TCM Acupuncture and Massage

Chapter 30 Common Acupuncture and Moxibustion Methods (1)
Ancient Chinese people used acupuncture and moxibustion methods for health care and physical fitness long ago.In the "Huangdi Neijing", doctors who master acupuncture and health care technology are called "Shanggong", and in "Lingshu·Nishun", it is said: "Shanggong stabs the unborn." By the Tang Dynasty, acupuncture and moxibustion health care had occupied a considerable position , For example, in "A Thousand Golden Prescriptions", it discusses many materials used in acupuncture and moxibustion for health care.In the "Acupuncture and Moxibustion Zisheng Jing" written by Wang Zhizhong in the Song Dynasty, it is recorded that acupuncture can be used to prevent various diseases, such as pricking and purging the damper arm without carbuncle and so on.Physicians in the Ming Dynasty also advocated acupuncture and moxibustion for health care. Gao Wu said in "Acupuncture and Moxibustion": "If you are not sick, acupuncture and moxibustion will go against the sun first. If you go against it, you will welcome it before it arrives." Against, that is, the meaning of disease prevention.In the book "Health Requirements", Pan Weiru in the Qing Dynasty also expounded the health care function of acupuncture. He said: "People's viscera, meridians, blood, qi, and muscles are careless every day, and external evils are dry. The ancients used acupuncture as the basis. …so sharpen the joints and qi and blood, so that the evil will be eliminated quickly, the evil will be eliminated and the righteousness will recover, and the righteousness will recover and the disease will heal itself.”

Therapeutic effects of acupuncture

[-]. Harmonize Yin and Yang

"Lingshu Genjie" said: "The key to using acupuncture is to know how to adjust yin and yang, and to adjust yin and yang. Essence and qi are light, and form and qi are combined to make the spirit hidden." role.And this effect is accomplished through the combination of meridians and acupoints and acupuncture.For example, headaches caused by deficiency of kidney yin and hyperactivity of liver yang should be treated by nourishing yin and subduing yang. Acupuncture at the points of the Foot-Shaoyin Meridian can be used as a tonic method, and acupuncture at the points of the Foot-Jueyin Meridian can be used as a purging method.Another example is the excess of yang qi and deficiency of yin qi can lead to insomnia; the excess of yin qi and deficiency of yang qi can cause drowsiness. Both of them can be treated with the Zhaohai of yin qi and the Shen pulse of yang qi. Drowsiness should nourish yang and relieve yin.

Second, strengthening the body and eliminating evil

Reinforcing the body, aiding disease resistance; dispelling evil, eliminating pathogenic factors.The process of the occurrence, development and outcome of the disease is the process of the struggle between righteousness and evil.

"Su Wen · Acupuncture Theory": "There is righteousness inside, and evil cannot be done." "Suwen Commentary on Febrile Diseases": "When the evil gathers, its qi must be deficient."It shows that the occurrence of diseases is caused by the relative inferiority of healthy qi and the relative superiority of evil qi.If the righteous energy is strong, the evil energy will not be enough to cause disease; if the righteous energy is weak, the evil energy will take advantage of the deficiency to invade and cause disease.

Acupuncture and moxibustion to treat diseases lies in its ability to strengthen the body and eliminate pathogenic factors.Generally, acupuncture and moxibustion have the effect of strengthening the body; acupuncture and purging method and bloodletting have the effect of dispelling evil, but the specific application must be considered in conjunction with the characteristics of acupoints.For example, acupoints such as Gaohuang, Qihai, and Mingmen are mostly used for strengthening the body; Shixuan, Zhongji, and Renzhong are mostly used for dispelling evil.In addition, it is also necessary to distinguish the priority of the specimens of the disease according to the transformation of the growth and decline of the evil and the right, and randomly apply the rules of strengthening the health and eliminating the evil.Otherwise, it will not be able to achieve the expected curative effect, and even cause adverse consequences.

