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.