Hou Xiao-Fei, Wang Xin-Jun, Zhang Jian-Bin, Gu Yuan-Yuan, Song Si-Yuan
Second Clinical Medical School of Nanjing University of CM, Nanjing 210023, Jiangsu Province, China.
Zhongguo Zhen Jiu. 2019 Jul 12;39(7):729-33. doi: 10.13703/j.0255-2930.2019.07.014.
By analyzing the evolution of reinforcing-reducing manipulation achieved by lifting and thrusting the needle recorded in ancient literature of traditional Chinese medicine, it is found that the main contents of reinforcing-reducing manipulation by lifting and thrusting the needle include manipulating speed change, manual amplitude, insertion layer, gender, the direction to the acupuncture receiver, forenoon and afternoon and relevant quantity. Among them, gender, the direction to the acupuncture receiver, forenoon and afternoon and relevant quantity are the unnecessary parameters, while the manipulating speed change, manual amplitude and insertion layer are the indispensable parameters. The manipulating speed change is the core of the necessary parameters for the reinforcing-reducing manipulation achieved by lifting and thrusting the needle. Combined with the manual amplitude, the manipulating speed of needle determines the volume of needling stimulation. The insertion layer is decided on the base of the clinical demand. In the core technique of reinforcing-reducing manipulation by lifting and thrusting the needle, the reinforcing is achieved by thrusting the needle forcefully and quickly and then lifting the needle body slowly and evenly back to the original layer. The reducing is achieved by lifting the needle forcefully and quickly and then thrusting the needle body slowly and evenly back to the original layer. The manipulating speed and manual amplitude of needling are the parameters to quantize acupuncture manipulation. In association with the acupuncture effects in human body, these parameters contribute to the interpretation of the dose-effect relationship of acupuncture and the improvement of clinical effects.
通过分析中医古代文献中记载的提插补泻手法的演变，发现提插补泻手法的主要内容包括手法速度变化、手法幅度、进针层次、性别、针向受针者的方向、上午和下午以及相关量。其中，性别、针向受针者的方向、上午和下午以及相关量是不必要的参数，而手法速度变化、手法幅度和进针层次是不可或缺的参数。手法速度变化是提插补泻手法必要参数的核心。结合手法幅度，针的操作速度决定针刺刺激量。进针层次根据临床需求确定。在提插补泻的核心技术中，补法是通过用力快速地将针下插然后缓慢均匀地将针体提回到原来的层次来实现的。泻法是通过用力快速地将针上提然后缓慢均匀地将针体下插回到原来的层次来实现的。针刺的操作速度和手法幅度是量化针刺手法的参数。结合人体的针刺效应，这些参数有助于解释针刺的量效关系并提高临床疗效。