[-]. Dredge the meridians

The meridians of the human body "belong to the viscera inside, and connect to the limbs outside".The distribution of the twelve meridians, the yang meridian is on the surface of the limbs and belongs to the six internal organs; the yin meridian is in the four limbs and belongs to the five internal organs, and through the connection of the fifteen collaterals, it communicates with the exterior and the interior, forming a pathway for the circulation of qi and blood. Viscera and internal organs, externally moistening the interstitial muscles", maintaining normal physiological functions.

In terms of pathology, the meridians and viscera are also closely related.If the disease starts from the outside, the meridian first becomes ill and then spreads to the viscera; if the disease arises from the inside, the viscera first becomes ill and then can be reflected in the meridian.For example: Taiyang typhoid, the meridian syndrome of pain in the head, neck, back and back appears first, and then the viscera syndrome.Another example is appendicitis, cholecystitis, abdominal pain and hypochondriac pain, and tenderness points can be found near the lower He acupoint.The origin of these diseases is the result of some pathogenic factors causing the Qi and blood in the meridians and viscera to be more deficient and more abundant.

Acupuncture and moxibustion treatment is to perform acupuncture or moxibustion on acupoints according to the physiological and pathological interaction mechanism of meridians and viscera, so as to achieve the effect of "opening the meridians and regulating blood qi", thereby eliminating pathological factors and curing the disease.

acupuncture
Acupuncture with filiform needles refers to a method of stimulating acupoints and other parts of the human body with filiform needles to prevent and treat diseases.The filiform needling method is the main body of acupuncture therapy and is the most widely used in clinical practice. It is the basic technique that must be mastered in acupuncture and moxibustion.

Acupuncture health care is to stimulate certain acupoints of the human body with fine needles to stimulate the qi of the meridians and make the metabolism of the human body vigorous, so as to achieve the purpose of strengthening the body and prolonging life.This kind of health care method is acupuncture health care.

Although the methods of acupuncture health care and acupuncture treatment are basically the same, the focus is different. Acupuncture treatment focuses on correcting the body's yin and yang, and the partial decline of Qi and blood, while acupuncture health care focuses on strengthening the body and improving the body's metabolism Ability to preserve health and prolong life.It is precisely because the focus of the two methods are different that there are also certain differences in the selection of acupoints and the use of needles.If it is used for health care, the stimulation intensity of acupuncture manipulation should be moderate, and the selection of acupoints should not be too many, and the acupoints with strong effects should be the main ones.

[-]. The structure and specifications of the filiform needle
([-]) The structure of the needle
Structure of Filiform Needles Most of the clinically used filiform needles are made of stainless steel, and they are also made of gold, silver or alloys.The structure of the filiform needle is divided into five parts: the needle tip, the needle body, the needle root, the needle handle, and the needle tail.The sharp part of the needle is called the needle point, also known as the needle awn; the main part between the needle handle and the needle point is called the needle body, also known as the needle body; the part connecting the needle body and the needle handle is called the needle root; the needle body The part that holds the needle after the root of the needle is called the needle handle; the end part of the handle is called the needle tail.The needle handle and needle tail are mostly wound with copper wire or silver wire, and are in the shape of a spiral or a cylinder. The shapes of the needle handle include ring handle, flower handle, flat handle and pipe handle.

([-]) Specifications of filiform needles The specifications of filiform needles are distinguished by the thickness and length of the needle body.

[-]. Acupuncture practice

Acupuncture practice mainly exercises finger strength and techniques.

