《灵枢·官能》泻必用员 补必用方针具选择说

《灵枢·官能》“工之用针”部分论述了针刺补泻的具体操作。通过分析《灵枢》篇章排列体例以及后世针灸医籍体例可知,针具选择被列为针刺操作步骤的第一步。“泻必用员”“补必用方”作为首句,是针刺补泻的首要步骤,应当指针具选择。出土文物表明,《黄帝内经》成书时期存在圆柄和方柄2种针柄样式。在针具上进行特别设计以控制捻转角度大小使之达到补虚泻实的目的,符合“工之用针”主旨,亦可以进一步有效防止捻转误操作。故认为,“泻必用员”“补必用方”可能是指“泻法用圆柄针、补法用方柄针”。     

捻转补泻手法对头针治疗急性缺血性中风患者肢体运动功能即刻效应的影响

目的观察捻转补泻手法对头针治疗急性缺血性中风患者肢体运动功能的即刻效应的差异性。方法将116例患者随机分为捻转补法组(39例)、平补平泻组(37例)和捻转泻法组(40例),选取百会与双侧太阳穴的连线为施术部位,于双侧连线上接力式刺入3针,分别施以捻转补法、平补平泻法、捻转泻法,每针操作1 min,间隔10 min以相应手法行针1次,留针30 min。针刺结束后即刻和1、2、3 h以四肢简化Fugl-Meyer评分(FMA)和肢体部分神经功能缺损程度评分(NDS)量表评价患侧肢体运动功能。结果针刺后即刻、1 h和2 h,捻转补法组FMA明显高于平补平泻组和捻转泻法组(P0.05),而针刺后3 h组间比较差异无统计学意义(P0.05)。针刺后即刻和1、2、3 h,捻转补法组NDS均低于平补平泻组和捻转泻法组(P0.05)。平补平泻组与捻转泻法组各时点FMA和NDS差异均无统计学意义(P0.05)。结论捻转补法对头针治疗急性缺血性中风患者肢体运动功能的即刻效应优于平补平泻法和捻转泻法。     

头穴捻转补泻手法针刺对急性缺血性中风偏瘫患者肢体肌力的即刻影响:随机对照研究

目的:观察头穴捻转补、泻手法针刺对急性缺血性中风偏瘫患者肢体肌力即刻影响的差异性。方法:将符合纳入标准的126例患者随机分为捻转补法组、平补平泻组和捻转泻法组,每组42例。选取百会与双侧太阳穴的连线为施术部位,于双侧连线上接力式刺入3针。捻转补法组施以捻转补法,捻转泻法组施以捻转泻法,平补平泻组施以平补平泻法,每针操作1 min,间隔10min以相应手法行针1次,留针30min。针刺结束后即刻评定偏瘫肢体肌力。结果:1上肢肌力:针刺后3组患者上肢近端肌力、远端肌力均较治疗前显著改善(均P0.05),针刺后3组患者上肢近端肌力的改善均显著优于上肢远端肌力的改善(均P0.05),上肢近端肌力的改善捻转补法组优于平补平泻组和捻转泻法组(均P0.05),上肢远端肌力3组间差异无统计学意义(均P0.05)。2下肢肌力:针刺后3组患者下肢近端肌力、远端肌力均较治疗前显著改善(均P0.05);捻转补法组和平补平泻组下肢近端肌力改善优于下肢远端肌力(均P0.05)。结论:头穴捻转补法针刺对急性缺血性中风偏瘫患者肢体肌力的改善优于平补平泻法和捻转泻法,且肢体近端肌力改善优于远端肌力改善。     

高武神针八法初探

明代高武深得素、难要旨,并编撰《针灸聚英》,推崇东垣针法,对古典医籍强调“取其同,议其异”。他在博采先人针法之长和总结自身经验的基础上而提出的神针八法,始见于《针灸大成》。他首先强调医患心神内收,“心无外慕”,左右双手协调进针。“左捻九而右捻六”,是运用捻转针法平调阴阳以止疼痛。要求咳嗽进针,意在“移其神”,分散病人难免的紧张心理。根据针下松紧定虚实,从而实施捻转补泻。凤凰展翅和饿马摇铃,是他得心应手的泻与补两种常用针法。对于晕针,采取了“用袖掩     

“捻转”如何定“补泻”

