捻转补泻之我见.pdf

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1、中国针灸2014年1月第34卷第1期ChineseAcupuncture&Moxibustion，Jan．2014，Vo1．34No．1文章编号：0255—2930(2014)01—0049—04中图分类号：R245．1文献标志码：A捻转补泻之我见沈特立(上海电力医院针灸推拿科，上海200050)[摘要]探讨捻转补泻手法的实质，为补泻手法的临床应用提供理论指导。通过回顾针刺捻转补泻手法历史文献，从古籍记载注文探究，分析现存的几种观点如与经脉循行方向结合，细分左右、男女、手足；刺激量大小，操作时间长短；捻转手法属于螺旋运动等，发现捻转补泻的关键是决定三维运动的持

2、针手型，捻转细分左右、男女、手足等，就同时忽略了捻转手法必然带有提插动作的立体效应。认为捻转补泻的实质不离《灵枢·九针十二原》“徐而疾则实，疾而徐则虚”的提插补泻原则。以此原则为指导，将捻转补泻手法应用于临床中，才能避免手法操作流于形式而陷入虚无飘渺的玄学。[关键词]针刺手法；捻转；提插；补泻Discussionontwirlingreinforcing-reducingmethodSHENTe—li(DepartmentofAcupuncture—MoxibustionandTuina，ShanghaiElectricPowerHospital，Shangh

3、ai200050，China)ABSTRACTTheessenceoftwirlingreinforcing—reducingmethodisdiscussedtOprovidetheoreticalguidanceforclinicalapplicationofreinforcing—reducingmethod．Throughretrospectiononhistoricalliteratureoftwirlingrein—forcing—reducingmethod，recordsandexplanatorynotesarethoroughlyexplo

4、red．Severalexistingopinionsareana—lyzedandexplainedforinstancetwirlingmethodhasconnectionwithcirculationdirectionofchannels；twirlingmethodissubdividedintorightandleft，maleandfemale，handandfoot；twrilingmethodisrelatedtOquantityofstimulusandoperationtime；twrilingmethodbelongstospiralm

5、otionandSOon．Asaresult，itisfoundthatthekeyoftwirlingreinforcing—-reducingmethodisthepostureofneedle—。holdinghandthatdefinesthree—。dimensionalmotion．Iftwirlingmethodissubdividedintorightandleft，maleandfemale，handandfootandSOon，stericeffectsoflifting—thrustingmovementthatcomealongwith

6、twirlingmethodcouldbeignoredatthesametime．Itisconsideredthattheessenceoftwirlingreinforcing—-reducingmethodisclosetotheprincipleofliftingthrustingrein—_forcing—reducingmethod，enrichingeffectwithslowinsertionandfastwithdrawalofneedlewhilereducingeffectwithfastinsertionandslowwithdraw

7、al，whichisrecordedinMiraculousPivot：NineneedleandTwelveYuan．Withthisprincipleasguide。manipulationcouldbeavoidedtobecomeamereformalityandillusorymetaphysicsduringclinicalapplicationoftwirlingreinforcing—reducingmethod．KEYWORDSacupuncturemanipulation；twirlingmanipulation；liftingandthr

8、ustingmanipulation；