([-]) Finger exercises

Practice mainly on paper pads or cotton balls.Use soft paper, fold a piece of paper with a length of 8cm, a width of 5cm, and a thickness of 2cm to 3cm, tie it tightly with a thread like a "well" to make a paper pad, or take a ball of cotton, wrap it with cotton thread, and tighten it Loosen the inside, make a ball with a diameter of about 6cm to 7cm, and wrap it with a layer of white cloth to sew it to practice needles.When practicing acupuncture, hold the paper pad flat with the left hand, hold the needle handle with the thumb, food, and middle three fingers of the right hand, and hold a 1-1.5-inch needle as if holding a pen, so that the needle tip is vertically against the paper block, and then the thumb of the right hand is aligned with the food, food, and middle fingers. Twist the needle handle alternately with the middle finger, and gradually add a certain amount of pressure. After the needle penetrates the paper pad, change to another place, and practice repeatedly.When practicing with cotton balls, because the cotton balls are soft, you can practice the simulated actions of lifting and inserting, twisting, inserting and withdrawing needles, etc.For lifting and inserting practice, hold the needle in the pen-holding style, pierce the needle into the cotton ball, and lift and insert at the original place. It is required that the depth is appropriate, the width is uniform, and the needle body is vertical.

([-]) Technique exercises

Acupuncture manipulation exercises are carried out on the basis of finger force exercises, and mainly include the following types:

1. Quick needling practice This method is to cut with the claw of the left thumb and index finger, and hold the needle in the right hand, so that the needle tip penetrates 2-3mm quickly, and practice repeatedly to master the speed of needle insertion and reduce pain.

2. Twisting practice Twisting is to hold the needle with the thumb, index, and middle finger of the right hand. After piercing, the thumb, index, and middle finger rotate back and forth in the same place forward and backward.The angle of twisting is required to be uniform, flexible to use, and fast and slow freely.

3. Lifting and inserting practice To lift and insert is to hold the needle with the thumb, index and middle finger of the right hand.It is required that the depth of lifting and insertion is appropriate, and the needle body is vertical without deflection.

To a certain extent, the three methods can be combined and practiced to make them into one.

([-]) Self-practice

After you have mastered a certain amount of finger force and technique by practicing needling with paper pads and cotton balls, you can practice needling on your own body to experience the strength of finger force, the feeling of needling, and the technique of needling.When practicing acupuncture, one can gradually achieve painless or slightly painful needle insertion, straight needle body without bending, smooth insertion, free lifting, insertion and twisting, even finger force, and skillful technique.At the same time, carefully understand the relationship between finger force and needle insertion, technique and deqi, as well as the feeling of the finger holding the needle and the feeling of the punctured part.

[-]. Preparation before acupuncture

([-]) Needle selection
The selection of needles should be based on the patient's gender, age, fatness and thinness of the body, the lesion site and the specific location of the acupoints to be selected, and the needles with appropriate length and thickness should be selected.For men, strong, fat, and deep lesions, you can use slightly thicker and longer needles; on the contrary, for women, weak, thin, and shallow lesions, you should use shorter and thinner needles Tool.Clinically, the length of needles should be selected according to the specific location of the acupuncture points used. Generally, for thin skin and less flesh and shallow acupuncture points, shorter and thinner needles should be selected; Longer and thicker needles should be used for deep acupoints.The length of the selected needle should be greater than the depth to be inserted into the acupoint so that part of the needle body is exposed on the skin after the needle is inserted.If it should penetrate 0.5 inches, a 1-inch needle can be used; if it should penetrate 1 inch, a 1.5-inch needle can be used.

([-]) Body position selection
Choosing an appropriate body position is of great significance to the correct positioning of acupoints, the operation of acupuncture, the improvement of therapeutic effect, and the prevention of abnormalities in acupuncture.For newly diagnosed patients who are mentally stressed, or those who are seriously ill and infirm, acupuncture in the sitting position is prone to needle fainting, and acupuncture in the supine position is generally used.If the patient is in an uncomfortable position, abnormal situations such as bent needles, stuck needles or even broken needles are often caused by moving the position.The commonly used body positions for acupuncture in clinic are as follows.

1. The supine position is suitable for taking acupoints on the anterior body (head, face, neck, chest and abdomen, front of limbs), such as Yintang, Baihui, Tanzhong, Zhongwan, Zusanli and other points.

2. The side lying position is suitable for taking acupoints on the side of the body (side head, side ribs, side waist, buttocks, sides of the limbs), such as Touwei, Taiyang, Xiaguan, Shoulder Skull, Waiguan, Fengshi, Yanglingquan, etc. hole.