“捻转补泻法”和“提插补泻法”是针灸临床最基本、最常用的补泻手法。“提插补泻法”以提插时用力的轻重不同来区分补泻 ,其法较易确定。而“捻转补泻法”涉及到捻转的方向 ,用力的轻重 ,速度的快慢 ,具体如何操作较多歧义 ,故规范“捻转补泻法”对临床具有指导性意义。　　以针的捻转方法的不同来区分补法和泻法 ,在《内经》中记载较为简单。如《灵枢·官能》中载有 :泻法用“切而转之” ,补法用“微旋而徐推之”。《素问·八正神明论》也只讲到候呼吸而转针 ,但如何捻转区分补泻都没有明确说明。捻转补泻并没有成为《内经》时期的主要操…     

单式针刺补泻手法的参数分析

目的探讨单式针刺补泻手法的参数特征。方法应用ZFGA型针剌手法参数测定仪采集特定人群的单式针剌补泻手法操作,比较各手法参数的特征。结果提插手法中,补法的上升时间与泻法、均匀提插比较,差异有统计学意义（P〈0．01）：泻法的下降时间与补法、均匀提插比较,差异有统计学意义（P〈O．01）：补、泻、均匀三组手法的上升下降时间比比较,差异均有统计学意义（P〈O．01）。捻转手法中,泻法的上升时间与补法、均匀捻转比较,差异有统计学意义（P〈O．01）：补法的下降时间与泻法、均匀捻转比较,差异有统计学意义（P〈0．01）：补、泻、均匀三组手法的上升下降时间比比较,差异均有统计学意义（P〈O．01）。结论上升时间、下降时间、上升下降时间比可以作为区别单式针刺补泻手法操作的特征参数之一。     

浅谈临床常用的几种补泻手法

《灵枢·胀论》篇曰:“当泻则泻,当补则补,如鼓应桴。”说明古代医家早就认识到必须恰当运用针刺补泻手法,才能提高疗效。如果补泻相反地运用,则犯“虚虚、实实”之戒,就会出现“补泻反,病益笃”的情况。笔者在临床中谨遵古法,经常采用下述补泻手法,取得很好的临床效果。现综述之,以求就正于同道。1　捻转正旋法　临床操作时以捻转操作为主。泻法一般连续较大幅度捻转数下,然后放开手,拇、食指张开,如飞鸟展翅之状,捻时食、中指内收,针体外转,放时食、中指外伸,针体退向内转,一捻一放,反复数次,可使针感增强。反之,捻转角度小,飞旋手法轻为…     

针药结合治疗周围性面瘫

一、取穴:取穴为两点、一透、一交叉。两点是取双侧合谷;一透是阳白透鱼腰;一交叉是地仓透下关与颊车透四白。二、操作方法:用1.5寸毫针,针尖向上(针柄与第二掌骨夹角为75°)刺双侧合谷穴,针感达肩部以上为佳。用2寸毫针直刺阳白穴,当针刺入皮下后向上扳倒针柄透刺至鱼腰穴。用5寸毫针直刺颊车穴,当针刺入2分后扳倒钵柄横刺至四白穴。用5寸毫针直刺入地仓穴,当针刺入表皮与口腔内粘膜1/2时扳倒针柄横刺至下关穴。运针时用捻转提插手法,新病采用泻法,久病采用补法。刺双合谷穴术者用双手同时运针,刺面     

针刺治疗慢性咽炎46例

1994～ 2 0 0 0年 ,笔者运用针刺疗法治疗慢性咽炎 46例 ,收到了良好的疗效 ,现报道如下。1　一般资料本组 46例 ,男 15例 ,女 31例 ;年龄最小 19岁 ,最大 5 8岁 ;病程最短 6个月 ,最长 10年。均确诊为慢性咽炎。2　治疗方法2 .1　取穴　主穴 :天容 (双 )、列缺 (双 )、照海 (双 )。随症配穴 :咽痛重加合谷 ;咽干重加复溜 ;咽喉堵塞感明显加天突、太冲。2 .2　操作　穴位常规消毒 ,天容用 3寸针向对侧天容方向透刺 ,行捻转泻法 ;列缺循经向上刺用泻法 ;照海用捻转配呼吸补法 ;余穴除复溜用补法外均用泻法。每日针 1次 ,每次留针 30ｍｉｎ ,…     

