TCM Acupuncture and Massage

Chapter 34 Common Acupuncture and Moxibustion Methods (5)
[-]. The method and precautions of lifting the can

([-]) The method of opening the can
When taking out the can, generally hold the cupping can with one hand, and press the thumb or forefinger of the other hand from the side of the can mouth to allow air to enter the can, and then the can can be removed.If the canister is too strongly adsorbed, do not pull it out forcefully to avoid scratching the skin.

([-]) Matters needing attention

1. When cupping, choose an appropriate body position and a part with full muscles.If the body position is improper, moving, the bones are uneven, and the parts with more hair, the cupping pot is easy to fall off, so it is not suitable.

2. When cupping, choose a suitable size pot according to the area of ​​the part to be pulled.If there are wrinkles on the part to be pulled out, or if the cupping pot is too large to absorb easily, you can make a thin dough cake and place it on the part to be pulled out to increase the local area, and then pull it out.The operation must be done quickly so that the tank can be pulled tightly and the adsorption can be strong.

3. Be careful not to burn or scald the skin when using the cupping can.If the skin is blistered due to burns or left in the jar for too long, the small blisters do not need to be treated, just apply sterile gauze to prevent abrasion; when the blisters are large, release the water with a sterile needle and apply gentian violet lotion, or Wrap with sterile gauze to prevent infection.

4. If the skin has allergies, ulcers, edema and large blood vessels, cupping is not suitable.People with high fever and convulsions, as well as the abdomen and lumbosacral area of ​​pregnant women, are also not suitable for cupping.

Triangular Needle Therapy

The three-edged needle therapy is to use a three-edged needle to puncture the blood collaterals or acupoints, release a proper amount of blood, or squeeze out a small amount of liquid, or pick off the subcutaneous fibrous tissue to treat diseases.The ancients called it "blood pricking" or "pricking collaterals", and it is called "bloodletting therapy" in modern times.The three-edged needle is called "sharp needle" in ancient times. It is a commonly used bloodletting tool. It is made of stainless steel. The needle is about 6cm long. The needle handle is slightly thicker and cylindrical, and the needle body is triangular. .

[-]. Operation method

Three-edged needle acupuncture methods are generally divided into four types: point pricking, scattered pricking, collateral pricking, and pricking pricking.

1. Pricking is a method of pricking acupoints to release a small amount of blood or squeeze out a small amount of liquid.Before needling, push and press the points above and below the pricking points to make blood accumulate in the pricking sites, then disinfect with 2% iodine cotton balls, and then use 75% alcohol cotton balls to remove iodine. Fix the puncture site with the index and middle three fingers, hold the needle in the right hand, and pinch the needle handle with the thumb and index fingers. ~3mm deep, then quickly withdraw the needle, gently squeeze around the needle hole to cause a little bleeding, and then press the needle hole with a sterile cotton ball.This method is mostly used for Shixuan and Shierjing points on the extremities, Cuanzhu, Shangxing, Taiyang, Yintang and other points on the tips of the ears and the head and face.

2. Scattered needling, also known as "leopard pattern needling", is a method of continuous pricking at the lesion and its surroundings to treat diseases.During the operation, depending on the size of the lesion, 10-20 needles can be pricked, from the outer edge of the lesion in a circular shape to the center, so as to promote the elimination of blood stasis or edema, and achieve the purpose of dispelling blood stasis, promoting regeneration, dredging meridians and activating collaterals.This method is mostly used for local blood stasis, hematoma or edema, stubborn tinea, etc.

3. Pricking is a method of piercing superficial blood vessels or veins to release an appropriate amount of blood.During operation, an elastic band or rubber tube can be used to ligate the upper end (near the heart) of the acupuncture site, and then routinely disinfected.When needling, press the thumb of the left hand on the lower part of the acupuncture point, and hold the triangular needle in the right hand to aim at the vein at the acupuncture point, and penetrate 2 to 3 mm into the vein, then withdraw the needle immediately to let a small amount of blood flow out. Press the needle hole with a sterile cotton ball.When bleeding, you can also gently press the upper end of the vein to help expel the blood stasis and relieve toxins.This method is mostly used at Quze and Weizhong acupoints to treat acute vomiting and diarrhea, heatstroke, and fever.

4. The pricking method is to use a three-edged needle to pick off the subcutaneous fibrous tissue at the acupoints to treat diseases.During the operation, press the two sides of the operation site with the left hand, or pinch the skin to fix the skin, and quickly pierce the skin with the needle in the right hand for 1-2mm, and then tilt the needle body to pierce the skin, causing a small amount of blood or mucus to flow out.It is also possible to puncture about 5mm deep, tilt the needle body and gently lift the needle tip, pick off the white fibrous tissue under the skin, and then pull out the needle to cover the dressing.This method is often used to treat frozen shoulder, stomach pain, cervical spondylosis, insomnia, bronchial asthma, angioneurotic headache, etc.

