In the 14th year of Emperor Kangxi of Qing Dynasty (1675), Guo Youtao ruled out all interference and was not afraid of being laughed at by his peers. He summed up the folk methods of picking, scraping and bloodletting. , and wrote the book "A Jade Scale Scabies". Chen Xiuyuan, a famous doctor in Qing Dynasty, also introduced the method of treating the emergency of bloating with acupuncture and moxibustion. In the four years of Tongzhi in Qing Dynasty (1865), Wu Shangxian collected and sorted out various folk therapies for external use because he saw that many folk therapies were effective and overcame all difficulties, and wrote a book called Li Zhuo Parallel Prose, which introduced many folk therapies.
operational approach
Before operation, you must first select the needle picking point. Acupoint selection is the * * * point of acupuncture therapy, referred to as "acupoint selection" or "acupoint selection". It is an important part of acupuncture therapy and an instrument for acupuncture treatment in human body. It can be divided into fixed needle pick-up points and non-fixed needle pick-up points. The former is divided into acupoints, sub-regional acupoints and scalp acupoints; The latter is divided into skin anomalies, anomalies, granular points, nodes and pulse points. At present, the commonly used needle picking methods are as follows:
First, the scraping method
First, the skin on the predetermined body surface is scraped to make it bloodshot, revealing hidden spots, and then the spots are picked by picking and bloodletting.
Second, the clamping method
Similar to scraping. The difference is that the scraping method is to make the skin congestion and rash first, and then pick the rash; The rule of pinch is to make the skin bloodshot by pinch. The gesture of pinching is to form a crab pincer with the middle finger and forefinger of the right hand. Dip in some salt water or boiled water and aim at the skin to be pinched. After pulling it for several times, there will be congestion and congestion in some parts of the skin. The heavier the heat poison, the more likely the skin color is to be bruised. If it is not the serious heat toxicity of eczema, it is not easy to cause blood stasis.
Third, the method of catching snakes.
The operator grasps (or restrains) the plump parts of the patient's muscles (usually located in the upper arm, pectoralis major and dorsal scapula) with the thumb and forefinger of his right hand. If an object like a snake bulges immediately, it is called a snake. In the case of snake hunting, a snake-shaped protrusion may appear where you are caught. You should immediately clamp this "snake head" with a pincer gesture, pull it up, pull it to a certain extent, then let it slip out of the pliers, and catch the snake tail (the first one is the head, the last one is the tail) from the snake head, and so on for several times until the snake is clamped. In this way, one part at a time is captured in sequence. This method is called "catching snakes".
Fourth, the method of picking points
It is a kind of picking method that aims at the center of a certain point on the body, quickly enters the needle, quickly picks through the skin, and does not swing or pull. It is also a common method of breaking the skin and opening the mouth in various picking methods.
Five, pick reinforcement method
Select the needle taking point to be disinfected, hold a slender needle (sewing needle or special needle taking) with sufficient hardness by fine needle holding method, place the needle tip in the center of the needle taking point and slowly insert the needle. When the needle tip passes through the skin, you can relax the pressure of the index finger of your left hand, and at the same time raise the needle tip a little with your right hand, so as to improve the left-right swing of the needle body and break the provoked epidermis. Because the first one or two stitches are epidermis, the fiber is short and easy to break, and it is only used for breaking skin. After picking the opening, you can pick out some slightly sticky intradermal fibers (note that they are not subcutaneous fibers), pick one by one, and pick them down one by one until you pick the fibers around the needle opening.
Six, pricking blood method
The parts selected by this method are arteries, veins and capillaries on the body surface, such as the frontal branch of superficial temporal vein. The principle of picking needles is that "picking" is the main thing and "shaking" is the auxiliary thing. That is to say, the first needle should pierce the skin a little more (but not too much), swing it for a certain time (about 1 minute), and then forcibly remove the skin. Then use the broken needle picking method (picking, pulling around) to pick to a certain depth to let the blood vessels ooze or flow out some blood. There are also those that don't need to swing, such as picking the collaterals behind the ears, and only using the method of picking points to pick and cure the bleeding on the veins. In the process of winding, the fixed points are generally selected at the bifurcation of blood vessels, and the distance between each point is about a horizontal finger. If the vein is obviously congested or pulsating, it should be picked from the far end to the near end; If the vein is not exposed, and it is still difficult to determine the position of the blood vessel after being slapped by * * *, the blood vessels should be picked from the proximal end to the distal end in turn, so that the blood vessels will be gradually exposed with the shaking of * * *. If you choose "red tendon" (the internal organs are sick, and if it is hot, red tendon or blue root may appear in the corresponding position of the eyes) and "snake gas" (referring to a red line appearing on the body surface, also known as "red silk". This red line extends upward and develops rapidly, with local redness and tenderness, and the starting point is mostly at the primary infection focus. When its trend is similar to that of meridians (clinical manifestations are similar to secondary lymphangitis in modern medicine), we should first pick the "snakehead" (that is, the front end of its development) to defeat its trend.
