第二节　梅花针 Section 2　Plum-Blossom Needle

梅花针疗法，古称“毛刺”“扬刺”“浮刺”“半刺”，将5～7枚6号或7号不锈钢针，依法捆扎在一根富有弹性的筷子（或小竹棒、小木棒等）一端（钻一小孔）的小孔内，露出针尖，捆成一束，像梅花的形状，或使用软柄、硬柄梅花针，术者右手握住针柄，在人体皮肤（应刺部位）上，运用一定的手法，只叩击皮肤，不伤及肌肉，以达到疏通经络、调节脏腑、祛邪扶正、防治疾病的一种外治疗法。

Plum-blossom needle therapy，being called as“skin needling”，“quintuple needling”，“superficial needling”or“half-needling”in ancient time，is an external therapy，in which，according to the convention，five to seven 6# or 7# stainless steel needles are bundled in a drilled hole at one end of a flexible chopstick（or a bamboo stick or a wooden stick，etc.），several sticks are bundled in a shape of plum blossom，with the needle tips pointing out.The handle of plumblossom needle can be soft or hard.When practicing，the doctor holds the handle in his right hand and taps the patient on the skin in an area which needs operation but the muscles should not be hurt.The therapy can dredge meridians and collaterals，regulate functions of zang-fu organs，eliminate pathogenic factors，reinforce body resistance and prevent disease.

由于针数不同，故又有五星针（5枚）、七星针（7枚）之称。

According to the number of needles，it is called five-star needle（five needles）or seven-star needle（seven needles）.

又因叩打在皮肤上，故又被人称为“皮刺针”“皮肤针”“丛针”。

The therapy is also called“skin puncture”，“skin needling”or“bundled needling”because it taps on the skin.

一、梅花针刺激部位 Ⅰ.Stimulating Parts of Plum-Blossom Needle

梅花针可以刺激的部位有很多，除特定刺激部位外，还可根据中医经络学说选用经穴、阿是穴，随证选用刺激部位经穴，均可取得一定的疗效。

There are many parts on the human body that could be tapped and stimulated for plum-blossom needle.Apart from specific stimulating parts，we can choose the meridian points and Ashi points according to syndrome differentiated based on the TCM theory of meridians and collaterals，and the treatment effects can be also certain.

（一）梅花针刺激部位检查方法（Ⅰ）Method to Choose Stimulating Parts of Plum-Blossom Needle

梅花针应用于临床治疗，其检查方法中脊柱两侧检查诊断法最具特色，即医师运用两手触按脊柱两侧，检查有无异常反应，如有条索状、结节状物或疱状软性物，可称为阳性反应检查或阳性物，即适宜用梅花针治疗。

When the plum-blossom needle is applied to clinical treatment，among its examining methods，a diagnostic method to examine both sides of the spinal column is unique.The doctor uses his or her hands to press both sides of the spinal column to check whether there is any abnormal reaction，such as soft cord-like，node-like or blister-like indicator，which can be taken as positive reactions or positive indicator，being suitable for treatment by plum-blossom needle.

这种异常反应在治疗中占有很重要的地位，检查发现的异常部位，即是治疗过程中的重点刺激部位。

Such abnormal reactions play an important role during the treatment，and the abnormal positions discovered through examining are the key stimulating parts in treatment.

在进行检查时，嘱患者露出整个背部和臀部，采取俯伏坐位，俯伏在检查台上，头向下低，背成弓形。

In examination，the doctor should ask the patient to take a prone position in an examining bed with the head bowed and the back arched，exposing the whole back and buttocks.

并嘱患者不可过于紧张，要全身放松，积极配合，否则会影响检查的结果，施术者应坐或站在患者的右后方。

During the examination，the patient should not be too nervous，with the body being relaxing，and coordinate with the doctor actively.Otherwise，the result of examination will be affected.The operator should sit or stand in the right rear of the patient.

检查方法归纳为叩、摸、推、压、捏五法。

Checking techniques are generalized into five methods，i.e.percussing，touching，pushing，pressing and pinching.

叩诊：又称“敲诊”，即检查者将右手或左手示指、中指、环指、小指四个手指并拢，稍弯曲，如同西医叩诊一样，用适当的腕力，从上（颈椎开始）往下（至腰骶部为止）叩打，如果身体某部位有病，往往在叩诊时会在颈、胸、腰、骶部发现异常音响。

Percussing：It is also called“knocking”.First，the examiner joins his or her index finger，middle finger，ring finger and little finger of right or left hand together and bends them slightly.And then，as the percussion in Western medicine，the examiner appropriately uses the wrist strength to knock the patient's body from top（cervical vertebra）to bottom（lumbosacral portion）.If a certain position of the body is ill，there will be abnormal sounds detectable from the neck，chest，waist or sacrum during percussion.

