Research progress of acupuncture manipulation

Research progress of acupuncture manipulation

Wang Chongqing Institute of Traditional Chinese Medicine

Acupuncture manipulation refers to the operation method of acupuncture treatment with filiform needle as needle. Which belongs to the important content of acupuncture therapy. The process of acupuncture manipulation includes: syndrome differentiation-acupoint matching-acupuncture-curative effect. Acupuncture method is one of the three major factors affecting curative effect. On the premise of accurate acupoint selection based on syndrome differentiation, manipulation has become a decisive factor. This may be the main reason for the diversity of techniques in past dynasties.

First, the basic purpose of different acupuncture techniques

(1) Pain relief: The ancient claw-cutting needling, quick needling and cough needling all aim at pain relief. These methods are of practical value. Especially for patients who receive acupuncture for the first time. Modern acupuncture methods, such as holding needles, clamping needles and relaxing needles, especially the needle-tube acupuncture method created in recent years, aim at relieving pain.

(2) Acupuncture is accurate. Because acupoints are located in different parts, the skin is thick or thin, the pathogenic factors are deep or shallow, and the level of qi and blood in the affected part is different, which requires different acupuncture methods. Su Wen's Essentials of Acupuncture pointed out: "The disease has ups and downs, the thorns have depths, and each has its own reasons. There is no other way." The specific techniques are straight needling, horizontal needling and oblique needling, which belong to the "five-needle method". Hegu thorn, Guan thorn, and needle dropping; Stabbing, splitting and winding are "nine needling methods" (Lingshu Guan Zhen Pian). Shallow needling can also avoid stabbing important organs.

(3) Get a sense of qi and keep it: The original chapter of Lingshu Nine Needles and Twelve says: "Thrust is essential and qi is effective." Notes on Difficult Classics says: "Those who practice needles must get the spirit from God". Clinical practice shows that there is a significant difference between acupuncture and non-acupuncture (P

Most methods of moving needles (activating qi) and (transporting needles) have this purpose. Including the needle waiting method. Maintaining gas is called urging gas. Or acupuncture.

The basic methods of urging gas are elastic method, scraping method, flying method, shaking method, pressing method and rubbing method. The circulation of qi should spread and conduct the acupuncture sensation to a certain part. For example, acupuncture Dacheng said that "those who stay away from the disease must first gather qi in the affected part." To achieve this goal, there are various methods, such as following the method, shaking the method, flying the meridian, such as putting the dragon's tail and shaking the Danfeng head to pass through the meridians.

(4) reinforcing and reducing. Adjust various functional states of cold and heat deficiency. The reinforcing and reducing method is generally implemented on the basis of acupuncture to take qi. There are many ways to tonify diarrhea. Generally speaking, the simple reinforcing and reducing manipulation consists of 1~2 operational factors, such as Ji Xu's reinforcing and reducing, lifting and inserting, twisting and reducing, welcoming and reducing, breathing, opening and closing reinforcing and reducing, 96 reinforcing and reducing, and flat reinforcing and reducing. Compound reinforcing and reducing manipulation is usually composed of more than two operational factors. Such as burning a mountain fire, penetrating the sky, covering the yang in the yin and hiding the yang in the yin.

Acupuncture basically revolves around these four basic purposes. Among them, getting angry is the core problem of all technologies. Although reinforcing and reducing is also one of the basic purposes, it must be based on acupuncture and moxibustion.

It must be pointed out that there are many classic manipulations, mainly compound manipulations, which are not only for promoting qi circulation, but also for reinforcing diarrhea, and even more directly for treating certain diseases. For example, dragon and tiger fight to cure pain, mortar ramming meridians to control water, dragon and tiger rise and fall to reconcile camp and guard. Like qi, luck, qi, qi.