Seven, the method of picking furuncle
For wool boils (pores are sunken, there are red circles around them, and there are gaps in the red circles. News.
Fading, the hair at the tip is upright and straight, like a nail nailed to a lenticel; If the hair fades, the hair at that point is upright and straight, like a nail nailed to a lenticel; If you pull your hair up gently, there will often be a thick wool-like filament at the root of your hair. After local disinfection, use medium and small sewing needles as needles, and gently prick the needle tip obliquely into the hair follicle roots at selected points. Be careful not to be too shallow or too deep. It's best to just prick the hair follicle and stir the hair roots with gentle force. At this time, the hair root rises with the needle, and the hair follicle will be accompanied by sticky lines. This line will come out. If at first you don't succeed, you can do it again. If you can't pick something like hair, don't force it, but pick it at the root of the hair several times, do destructive picking, and squeeze out poisonous blood to be effective. If there are many boils, try to finish them in order. If you can't pick it all at once, you can pick it several times.
Eight, root cutting method
Choose a thick sewing needle or a special round needle (the needle handle and needle body are like awls), after fixed disinfection, the operator will open his thumb and forefinger with his left hand, fix the part to be picked by the patient, hold one third of the needle handle or sewing needle with his right hand, aim the needle tip at the center of the picking point, pick the fiber (root) in the skin or subcutaneous fascia from shallow to deep by tendon picking method, and cut it off with a knife or force. Pick out the stump left by cutting, let it shrink back, don't pull it out. So pick and chop until you don't pick. The needle opening can be larger. After picking, disinfect the needle mouth and apply gauze for protection.
Nine, pick and squeeze method
This method is simple to operate, that is, after piercing the cortex with acupuncture, it can be squeezed. It is forbidden to use the method of picking and squeezing for inflammatory lesions in the dangerous triangle of face, so as not to poison the brain.
Ten, pick fertilizer (wet) method
Now, take the "malnutrition point" of picking hands (the center of the ventral surface of the knuckles near the palm of the index finger, middle finger, ring finger and little finger) as an example to introduce.
1. Selection and disinfection.
2. Hold hands. Because you have to pick the subcutaneous fat layer and take out the cellulite, it is easy to bleed. Therefore, we should make full use of holding hands to liposuction and stop bleeding. In order to finish this task, you'd better ask an assistant for help. The method is: the operator and assistant hold the finger that the patient wants to take with their left hands, press the thumb of the left hand several times in their own direction after taking the point, and then press it firmly next to the point. Its purpose is to exclude local blood, compress and stop bleeding, expose the skin and make subcutaneous fat easy to be squeezed out.
3. The performer holds the midpoint of the quasi-picking point with his right hand and uses the action of "picking point method" to pick it quickly.
Open the cortex and enter the subcutaneous layer. At this time, the subcutaneous fat will be exposed to the needle mouth quickly because of the pressure of the two fingers next to it. Then pick and scrape with the needle tip, pick out the sparse fibers distributed on the cellulite, squeeze out the fat body as much as possible, and finally scrape off the residual fat at the needle mouth with the needle body.
4. After taking out the fat body, apply mercuric chloride to the needle mouth, seal it with gauze pad and press the needle mouth, then wrap it with bandage and pressurize it for 3 ~ 5 minutes to prevent bleeding. Before sealing the needle mouth, the hands of the surgeon and assistant should not be relaxed, otherwise they will bleed immediately.