[-]. Scope of application
Three-edged needle bloodletting therapy has the functions of dredging meridian and activating collaterals, resuscitating heat, harmonizing qi and blood, reducing swelling and relieving pain.It is more commonly used for certain acute and chronic diseases, such as fainting, high fever, heat stroke, stroke syndrome, sore throat, red eyes and swelling, stubborn tinea, carbuncle, sprain, bruise, malnutrition, hemorrhoids, stubborn numbness, headache, Erysipelas, finger (toe) numbness, etc.

Three, matters needing attention

1. Do a good job of explaining the patients necessary to eliminate their ideological concerns.

2. Strict disinfection to prevent infection.

3. When pricking, the technique should be light, steady, accurate, and fast. Do not use too much force to prevent too deep penetration, excessive trauma, and damage to other tissues.General bleeding should not be too much, do not hurt the artery.

4. People with weak constitution, pregnant women, postpartum and those with spontaneous bleeding tendency should not use this method.

5. The triangular-edged needle stimulates strongly. During the treatment, it is necessary to pay attention to the patient's position to be comfortable, and beware of needle fainting.

6.每日或隔日治疗1次，1～3次为1疗程。出血量多者，每周1～2次。一般每次出血量以数滴至3～5ml 为宜。

skin acupuncture

Skin acupuncture therapy is a method that uses skin needles to puncture certain parts or acupoints of the human body to stimulate the functions of meridians and collaterals, and adjust the viscera and blood, so as to achieve the purpose of disease prevention and treatment.

Skin acupuncture is also divided into "plum blossom needle", "seven star needle" and "arhat needle".

The needle head of the skin needle is in the shape of a small hammer. The needle handle is generally 15 to 19 cm long. There is a lotus-shaped dial at one end, and short stainless steel needles are scattered below the dial.According to the number of short stainless steel needles embedded, they can be called plum blossom needles (5 needles), seven star needles (7 needles), Arhat needles (18 needles), etc.The needle tip of the skin needle is pine needle-shaped and should not be too sharp. The needle handle should be firm and flexible, and the whole bundle of needles should be flush to prevent deflection, hooking, rust and defect.In modern times, a rolling needle cylinder has been invented, which is a cylindrical skin needle made of metal, which has the advantages of wide stimulation area, uniform stimulation amount, and easy use.

[-]. Operation method

1. Percussion site The percussion site of the skin needle can generally be divided into three types: meridian percussion, acupoint percussion, and local percussion.

(1) Tapping along the meridians: refers to a method of tapping along the meridians, usually used on the Governor Vessel and the Bladder Meridian of Foot Taiyang in the back of the neck and lumbosacral region.The Du Meridian is the sea of ​​yang vessels, which can regulate the yang energy of the whole body; the back-shu points of the internal organs and six fu-organs are all distributed in the bladder meridian, so it has a wide range of treatment; the second is the meridians below the elbows and knees of the limbs, because they are distributed with the original points of each meridian , Luo points, Qi points, etc., can treat diseases of the corresponding viscera and meridians.

(2) Acupoint tapping: refers to a method of tapping on acupoints. It is mainly based on the indications of the acupoints and selects appropriate acupoints for tapping treatment. Clinically, various specific acupoints and Huatuo Jiaji are commonly used. point, Ashi point, etc.

(3) Partial tapping: refers to a method of tapping on the affected part, such as local bruising pain after sprain, stubborn ringworm, etc., can be performed locally or scattered.

2. Stimulation intensity and course of treatment The intensity of stimulation is determined according to the location of stimulation, the patient's constitution and condition, and is generally divided into three types: light, medium, and severe.

(1) Gently pricking: With a little force, the skin is only flushed and congested.It is suitable for head and face, elderly and weak women patients, as well as those with deficiency syndrome and long-term illness.

(2) Severe needling: the force is relatively large, and the degree of skin flushing and microbleeding is the degree.It is suitable for tender points, back, buttocks, young and strong patients, as well as those with evidence of disease and new patients.

(3) Medium needling: Between light needling and heavy needling, the degree of local flushing is obvious but no bleeding, suitable for general parts and general patients.

Tapping treatment, generally once a day or every other day, 1 times is a course of treatment, and the interval between courses of treatment can be 10 to 1 days.