Second, the development of acupuncture techniques

In the era of Neijing, acupuncture manipulation was relatively simple, mostly single manipulation and simple operation. Most of them are recorded in Lingshu Guan Zhen, Nine Needles and Twelve Original Articles, and Functional Articles, as well as Su Wen's Theory of Separation of Truth and Evil, Su Wen's Theory of Acupuncture, Su Wen's Theory of Complete Shape, etc. On the basis of reinforcing and reducing methods such as opening and closing, reinforcing and reducing Xu disease, reinforcing and reducing welcome, and reinforcing and reducing breathing, most of them originated from this period. It is pointed out that acupuncture is the basic principle of acupuncture. For example, "those who can't reach the gas of thorns don't ask their numbers." Air needling "is to go (nine needles and twelve books of Lingshu)", "Air needling is essential and effective". (same as above). The characteristics of acupuncture are as follows:

1. Acupuncture combined with acupoint matching. Such as lost thorn, long-distance thorn, giant thorn, continuous thorn and so on.

2. Combination of acupuncture and attending diseases. For example, five thorns, half of nine thorns, and thirteen skin needles, such as Hegu thorn, split thorn, floating thorn, etc.

3. It belongs to the specific operation of acupuncture, such as multi-needle straight needling, yang needling and stick needling; Single needle injury, five needle injuries.

During the Jin and Yuan Dynasties, acupuncture technology developed greatly. This is inseparable from the maturity of meridian theory, and its development law is also centered on several basic purposes: acupuncture, qi-getting, qi-moving and reinforcing and reducing. From simple to complex, the technique has ushered in a situation in which a hundred schools of thought contend. Famous acupuncturists and their masterpieces are:

Jin Ruoyu and His Brief Introduction to Liu Zhu's Fingers.

Dou Hanqing of the Jin Dynasty and his Guide to Needle Meridian, the famous Standard Fu You, came from here.

Kim and his nerves.

Feng and his complete works of acupuncture. The famous Ode to the Golden Needle is for this reason.

Wu and his acupuncture collection.

Ji and his acupuncture problems. His academic views are the same as Gao's.

Yang Ming Jeffery Ji and his Famous Articles on Acupuncture and Moxibustion are the third summary in the history of acupuncture and moxibustion in China. In terms of techniques, it also inherits and develops the characteristics of predecessors. Yang is a master of various schools, but acupuncture is even more mixed.

Acupuncture in Qing dynasty was shrinking. Acupuncture has not made much progress.

Third, the application and research of modern acupuncture manipulation

Since modern times, the application and research of acupuncture and massage have developed with the development of acupuncture and moxibustion medicine. In clinical application, people think that the essence of manipulation is the amount of stimulation by comprehensively analyzing the literature of various classical manipulations. Some people think that the amount of stimulation should be reflected from the subjective feelings of acupuncturists. Techniques to spread patients' strong feelings around or far away, such as large-scale twisting and inserting into strong stimulation, small-scale weak stimulation, and other feelings are also slight. Between the two, it is moderately stimulating (Acupuncture of Shanghai College of Traditional Chinese Medicine, 1974 edition). It is meaningful to guide the application of various manipulations by combining the patient's feelings and the amount of manipulation stimulation. However, the viewpoint of technical level and quantity is simple. On this basis, some people directly use strong stimulation as purgative method, weak stimulation as tonic method, and moderate stimulation as sedative purgative method.

Due to the role of modern scientific instruments, the research of acupuncture and massage has made progress.

1. The study of EMG at acupoints by Shanghai Institute of Physiology shows that when acupuncture at Hegu, Quchi, Shousanli, Waiguan, Zusanli and other acupoints with rich muscle tissue, doctors feel angry under their hands, which mostly leads to the increase of EMG amplitude. There is a parallel relationship between men's sense of gas and patients' sense of gas. It is believed that the feeling of qi in doctors' hands mainly comes from muscle spasm in acupoints.