5. Ask the patient (or family members) not to pollute the wound after operation, and it can be opened after 5 days.
XI。 Formula selection
Pick disinfection points at fixed points, and choose round needles with appropriate length and thickness according to the skin condition (i.e. thickness, etc.). ) at the selected point (generally speaking, the force is relatively large, so the surgical needle should be thicker and longer). Use the slow needle method to insert the needle, wear more skin and puncture the subcutaneous layer, so that the cortex will not be easily broken and torn when lifting hard. After wearing the skin, you can lift, lift and release it, gradually increase the intensity from low to high, and lift it for about 3 ~ 20 minutes at each point without peeling. Pick out the needle, restore the needle mouth, disinfect and protect the wound.
Twelve-choice Rafah.
The lifting method is similar to the lifting method. The pulling method is vertical force pulling, and the pulling method is lateral force pulling, and the pulling direction is opposite to the diseased position.
Thirteen, take and put the method
After disinfection, use towel tongs (towel fixing tongs for fixing disinfection cloth towels) or thick needles to penetrate the skin more than once, pick them up and swing them rhythmically for 40-80 times per minute, as if pulling the skin. The swing amplitude depends on the tightness of the skin in various parts of the body. The swing amplitude of loose leather can be larger, and the swing amplitude of tight leather can be smaller, each time 10 to 30 minutes. There are three kinds of swing force: strong, medium and weak, depending on the patient's condition. Treat the wound as usual after pulling out the needle.
Fourteen, pick cans method
According to the needs of the disease, a certain selection method should be carried out first, and then cupping should be added with the needle mouth as the center (the size of cupping and the length of suction and pulling time depend on the disease and site). After lifting the can, wipe the blood clean and disinfect the skin and needle mouth routinely.
Fifteen, drug selection methods
Also known as the selection method. The selection method depends on the condition, and some drugs are applied to the needle mouth according to the condition to strengthen its function. After the drug is released, it is fixed with adhesive tape to protect the wound and prevent infection. Ask the patient to come back for dressing change regularly.
Sixteen, picking moxibustion method
First, choose the needle according to the condition, and then put the moxa cone the size of mung bean on the needle mouth and ignite it for moxibustion. When moxibustion is very painful, you can crush the fire without burning all its moxa sticks (the strength of moxibustion depends on the condition). You don't need medicine after moxibustion, just wrap the needle mouth.
Seventeen, machine pick method
It is a method of picking and processing by machine instead of manual work. Since it was officially used in clinic from 65438 to 0958, five types of needle picker have been developed so far, each with its own characteristics, so I won't repeat them here.
Indication disorder
Acupuncture therapy can treat various diseases of internal and external medicine, gynecology, pediatrics and otolaryngology. It is effective not only for functional diseases, but also for some bacterial inflammations and solid tumors.
First, epigastric pain
Generally, points such as Ganshu, Pishu, Danshu, Sanjiaoshu and Zusanli are selected. Clinically, we should select points based on syndrome differentiation, adopt the method of picking tendons, and then use the method of picking and throwing. Choose/kloc-0 every l ~ 3 days, and 5 ~ 1 0 times is 1 course of treatment.
Second, abdominal pain.
Acupuncture treatment of abdominal pain, whether acute or chronic, mainly takes Ashi point, and the manipulation is mainly based on TCM syndrome differentiation, and the treatment is based on differentiation of deficiency and excess. Deficiency should be supplemented with fine needles, while diarrhea should be applied with coarse needles, or cupping. If the pain radiates to the lumbosacral region, the back and waist tenderness points should be added; If it is caused by summer heat and diarrhea, it should be used around the navel. "Pinch therapy" treatment, flexible combination. For general abdominal pain, acupuncture can be used to treat it. The more severe acute abdominal pain, countless; Chronic abdominal pain 1 ~ 3 days, 1 ~ 3 o'clock every day, 10 times is a course of treatment.
Third, chest pain.
Take Ashi point and match it with Hope Gate, Ganshu, Shu Fei, Shu Ge, Shen Zhu, Pishu and Pengzhong as appropriate. Take and put method as the main method. When the curative effect is not significant, the method of picking tendons can be used instead. If several treatments fail, we should pay attention to check the reasons and treat according to the reasons.
Fourth, low back pain
Take Ashi point (the painful part) at the waist for acupuncture. For those with cold and dampness, waist and yang are clear; For those who are damp and hot, add a Committee; Kidney deficiency, plus kidney