3. After sterilizing the operation needle and the tapping site with 75% alcohol, hold the needle handle with the thumb, middle finger, and ring finger of the right hand, press the middle of the needle handle straight with the index finger, and tap the needle against the skin. After the needle tip punctures the skin, it bounces off immediately, and it is repeatedly tapped like this.When tapping, the needle tip must be perpendicular to the skin, the puncture must be accurate, and the intensity must be uniform. Different stimulation sites or stimulation intensity can be selected according to the disease.

[-]. Scope of application
Skin acupuncture has a wide range of adaptations, and can be applied to various clinical diseases, such as myopia, optic atrophy, acute tonsillitis, colds, coughs, chronic gastrointestinal diseases, constipation, headache, insomnia, low back pain, cutaneous neuritis, alopecia areata, dysmenorrhea, Mentally handicapped children, etc.

Three, matters needing attention

1. The needle should be checked frequently, pay attention to whether there is a hairy hook on the needle tip, whether the needle surface is even, and whether the rotation of the rolling cylinder is flexible.

2. When tapping, the movement should be light and quick, upright and without deviation, so as not to cause pain to the patient.

3. This method is not suitable for those with local ulcers or injuries, and it is not suitable for acute infectious diseases and acute abdomen.

4. Tap the local area and acupoints. If the technique is heavy and causes bleeding, it should be cleaned and disinfected to prevent infection.

5. Do not roll the needle-rolling cylinder on the protruding part of the bone to avoid pain or bleeding.

Intradermal acupuncture
Intradermal acupuncture is a method in which special small needles are inserted into and fixed in the skin or subcutaneously of acupoints to retain the needle for a long time, also known as "needle embedding".After the needle is pierced into the skin, it is left for a certain period of time to give weak and long-term stimulation to the acupoints, which can adjust the functions of the meridians and viscera, and achieve the purpose of preventing and curing diseases.

There are two types of needles for intradermal needles.One is grain-shaped, or wheat-grain-shaped, generally 1 cm long, with a handle shaped like a wheat grain; the other is press-nail-shaped, or thumbtack-shaped, about 0.2-0.3 cm long, with a ring-shaped handle.The former needle body is in a straight line with the needle handle, while the latter needle body is perpendicular to the needle handle.

Acupuncture sites are mostly acupoints that do not hinder normal activities, and generally back-shu points, limb points and ear points are used.

[-]. Operation method

Acupuncture can be performed after the intradermal needles, tweezers and the skin where the needles are buried are strictly sterilized.

1. Use tweezers to hold the needle handle with tweezers, align it with the acupoint, and insert it laterally under the skin. The needle body can penetrate 0.5-0.8 cm, leaving the needle handle outside the skin, and then use adhesive tape to enter along the needle body. Direction paste fixed.

2.1 Push nail type intradermal needles hold the needle loop with tweezers, aim at the acupoint, press it in straight, and then fix it with adhesive plaster; you can also place the needle loop shell on a small piece of adhesive plaster, hold the adhesive plaster in your hand and press it directly on the pierced area acupuncture points.

The duration of intradermal needle retention can be determined according to the disease condition, usually 3 to 5 days, up to 1 week.If the weather is hot, the needle retention time should not be too long, preferably 1 to 2 days, to prevent infection.During the needle retention period, you can press the buried needle for 4 to 1 minutes every 2 hours to strengthen the stimulation and improve the curative effect.[-]. Scope of application Intradermal acupuncture is mostly used clinically for certain painful diseases that require long-term needle retention and chronic diseases that cannot be cured, such as nervous headache, facial paralysis, biliary colic, low back pain, arthralgia syndrome, neurasthenia, high blood pressure, asthma , enuresis in children, dysmenorrhea, postpartum uterine contraction pain, etc.

Three, matters needing attention

1. Do not bury needles near joints, as it will cause pain when moving.The chest and abdomen will move when breathing, so it is not suitable to bury the needle.

2. After embedding the needle, if the patient feels pain or hinders the movement of limbs, the needle should be taken out and the acupuncture point should be re-embedded.

3. During needle embedding, the needle should not be exposed to water to avoid infection.Sweating more in hot weather, do not bury the needle for too long to avoid infection.

Attachment: Subcutaneous needle retention method

The method of retaining needles under the skin is to pierce the selected acupoints with ordinary 30-32 fine needles with strong toughness and not easy to break. It is not easy to fall off, and the needle can generally be retained for 1 to 3 days.Using this method, the selected filiform needle should not be too long.

ear acupuncture
Auricular acupuncture is a method of stimulating the auricular acupoints with acupuncture or other methods to prevent and treat diseases.It has a wide range of treatment, is convenient to operate, and has certain reference significance for the diagnosis of diseases.