摸诊：检查者以右手或左手摸患者的皮肤，主要是检查患者皮肤的温度、光洁度（粗糙）及湿润度等是否有异常。

Touching：The examiner touches the skin of the patient with his right or left hand to examine whether there is an abnormality in skin temperature，smoothness（toughness）and moisture.

推诊：检查者以右手或左手拇指压在患者脊柱两旁的一侧，用适当的压力，从下向上推。此法不但有助于诊断，而且有重要的治疗作用。

Pushing：The examiner presses one side of the patient's spinal column with his or her right or left hand and push up from bottom with adequate force.This method not only helps to make diagnosis but also has important therapeutic effect.

压诊：检查者右手或左手拇指在患者脊柱两侧及其他部位，用适当的压力按之。

Pressing：The examiner presses both sides of the patient's spinal column or other positions using the thumb of his or her right or left hand with adequate force.

在压诊时，如发现异常现象，则说明疾病的存在，并可预知疾病的预后及其进展情况。

Any abnormal phenomenon detected during pressing means that there is a disease and the prognosis and progress of the disease can be predicted.

捏诊：检查者以左手或右手，在患者一定的部位上按捏。

Pinching：The examiner pinches certain positions of the patient with his or her left or right hand.

在按捏时，如发现组织发硬、有抵抗或疼痛等异常变化时，表示有疾病的存在。

During pinching，any abnormal change such as hardening，resisting or aching shows that there is a disease.

（二）梅花针特定刺激部位全身各部区分布示意图（Ⅱ）Distribution Diagram of Specially Stimulating Parts of Body for Plum-Blossom Needle

特定刺激部位，是梅花针治病的一个特色。

The specially stimulating part is one of the features of plum-blossom needle therapy.

其刺激部位，是以中医经络学说中十二经所分布的区域为依据。

The stimulating parts are based on the distribution areas of 12 meridians in the TCM theory of meridians and collaterals.

《中国针灸学》提出人体各部分区分为头部、颈部、项部、躯干及四肢穴位的分部法，于梅花针特定刺激部位的划分颇为适用。

The Chinese Acupuncture and Moxibustion says that the human body is divided into acupoints of the head，neck，napex，trunk and limbs.This is very suitable to divide the specific stimulating parts of plum-blossom needle.

由于梅花针刺激的范围较广，每一个刺激部位都涉及几条经络之循行部位，包括了许多穴位。

The stimulation scope of plum-blossom needle is wide，and each stimulating part is involved with several meridians and collaterals and many acupoints.

人体各部区之划分（图1-2、图1-3），头部位于身体之最上部，分为头盖和颜面部。

The division of human body is shown in Figs.1-2 and 1-3，and the head on the uppermost part of the body is subdivided into the parts of skull and face.

颈部和项部，为头颅与躯干连接之圆柱状部分，通常分为前颈部、后颈部、左右侧颈部三部分。

The neck and napex，a cylinder-shaped part between the head and trunk，is generally subdivided into parts of anterior neck，posterior neck and lateral neck.

躯干分为胸部、腹部和背部。

The trunk is subdivided into parts of chest，abdomen and back.

四肢分上肢部（肱、前臂、手）和下肢部（大腿、小腿、足）。

Limbs are subdivided into parts of upper limbs（upper arms，forearms and hands）and lower limbs（thighs，shanks and feet）.

二、梅花针操作技术 Ⅱ.Operation Technique of Plum-Blossom Needle

（一）练针（Ⅰ）Training for Needling

为了增强手腕的弹力和力度，术者应掌握正确的叩打手法，这是决定治疗效果的重要环节。

To enhance the flexibility and strength of wrist，the operator should master correct tapping technique，which is an important step to determine the treatment effects.

对不同的疾病和不同的叩打部位，必须采用轻重不同的刺激量。

Stimulation of different qualities must be applied to different diseases or different positions.

刺激过重，必将增加患者的痛苦。

Excessive stimulation will increase the patient's pain.

刺激太轻，又不能达到治疗的目的，影响治疗的效果。

Too light stimulation cannot achieve the therapeutic purpose and affect therapeutic effects.