3. The prone position is suitable for taking acupoints from the back of the body (head and neck, back, waist, buttocks, back of the lower limbs), Baihui, Fengfu, Fengchi, Dazhui, Beishu, Chengfu, Weizhong, Xuanzhong, etc. hole.

4. Sitting on the back is suitable for taking some acupoints on the head, face, neck, chest, and limbs, such as Shangxing, Yintang, Tiantu, Jianku, Quchi and other acupoints.

5. Sitting on the side is suitable for taking some acupoints on the side of the head, cheeks, ears, side of the neck, and upper limbs, such as Touwei, Taiyang, Fengchi, Jacara, Tinggong and other acupoints.

6. Sitting prone is suitable for taking some acupoints on the top of the head, back of the head, neck, shoulders, back, and upper limbs, such as Fengchi, Fengfu, Jianjing, Tianzong, Beishu and other acupoints.The body position should be selected clinically based on the principles of accurate acupoint selection by the doctor, convenient operation, natural comfort for the patient, and long-lasting needle retention.Also note:
For those with mobility impairments, the position that is convenient for acupoint selection should be selected according to the patient's own body position; for those who are newly diagnosed, mentally stressed, old, weak, or seriously ill, it is best to choose the supine position to prevent fainting; when selecting acupoints for prescription Body position should be taken into consideration, and one body position should be used for acupoint selection as much as possible.

([-]) Disinfection

Disinfection must be done well before acupuncture, including disinfection of needles, acupoints and fingers of the user.As a health acupuncture, the needles can be sterilized by boiling, that is, the needles are wrapped with gauze, put into a pot of clean water and boiled. Generally, the purpose of disinfection can be achieved by boiling for 15 to 20 minutes after the water is boiled.It can also be sterilized with drugs, that is, place the needle in 75% alcohol, soak it for 30 minutes, take it out and wipe it dry for application.Disposable sterile acupuncture needles are often used in modern clinical practice.

For the acupuncture points, generally use 75% ethanol cotton balls on the skin of the acupuncture points to be punctured, and wipe and disinfect from the center to the periphery; or first rub 2% iodine tincture, and then wipe with 75% ethanol cotton balls to remove iodine after a little dry.After the acupoint skin is disinfected, avoid contact with dirt to prevent re-pollution.The finger of the needle applicator should be washed with clean water and wiped with 75% alcohol cotton ball before acupuncture.

Fourth, the needling method
The needling method refers to the operation method of inserting a filiform needle into the subcutaneous point of an acupoint.When operating filiform needles, the doctor's hand holding the needle is generally called the "stabbing hand", which is mostly the right hand; the hand that presses the acupuncture points is called the "push hand", which is mostly the left hand.The needle-holding posture is mainly to hold the needle handle with the thumb, index, and middle three fingers, and the pulp of the thumb is opposite to the pulp of the index and middle fingers, which looks like holding a brush.

([-]) One-handed needle insertion
The method of inserting the needle into the acupuncture point only with the pricking hand.There are many methods of one-handed needle insertion, the following two are mainly introduced here:

1. Holding the handle of the needle to enter the acupuncture method Hold the lower part of the lower handle of the needle with the pulp of the thumb and index finger of the right hand, and the pulp of the middle finger is close to the side of the needle body, relying on the flexion and extension of the joints of the thumb and index finger to insert the needle into the acupuncture point.Suitable for needle insertion of short needles.

2. Holding the needle body and inserting the acupuncture method Hold the lower end of the needle body with the thumb and forefinger of the right hand, with the needle tip exposed for two or three points, aim at the acupoint, and quickly penetrate the acupoint with finger force and wrist force.Both long and short needles can be inserted using this method.In addition, the thumb and index finger can be used to hold the needle body, the middle finger pad is close to the lower end of the needle body, and the needle tip is exposed for two or three points. When the needle tip reaches the acupoint, use finger force and wrist arm strength to quickly penetrate the needle into the acupoint.This method is also applicable to needles of various specifications.