In order to facilitate international research and exchanges, my country has formulated the "National Standard Program for the Names and Locations of Auricular Points".

[-]. The connection between ears and meridians and viscera

There is a close relationship between the ear and the meridians. The meridians and meridians of Hand Taiyang, Hand Foot Shaoyang, and Hand Yangming all enter the ear, while the meridians of Foot Yangming and Foot Taiyang go to the front of the ear and to the upper corner of the ear respectively.Although the six yin meridians do not enter the ear directly, they are all connected with the ear through their combination with the yang meridian.Therefore, the twelve meridians reach directly or indirectly to the ear.Among the eight extraordinary meridians, the yin and yang meridians merge into the back of the ear, and the yangwei meridian runs along the head and enters the ear.Therefore, "Lingshu · Kouwen" said: "The ear is where the clan veins gather."

Ears are closely related to viscera. For example, "Lingshu·Maindu" says: "Kidney qi flows through the ears, and when the kidneys are in harmony, the ears can hear the five tones." "Difficult Classics Forty Difficulties" says: "The lungs control the sound, making the ears hear the sound."Later generations of doctors discussed the relationship between the ear and viscera in more detail. For example, "Criteria for Syndrome and Treatment" said: "The kidney is the master of the ear orifice, and the heart is the guest of the ear orifice." "Lizheng Massage Essentials" says: "The ear beads belong to the kidney, the helix belongs to the spleen, the upper ear wheel belongs to the heart, the skin and flesh of the ear belong to the lung, and the jade tower on the back of the ear belongs to the liver."The auricle is further divided into five parts: the heart, the liver, the spleen, the lung, and the kidney, indicating that the physiological functions of the ear and the viscera are closely related.When the viscera or body of the human body becomes ill, reactions such as tenderness sensitivity, skin electrical specific changes, deformation, and discoloration often appear in the corresponding parts of the auricle.Diseases are diagnosed with reference to these phenomena, and diseases can be prevented and treated by stimulating these parts.It can be seen that the ear is not only related to the physiological activities of the viscera, but also inseparable from its pathological changes.

[-]. Surface anatomy of the pinna
The auricle is divided into a concave front ear and a convex dorsal ear, and its body surface anatomy.The free part of the helix that curls up the pinna.Helix tubercle The enlarged part of the upper posterior part of the helix.Helix The part of the helix that travels down the earlobe.The depression between the helix and the trailing edge of the earlobe.Helix The part of the helix that penetrates into the concha of the ear.The cartilaginous bump between the helix crus and the helix.The crus of the helix notches the depression in front of the crus of the helix.The anti-helix is ​​a "Y"-shaped bulge relative to the anti-helix, which is composed of three parts: the anti-helix body, the upper leg of the anti-helix and the lower leg of the anti-helix.Anti-helix body The lower part of the anti-helix is ​​the main part that goes up and down.The part of the upper foot of the anti-helix that branches forward from the anti-helix.The part of the lower foot of the anti-helix that branches forward and downward from the anti-helix.Triangular fossa The triangular dimple between the upper and lower feet of the antihelix and the corresponding helix.

The groove between the scaphoid helix and the antihelix.The tragus is a flap-shaped bulge in front of the auricle.The notch on the screen is the depression between the tragus and the helix.

The petal-like protrusion above the antitragus earlobe, opposite the tragus.

Interscreen notch The depression between the tragus and the antitragus.The chakra notch is the depression between the antihelix and the antitragus.The cartilaginous part of the lower part of the pinna of the earlobe.The recess between the helix and the antihelix, the antitragus, the tragus, and the external ear door.It consists of two parts, the concha boat and the concha cavity.The part of the concha of the ear below the crus of the helix.The part of the concha of the ear above the crus of the helix.The orifice in front of the concha cavity of the external ear.

[-]. Distribution characteristics of auricular points

Auricular points refer to some specific areas distributed on the auricle.The distribution of auricular points on the auricle is like an inverted fetus in the womb, with the head facing down and the buttocks facing up.According to the distribution map of auricular points shaped like an embryo, it can be seen that the ear points corresponding to the head and face are located in the earlobe and antitragus; the ear points corresponding to the upper limbs are located in the auricle; The lower feet; the auricular points corresponding to internal organs are concentrated on the conchae, among which the auricular points corresponding to the abdominal organs are mostly in the concha; the auricular points corresponding to the chest viscera are mostly in the concha cavity; the auricular points corresponding to the digestive tract are mostly around the helix crus .

(End of this chapter)