Modern Acupoint Therapy Encyclopedia

Author: Chief Editor: Wu Xuping et al
Publisher:
Publishing Date: 1999-02-01
Features: The book is divided into two parts. The first part compiles 42 acupoint needling and moxibustion therapies for modern clinical applications, each including an overview, operational methods, scope of application, and precautions, presented in a concise manner. The second part collects and organizes over 5,000 clinical acupuncture and moxibustion research papers published in open journals since the 1980s, categorized into common TCM syndromes, infectious diseases, internal medicine, neurology and psychiatry, surgery, orthopedics, gynecology, pediatrics, ophthalmology, otolaryngology, dermatology, oncology, and other categories, totaling 162 syndromes. Each syndrome includes an overview, various acupoint therapies, comments, and references. The therapies are diverse, operational descriptions are detailed, and the efficacy is proven and reliable, reflecting the latest achievements in acupuncture and moxibustion clinical research at the current stage. It integrates practicality, scientificity, and academic rigor, making it a valuable academic and reference book for clinical practitioners, educators, and researchers in acupuncture and moxibustion. Excerpt:
① Needle Sterilization When possible, steam sterilization can be used. Wrap the acupuncture tools in gauze and place them in a high-pressure steam sterilizer. At 15 pounds of pressure and 120°C for 15 minutes, the sterilization goal can be achieved. For boiling sterilization, wrap the tools in gauze and place them in a pot of boiling water. After the water boils, cook for 15–20 minutes to achieve the same sterilization effect. Alternatively, the tools can be immersed in 75% alcohol for 30 minutes, then dried and used.
② Sterilization of the Practitioner’s Hands Before the procedure, the practitioner should first wash their hands thoroughly with soap and water, then dry them before using a 75% alcohol swab. During the procedure, the practitioner should avoid direct finger contact with the needle. If contact is necessary, a sterile dry cotton ball can be used as a barrier to maintain the sterility of the needle.
③ Sterilization of the Needling Site For sterilizing the acupuncture points on the patient’s body, a 75% alcohol swab can be used. The swab should be wiped from the center of the point outward in a circular motion. Alternatively, first use a 2.5% iodine swab, then follow with a 75% alcohol swab for sterilization. After sterilizing the point, avoid touching any contaminated objects to prevent recontamination.
(II) Needling Techniques
Needling refers to the process of inserting the needle into the skin and advancing it to deeper tissues. The right hand, which performs the insertion, is called the "inserting hand"; the left hand, which presses or assists the needle, is called the "guiding hand." The inserting hand holds the needle handle with the thumb, index, and middle fingers, using finger force to quickly penetrate the skin and then twist to advance deeper. The guiding hand fixes the point, holds the needle, and presses the skin to reduce pain and assist in regulating and controlling the needle sensation. Common needling techniques include the following.
1. Single-Hand Needling Method The inserting hand holds the needle with the thumb and index fingers, with the middle fingertip close to the point, pressing the needle shaft lower. When the thumb and index fingers press downward, the middle finger flexes, inserting the needle straight to the desired depth. This method is often used for shorter needles.
2. Two-Hand Needling Method Both hands work together to insert the needle. The following four methods are commonly used.
① Finger-Tapping Needling Method (also known as Nail-Tapping Needling) The left thumb or index fingertip taps the side of the point. The right hand holds the needle close to the fingertip to insert it into the point. This method is suitable for short needles.
② Pinching Needling Method (also known as Clenched-Finger Needling) The left thumb and index fingers pinch a sterile dry cotton ball, holding the lower end of the needle. The needle tip is fixed at the skin surface of the point, and the right hand twists the handle to insert the needle. This method is suitable for long needles. Clinically, insertion can also be done by pushing the needle in with the right thumb and index fingers holding a sterile cotton ball, with the needle tip exposed 2–3 fen, aligned with the point, and then quickly inserted. After insertion, the needle is twisted to the desired depth, and appropriate guiding techniques are used as needed.
③ Relaxing Needling Method The left thumb and index fingers stretch the skin around the point to make it taut, while the right hand inserts the needle from between the fingers. This method is mainly used for points on loose skin.
④ Lifting and Pinching Needling Method The left thumb and index fingers lift the skin at the point, and the right hand inserts the needle from the lifted upper end. This method is mainly used for points on thin skin and muscle, such as the Yintang point.