2. Basic research on needling sensation. Research by Shanghai Institute of Traditional Chinese Medicine shows that acupoints are distributed in all layers of tissues from subcutaneous to periosteum, mainly in deep layers. It is considered that stimulating nerve trunk causes needle sensation, stimulating inositol and periosteum causes needle sensation, stimulating muscle causes swelling and acid sensation, and stimulating blood vessels causes needle sensation. Some people think that all kinds of needle sensation under acupuncture may be the excitement of different stimulation methods and amounts to different numbers and types of nerve fibers or sensory endings or blood vessels, thus forming needle sensation information in different spaces.

3. The study of classical technology. Since 1997, some domestic units have purposefully observed the physiological effects of some classic manipulations, such as burning mountain fires, letting the weather cool, spreading wings, reinforcing and reducing Xu disease, twisting and reinforcing diarrhea, and calming diarrhea. The results show that different acupuncture techniques can produce different physiological effects.

Burning mountain fire-let the weather cool: Dong Chengtong of Hebei New Medical University and others have made more than 800 experimental observations on healthy people and patients. The results show that there is a warm feeling under the acupuncture needle, accompanied by an increase in limb volume curve and a slow pulse propagation, suggesting vasodilation reaction. The rule of diarrhea is the opposite. The same process in the experiment is not diarrhea first or diarrhea first and then tonic, and the results are consistent with the previous ones. Experiments show that the emergence of reinforcing and reducing effect is related to physical condition, and the obvious deficiency method is not obvious, while the obvious excess method also causes vasodilation reaction.

Liu Shaoan, the Third Hospital of Wuhan, observed the skin temperature through LCD. In 56 cases, the fever effect was 94.7% and the cooling effect was 83.33%. Statistically, the difference is very significant (P < 0.00 1).

Zheng Kuishan, Gansu Province, observed 4 1 subject, acupuncture Hegu point, and measured skin temperature in Nanyang and Shaoshang. It was found that heat supplement increased 1.4~ 1.9 degrees (Celsius), and cold diarrhea decreased1.1~/kloc-. The blood volume wave at the finger tip of the contralateral ring increased by 53~73% and decreased by 4 1.5~58.5%. After statistical processing, there is a significant difference (

Ji Xuzi supplements diarrhea. Chen Keyan of Beijing Institute of Traditional Chinese Medicine directly observed the changes of microcirculation with WX-75 microcirculation microscope. Tonifying method has a certain dilating effect, and purging method makes the capillaries of limbs contract. Observing11/patients with fever, it is found that both purging method and tonifying method have antipyretic effects, and purging method is better than tonifying method. 30 cases of breast cancer after chemotherapy were observed to observe its curative effect and improve hematopoietic function, but the reinforcing method was better than the purging method.

Pingbu Xie Ping, Sheng Canruo of Nanjing College of Traditional Chinese Medicine observed 585 points with moderate stimulation, and found that 308 points were heated and 163 points were cooled, while165,438+04 points remained unchanged, with the heating and cooling range of 1℃, and most of them appeared at the needle retention time of 20 minutes.

Phoenix spreads its wings. Chan Nai Ming of Guangxi College of Traditional Chinese Medicine let Phoenix spread its wings and found that the cooling effect was 0. 1~3. 1℃, with an average cooling of 0.79℃. The best cooling effects are: gold needle 1. 17℃, silver needle 1. 1 1℃ and stainless steel needle 0.64℃.

In the theory of acupuncture manipulation. Jin Zhang Cunsheng and others put forward the concept of twisting manipulation metrology. Direction, size, duration, curative effect, etc. It is considered that the twisting direction should not be supplemented by the thumb forward, but should be centered on the Ren and Du meridians and supplemented by the centripetal direction, and vice versa. Huang Qibo of Jiangxi suggested that reinforcing diarrhea in 1996 depends on the angle of needle rotation and also includes the luck rate. Xi 'an's Guo Ming's three suggestions, purging it to make up for it and welcoming it with new menstruation, have been lost.

In a word, the study of techniques in modern times has gradually attracted people's attention. Its characteristics are: first, attach importance to the objective index of needle sensation, and second, attach importance to its physiological effect. From the above data, it shows that different techniques do have different effects. Classical techniques deserve further exploration and study.