叩打时必须叩平、叩准、叩稳，力度与速度适宜，因此术者必须事前练好手法。

When knocking，the operator must tap flatly，exactly，and steady，and the intensity must match with the speed，so the operator must practice his or her technique in advance.

练针必须做到下列各点：

During training for needling，the following requirements must be followed：

1.术者用左手握住右手腕，左手再用适当的力量使右手腕关节上下摆动，练习手腕的弹力，或者用右手腕上下弹动，如同西医叩诊一样。

1.The operator should hold right wrist with left hand and make right wrist joints swing up and down with appropriate force to practice the flexibility of wrist or catapult right wrist up and down，just like percussion in Western medicine.

2.右手持针，可先在枕头等软物上进行叩刺。

2.Hold the needle with the right hand to perform needle tapping on pillows and other soft objects.

其目的一是练习手腕弹力，二是练习叩准、叩稳，以便以后在人体上叩刺。

One of the aims is practicing flexibility of wrist，and the other is tapping exactly and steady，so as to perform needle tapping on human body.

3.在练习一定的时间后，可在自己手臂或大腿上叩刺，纠正缺点和不正确的手法，以便在患者身上进行治疗。

3.After practicing for some time，the operator can practice needle tapping on his/her own arm or thigh to correct shortcomings and incorrect techniques，so as to provide treatment for patients.

（二）操作前准备（Ⅱ）Preparation Before Operation

1.持针

术者用右手握住针柄的尾端，以环指和小指将针柄的尾端固定于手掌小鱼际处，针柄尾端露出手掌1～1.5cm，再以中指和拇指扶持针柄，示指固定在针柄的前端（中段），使针不能向四周摆动（图1-4）。

1.Needle Holding

The operator holds the tail end of the needle handle with the right hand，fastens the tail end to hypothenar position in the palm with the ring finger and little finger with the tail end 1-1.5cm above the palm，supports the needle handle with the middle finger and thumb，and put the forefinger on the front end（central section）of the needle handle so as to make the needle unable to swing around（Fig.1-4）.

将针固定好后，再灵活、适当地运用手腕的弹力和冲力进行叩刺。

After the needle is fixed，the operator performs needle tapping flexibly and properly by using the flexibility and momentum of the wrist.

叩刺时，落针要准、要稳，针尖与皮肤呈垂直接触，提针要快，拔出要有短促清脆的“哒哒”声。

When tapping，the operator should put the needles down exactly and steadily，with the needle points going into the patient's skin vertically，and lift the needles very quickly，and a short and clear sound of“Da，Da...”can be heard.

就这样将针反复提落，连续不断地、有节奏地进行叩刺。

In such a way，needle tapping is performed continuously and rhythmically by repeatedly lifting and lowering the needles.

以上就是弹刺手法的要领，一般每分钟叩打70～90次。

The above are main points of technique in needle tapping，and generally 70-90 times of tapping per minute may be done.

2.解释

为了取得患者的积极配合，在治疗前应向患者进行必要的解释，包括刺激的疼痛程度、疗程、疾病的预后等，尤其对初诊患者，更加必要，以免患者产生恐惧心理，从而不愿意接受本疗法的治疗，或因不能连续治疗而影响疗效。

2.Explanation

To achieve the cooperation of patients，the operator should give necessary explanation to the patients before treatment，including the degree of aching caused by acupuncture，course of treatment and progress of disease.This is more necessary for patients receiving the treatment for the first time，so as to avoid their fear and unwillingness to receive the treatment，or failure to keep a successive course of treatment.As a result，the effect will be influenced.

3.消毒

在术前，除对针具消毒外，对针刺部位也应严格地消毒，以免造成感染。

3.Sterilization

Before operation，apart from the needles，the acupuncture positions must be strictly sterilized to prevent infection.

由于本疗法刺激的部位较广，刺激较浅，故只需要75%的乙醇消毒即可。

Because this therapy has wide range of positions suitable for needle tapping，and the depth of puncture is very shallow，only 75% alcohol is needed for sterilization.

4.检查针具

治疗前必须仔细检查针具，如针尖是否整齐，有否弯曲或带钩，合格后方可使用。

4.Needle Examination

Before treatment，the operator must examine whether tips of needles are sharp，smooth，bent or free from any hooks，and only the qualified plum-blossom needle can be used.

5.体位

指导患者选取适当的体位，以便于治疗。

5.Position

The operator guides the patient to select an adequate position so it is convenient for treatment.