针刺捻转补泻手法对自发性高血压大鼠RAS的影响

目的：通过观察针刺捻转补泻手法对自发性高血压大鼠（Spontaneously Hypertensive Rats,SHR）血浆及肾组织中肾素、血管紧张素Ⅱ（AngiotensinⅡ,AngⅡ）的影响,探讨捻转补泻手法对自发性高血压大鼠肾脏保护的可能机制。方法：雄性 SHR 大鼠60只随机分为模型对照组（A）、针刺留针组（B）、捻转补法组（C）、捻转泻法组（D）和平补平泻组（E）,每组12只。12只 WKY 大鼠作为空白组（F）。各针刺组分别采用不同的手法针刺“太冲穴”,模型对照组和空白组只做与针刺组相同抓捉刺激,不做针刺处理。治疗结束后,取全血和大鼠肾脏,采用 ELISA 法检测各组大鼠血浆及肾组织中肾素、AngⅡ含量,光镜下观察肾组织病理学变化。结果：模型对照组血浆及肾组织肾素、AngⅡ含量升高,与空白组比较差异有统计学意义（P ＜0.01）,与捻转补法组、平补平泻组和针刺留针组比较差异有统计学意义（P ＜0.05）。捻转泻法组血浆及肾组织肾素、AngⅡ含量明显降低,与捻转补法组、平补平泻组、针刺留针组和模型对照组差异有统计学意义（P ＜0.01）,与空白组比较差异无统计学意义（P ＞0.05）。结论：捻转泻法能有效降低 SHR 大鼠血浆及肾组织肾素、血浆 AngⅡ含量。捻转泻法对 SHR 大鼠肾脏的保护作用可能与循环及组织中肾素、AngⅡ含量的变化有关。     

论平补平泻针法技术

从文献与临床应用出发,探讨了平补平泻针法操作技术,指出了该法有单式与复式之分,单式手法应为均匀柔和的提插或捻转,而复式手法应为均匀柔和的提插、捻转结合。同时提出了平补平泻法与导气法、平针法之不同,认为《灵枢经》“导气法”为行气法,《医经小学》“平针法”是进针法与行针法的描述,均无补泻之意。     

扬州名医朱复林针法特点

扬州名医朱复林医德高尚，医术精湛，功底深厚，针法独特，其针刺手法的特点是独特的进针法，巧妙的运气针法，一步到位的烧山火透天凉复式补泻，他的大幅度正反两方向捻转，简化提插程序综合为一体达一步到位，秉承杨继洲之针钵，对运气针法进行了持针指式的改进，丰富了运气针法的内涵，形成上下前后传导的独特灵活风格。     

EFFECTS OF REINFORCING AND REDUCING METHODS BY TWIRLING AND ROTATING THE NEEDLE FOR LEFT VENTRICULAR DAMAGE OF SPONTANEOUSLY HYPERTENSIVE RATS

Objective: To explore the different effects of reinforcing and reducing methods by twirling and rotating the needle on prevention for left ventricular damage of spontaneously hypertensive rats(SHRs).Methods: Sixty male SHRs were randomly divided into a model group(A), group(B) with twirling reinforcement method,group(C) with twirling reducing method, group(D) without manipulation, and a normal Wistar rat group(E) without acupuncture.Groups B, C, and D were all treated on "Taichong" point(LR3), ten minutes every time.Twenty-eight days later, myocardial hypertrophy and myocardial fibrosis situation of each group were observed with biochemistry methods, and their blood pressure was also recorded.Results: The systolic pressure and diastolic pressure of the group C were lower than those of the groups A, B, and D, but higher than the group E; the levels of I, and III collagen mRNA were lower in group C than groups A, B, and D.HE and Masson pictures showed myocardial hypertrophy and myocardial fibrosis on the groups A, B, and D, but less serious on the group C.The expression of endothelin-1 was also lower in the group C, but higher than normal group E.Conclusion: Acupuncture with twirling reducing method can effectively decrease the blood pressure in SHRs, as well as the levels of I, III collagen mRNA and endothelin-1 in left ventricular.However, no significant similar effect was found by using reinforcing method.Therefore twirling reducing method has an important role in preventing myocardial damage caused by hypertension.Therefore, twirling reducing and twirling reinforcing method have different biomedical effect on hypertension.     

Effect of different twirling and rotating acupuncture manipulation techniques on the blood flow perfusion at acupoints