3. Tube Needling Method A metal tube or a special insertion device replaces the guiding hand. Flat or tube handles are used, and the needle is inserted into the point by tapping or pushing it through the tube. After insertion, the tube or device is removed.
(III) Needling Angle and Depth
During the needling process, mastering the correct angle, direction, and depth of the needle is crucial for enhancing needle sensation, improving efficacy, and preventing accidents. The correct angle, direction, and depth should be flexibly adjusted based on the specific location of the point, the patient’s constitution, the condition, and the needling technique.
1. Angle The angle refers to the angle between the needle and the skin surface. It is determined by the location of the point and the purpose of the needling. Generally, there are three types of angles.
① Perpendicular Needling The needle is inserted vertically at an angle of about 90 degrees to the skin surface. This method is suitable for most points on the body.
② Oblique Needling The needle is inserted at an angle of about 45 degrees to the skin surface. This method is used for points in areas with thin muscles or important internal organs, or for points that are not suitable for perpendicular or deep needling.
③ Parallel Needling (also known as Superficial Needling) The needle is inserted along the skin surface at an angle of about 15 degrees. This method is suitable for points on thin skin and little muscle, such as those on the head.
2. Depth The depth refers to how deep the needle penetrates the body. The depth for each point is detailed in the point discussions, but here are general principles based on the following factors.
① Constitution Thin and weak individuals should be needled superficially; strong and fat individuals should be needled deeply.
② Age Elderly and weak individuals, as well as young children, should be needled superficially; middle-aged and young, strong individuals should be needled deeply.
③ Condition Yang syndromes and new diseases should be needled superficially; Yin syndromes and chronic diseases should be needled deeply.
④ Location Points on the head, face, chest, back, thin skin, and little muscle should be needled superficially; points on limbs, buttocks, abdomen, and areas with abundant muscle should be needled deeply.
The angle and depth of needling are closely related. Generally, deep needling is perpendicular, while shallow needling is oblique or parallel. Special attention should be paid to the angle and depth for points such as Tianwu, Yamen, Fengfu, as well as those in the eye area, chest, and back with important internal organs like the heart, liver, and lungs. Different seasons also affect needling depth, which should be taken into account.
(IV) Manipulation and Obtaining Qi
Manipulation, also known as needle manipulation, refers to various techniques used after inserting the needle to achieve qi, regulate needle sensation, and perform tonification or sedation. Obtaining qi, also known as needle sensation, refers to the meridian qi response generated after inserting the needle. When this response occurs, the practitioner may feel a gentle or heavy sensation at the needle tip; the patient may also experience corresponding sensations such as soreness, numbness, distension, or heaviness, which may even spread to certain areas in a specific direction. If there is no qi response and the needle does not obtain qi, the practitioner will feel nothing at the needle tip, and the patient will have no soreness, numbness, distension, or heaviness. Whether qi is obtained and how quickly it arrives directly affects the treatment outcome and can also reveal the prognosis of the disease. Clinically, rapid qi response usually leads to better efficacy, while slow or no qi response results in poorer outcomes. If qi is not obtained, the treatment may be ineffective. The classic text "Golden Needle Composition" states: "Qi fast, effect fast; qi slow, effect slow." Therefore, if qi is not obtained during needling, the practitioner should analyze the reasons: inaccurate point selection, improper technique, incorrect angle, or inappropriate depth. In such cases, the point, angle, and depth should be adjusted, and necessary manipulation techniques should be applied. Generally, re-manipulation will then obtain qi. For some patients, even after all measures are taken, qi is not obtained, which may indicate declining organ function. Alternative treatments should be considered.
Manipulation techniques are generally divided into basic and auxiliary methods.
1. Basic Techniques
Basic manipulation techniques are the fundamental actions of needling. The following two are commonly used.
① Thrusting and Pulling Method After inserting the needle to a certain depth, the needle is moved up and down within the point. Thrusting refers to advancing the needle deeper, while pulling refers to retracting it to a shallower level. The amplitude, layers, frequency, and duration of the manipulation should be flexibly adjusted based on the patient’s constitution, condition, point location, and the practitioner’s goals.
② Twisting Method After inserting the needle to a certain depth, the right thumb and index and middle fingers hold the needle handle and twist it back and forth. The angle, frequency, and duration of the twisting should be adjusted based on the patient’s constitution, condition, point characteristics, and the practitioner’s goals.
2. Auxiliary Techniques
These are used to assist manipulation during needling. The following are commonly used.