not pushing. Zhi Gou mobilizes that stuck Qi across the Triple Energizer, restoring the downward movement the intestines need. It is often combined with points like Tian Shu (ST25) and Zu San Li (ST36) for a complete approach.

Clinically, acupressure on Zhi Gou is a popular and accessible self-care technique for occasional constipation — press firmly and hold for 1–2 minutes on each side.

Other Major Uses

Rib-Side and Hypochondrial Pain

Because the Triple Energizer meridian travels along the side of the body and chest, Zhi Gou is a classic distal point for pain, distension, or tightness along the ribs — including intercostal neuralgia and the rib-side discomfort that comes with stress and Liver Qi stagnation.

Chest Tightness and Hiccup

By helping Qi descend and move freely, Zhi Gou is used for chest oppression, a feeling of “something stuck in the chest,” and stubborn hiccups.

Tinnitus and Hearing

The Triple Energizer meridian travels to the ear, so Zhi Gou is sometimes used as a distal point for tinnitus or sudden hearing changes, particularly when tied to stress or Qi stagnation.

Common Combinations

Combination	Purpose
Zhi Gou + Zu San Li (ST36) + Tian Shu (ST25)	Functional constipation, abdominal distension
Zhi Gou + Yang Ling Quan (GB34)	Rib-side pain, hypochondrial distension
Zhi Gou + Nei Guan (PC6)	Chest tightness, palpitations, stress
Zhi Gou + Tai Chong (LR3)	Stress-related digestive and chest symptoms

Needling and Technique

Needling: Perpendicular, 0.5–1 cun depth. De Qi sensation often radiates up or down the forearm.
Acupressure: Press firmly with the thumb for 1–2 minutes per side, twice daily, for mild constipation or rib discomfort.
Moxibustion: May be applied, particularly for cold-type Qi stagnation.

Precautions

Pregnancy requires caution with abdominal and Qi-moving points; Zhi Gou is generally less restricted than points like He Gu or San Yin Jiao, but pregnant patients should consult a practitioner before use.
Persistent or severe constipation, blood in the stool, or sudden changes in bowel habits warrant medical evaluation — acupuncture is not a substitute for ruling out serious disease.

Key Takeaways

Zhi Gou (TE6) is the leading point for Qi-stagnation constipation — the stuck, stress-related type
It also treats rib-side pain, hypochondrial distension, chest tightness, and hiccups
Located 4 cun up from the wrist crease, between the radius and ulna on the back of the forearm
Easily used as acupressure self-care for occasional constipation
Often combined with Tian Shu and Zu San Li for digestive motility

Disclaimer: This article is for educational purposes only. Consult a licensed acupuncturist or physician for clinical treatment.