([-]) Needle insertion with both hands
A method in which the pricking hand and the holding hand cooperate to pierce the needle.There are 4 commonly used methods:
1. Finger-cutting needle method Cut and pinch the acupoint on the thumbnail of the left hand, hold the needle in the right hand, and insert the needle into the acupoint close to the surface of the nail of the left hand.Suitable for needle insertion of short needles.

2. Clamping acupuncture method Hold the sterile dry cotton ball with the thumb and forefinger of the left hand to pinch the lower end of the needle body. The needle tip is exposed for two or three points and fixed on the skin surface of the acupuncture point. Hold the needle handle in the right hand, cooperate with both hands, and press down with the left hand. Twist the right hand to insert the needle into the acupuncture point.Suitable for needle insertion with long needles.

3. Stretching acupuncture method: stretch the skin of the acupoint to both sides with the thumb and index finger of the left hand to make it taut, hold the needle in the right hand, and pierce the needle from the middle of the thumb and index finger of the left hand.It is suitable for acupuncture at acupoints on loose skin.

4. Lifting and pinching needle method: pinch the skin of the acupuncture site with the thumb and index finger of the left hand, hold the needle in the right hand, and pierce from the upper end of the pinched site.It is suitable for needling at acupoints in the superficial parts of the skin and flesh.

([-]) Needle insertion method
Use the needle tube instead of pushing the hand into the needle.Needles are mostly made of plastic, glass or metal.Choose a needle tube that is about 3 minutes shorter than the needle to be pierced and place it on the skin of the acupuncture point, put the needle into the needle tube, hold the needle tube with your left hand, and tap the needle tip at the end of the needle handle exposed on the upper end of the needle tube with your right index finger, and then pierce the needle tip into the acupuncture point , and then exit the needle.

[-]. The direction, angle and depth of acupuncture
([-]) The direction of acupuncture
The direction the pointer tip is facing.Determining the direction of acupuncture is mainly based on the following three aspects.

1. When adopting the "Ying Sui Reinforcing and Reducing" technique according to the fixed direction of the line, the needle tip of the reinforcing method must be consistent with the direction of the meridian, and needling along the meridian; the needle tip of the reducing method must be opposite to the direction of the meridian, and needling against the meridian.

2. Determine the direction according to the acupoints According to the local anatomy of the acupoints, when needling certain acupoints, the needle must be inserted in a specific direction.For example, at Yamen point, the needle tip should be inserted slowly toward the jaw; at Lianquan point, the needle point should be inserted slowly toward the root of the tongue; at the first lateral line point on the back, the needle point should be inserted toward the spine, etc.

3. Determine the direction according to the disease. According to the treatment needs of the disease, in order to make the needle feel reach the lesion, that is, to achieve the purpose of "Qi to the disease", the needle tip should face the disease, and adopt the appropriate method of moving Qi.

([-]) Angle of acupuncture
Refers to the angle formed by the needle body and the skin surface when the needle is inserted.It is mainly determined according to the local anatomical characteristics and treatment requirements of the points where the acupoints are located.Generally, it can be divided into three types: straight, oblique and flat.

1. The straight needle body is 90 degrees from the skin surface.Left and right, pierced vertically.It is suitable for most acupoints on the human body.Both deep and shallow needling are applicable, especially the acupoints on the rich muscles, such as the waist, buttocks, abdomen and limbs.

2. The oblique needle body and the skin surface are at about 45°, and penetrate obliquely.It is suitable for acupoints on the edge of bones, or where there are important internal organs that should not be pricked deeply, or to avoid blood vessels and scars, such as acupoints on the chest, back and joints.

3. Puncture the acupoints with the needle body and the skin surface at an angle of about 15°, also known as flat or along the skin.It is suitable for acupoints on shallow skin and flesh, such as acupoints on the scalp, face, and sternum.Sometimes this method is also used when performing point penetrating needling.

(End of this chapter)