OBJECTIVE: To analyze the effect of different twirling and rotating acupuncture manipulation techniques on the blood flow perfusion at acupoints to provide a reference for the study of acupoint specificity and the quantification and effectiveness of acupuncture methods.METHODS: Twenty healthy male or female college students each received four different acupuncture manipulation techniques, including simple acupuncture, uniform reinforcing-reducing needling,twirling reinforcing needling, and twisting reducing needling.The self-control method was applied.Acupuncture was performed by an acupuncture manipulation simulator at Neiguan(PC 6) and Zusanli(ST 36).The process of twirling and rotating was divided into seven timepoints.The PeriCam Perfusion Speckle Imager(PSI) System was used to collect the blood flow perfusion data at each acupoint.The specificity of twirling and rotating acupuncture manipulation was analyzed based on changes in the curve, video, and numerical blood flow perfusion data at each timepoint.RESULTS: There were two peaks in the blood flow perfusion curve of twirling and rotating acupuncture manipulation; one appeared after 3 min of needle retention, and the other appeared 3 min after needle removal.The blood flow perfusion parameters showed that the greatest differences between the four manipulation techniques occurred after 5 and 10 min of needle retention.The specificity of various manipulation techniques was most obvious at these two timepoints.There were significant differences between the four manipulation groups in the blood flow perfusion and the relative change rates of blood flow perfusion at each timepoint.CONCLUSION: Laser speckle imaging enables the real-time, non-invasive, rapid, and accurate collection of blood flow perfusion data during acupuncture.This imaging technique enables the easy attainment of various parameters such as visual images, two-dimensional curves, and data tables.At various timepoints, the four groups significantly differed regarding changes in blood flow perfusion and relative change rates of blood flow perfusion,which facilitated the differentiation of the four acupuncture manipulation methods.Based on this, further analysis could be conducted to study spatial distribution characteristics such as the influence area and flare area.The frequency domain analysis of acupuncture manipulation curves is important in the study of the dose-effect relationship and specificity of acupuncture manipulation.     

针刺补泻浅析

补泻方法的运用是为了达到理想的补泻效应，对于针刺补泻法的探求，应重视发挥针灸的无副作用，痛苦小的优势，应重视理，法，方，穴的，重视留针得气，手法倡用平补泻以补虚泻实。不应片面强求补泻手法对机体的作用，当悉心探究每用行之有效的远道刺法，输刺法，巨刺法及泻南补北法，刺井泻荥法等具体的辨证补泻配穴法。以平补平泻法制作之而“辅针导气，邪得淫溢，真气得导”。     

温通针法对应激性胃黎膜损伤的保护作用

目的 探讨温通针法对应激性胃黏膜损伤的保护作用。方法 以大鼠为研究对象,设正常空白对照组、模型对照组、温通针法组、捻转补法组。以血清胃泌素、血浆前列腺素E2（PGE2）及胃黏膜组织的胃泌素、PGE2及显微镜下胃黏膜组织形态结构的改变为效应指标。结果 针刺可明显地提高血浆及胃黏膜组织PGE2的含量,降低血清及胃黏膜组织胃泌素的含量;且温通针法优于捻补针法,两者相比有显著差异性（P＜0．01）。结论 针刺可减轻应激性胃黏膜损伤,起到保护作用,且温通针法优于捻转补法。     

郑魁山临证针法经验介绍

精选子郑老在揣穴、进针、行针候气、守气等几个方面的临证实践经验。突出介绍了取穴、进针应双手操作、重用左手的具体方法和必要性,善用温通法治疗疑难杂症的经验,“热补”及“凉泻”的操作手法,改革、研制的新型子午流注临床应用盘。     

温通针法治疗肝肾亏虚型膝骨性关节炎的疗效观察

目的:比较温通针法和捻转补法干预肝肾亏虚型膝骨关节炎(KOA)的临床疗效。方法:将72例KOA患者按完全随机法分为温通组与补法组,每组36例。两组均以血海、鹤顶、梁丘、内膝眼、膝中、犊鼻、阴陵泉、足三里和阳陵泉为主穴,太冲、太溪和三阴交为配穴,温通组施以温通针法,补法组施以捻转补法。每天治疗1次,10次为1疗程,疗程间休息2 d,共治疗3疗程。观察两组治疗前后西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评分并进行临床疗效比较。结果:治疗后,温通组总有效率94.3%,补法组为87.9%,组间差异有统计学意义(P<0.05)。治疗后,两组WOMAC疼痛、僵硬、日常活动评分及总分均低于本组治疗前(均P<0.01);温通组WOMAC各项评分及总分均低于补法组(P<0.05或P<0.01)。结论:温通针法治疗肝肾亏虚型KOA疗效优于捻转补法,能明显改善患者的疼痛、僵硬及日常功能活动。     

不同刺法针刺颈夹脊穴治疗颈椎病疗效观察

采用颈夹脊穴不同针刺方法治疗颈椎病104例,其中传导组53例,根据患者X线片提示,在病变椎体水平的夹脊穴处刺入1．5－2．0寸,行提插泻法,使患侧上肢抽动1－2次,健侧行捻转手法;对照组用常规针刺手法治疗。结果传导组总有效率明显优于对照组（P＜0．01）,疼痛的即时止痛效应及长时止痛效应均以传导组为优（P均＜0．01）。传导组针刺治疗后血清中吗啡样物质含量有显著增加（P＜0．01）,对照组针刺前后差异无显著性（P＞0．05）。