术者自己也要选择适当的操作位置，否则将会影响治疗效果。

Certainly，the operator himself or herself must select an adequate operation position，otherwise it may influence the treatment.

6.术者的态度

在治疗过程中，除了仔细询问病史、详细检查及耐心治疗外，术者的态度也起很重要的作用。

6.Operator's Attitude

During the treatment，the operator's attitude plays an important role，in addition to careful inquiry of case history，detailed inspection and patient treatment.

如果施术者态度不严肃，精神不集中，会影响患者情绪，甚至导致治疗中断而影响疗效。

If the operator is unserious and distracted，the patient would be affected and thus might discontinue the treatment.

（三）施术方法（Ⅲ）Operation Methods

1.循经叩刺法

循经叩刺是沿着经络路线进行叩刺的一种方法。

1.Needle Tapping along Course of Meridians

It is a method that needle tapping is conducted along the course of the meridians and collaterals.

最常用的是任脉、督脉和膀胱经。

The most frequently used are Ren meridian，Du meridian，and Bladder meridian.

任脉循行于身体之前，对全身阴经脉气有总摄、总任的作用，故有“总任诸阴”和“阴脉之海”的说法。

Ren meridian running in the front of the body can govern the qi of all Yin meridians of the body，so it is also called“general control of all Yin meridians”and“the sea of Yin meridians”.

又因督脉能调节一身之阳气，五脏六腑的背俞穴皆分布在背腰部的膀胱经，所以其治疗范围颇广。

In addition，Du meridian can adjust the whole body's yang qi，and all backshu points of the internal organs are distributed over the Bladder meridian of back and waist，so the treatment scope is very wide.

其次，四肢肘膝关节以下的经络，因原穴、络穴、五输穴等特定穴多分布在肘膝关节以下，故可治疗各相应脏腑经络的疾病。

Second，for meridians and collaterals below the elbow and knee joints of arms and legs，such special acupoints as yuan-primary points，luo-connecting points，five-shu points are mostly distributed there，so the diseases of corresponding zangfu organs and their meridians and collaterals can be treated.

2.局部叩刺法

即在病变局部叩刺，或在病变局部由外围向中心围刺或散刺。

2.Local Needle Tapping

Needle tapping on the local part of lesion，or surrounded needling or scattered needling from periphery part to center on local part of lesion.

在脊柱两侧及体表其他部位检查，发现阳性物（条索状物、结节状物、海绵状物）及阳性反应区（酸、痛、麻、木）时，治疗中需重点叩打。

Examination is carried out in both sides of spinal column and other positions of body surface.Any positive indicators（strip-like，node-like or sponge-like indicators）and positive reaction area（ache，pain or numbness）detected should be taken as the key parts for needle tapping.

对疼痛或酸痛区的叩打：在此区叩打，必须细心找到最痛的反应点，在痛点皮区做重点叩打，并加用辅助手法，即以左手示指、拇指指尖不时揉按痛点，并向四周疏散揉按。

Needle tapping on aching or paining area：First the most painful reactive points must be found carefully and then on the skin area of the reactive points the major tapping are performed with an auxiliary manipulation，that is the doctor rubs and presses the painful points with his/her tips of forefinger and thumb of left hand，and further rubs and presses the surrounding area.

对麻木皮区的叩打：麻木区的叩打，除对皮肤感觉迟钝或消失的阳性区进行密集叩刺外，还要在麻木区的周围健康皮肤处做疏通性叩打。

Needle tapping on skin area：Intensively，tapping should be performed on the positive areas with insensitivity or numbness.In addition，dredging tapping should be done on the healthy skin surrounding the numb area.

即用梅花针先叩打正常皮肤区，然后逐渐向麻木阳性反应区呈向心性叩打。

That is，tap the normal skin area with the plum-blossom needle first，and then onto the positive reaction area of numbness gradually in a centripetal way.

3.穴位叩刺法

即在选择好的穴位表面区进行叩刺。

3.Needle Tapping at Acupoints

Needle tapping is performed at selected acupoint in surface area.

临床较常用的有各种特定穴、夹脊穴、阿是穴等。

It is commonly used in all kinds of special acupoints，Jiaji points，Ashi points，etc.

一般以穴位表面0.5～2cm为直径做圆形均匀叩刺，每个穴位开始20次左右，随后可增至40～50次。

Generally speaking，circular and uniformed close tapping is performed on acupoint surface with a diameter of 0.5-2cm，20 times or so for each acupoint firstly and then it may be increased to 40-50 times.

临床治疗方案的确定通常遵循以下三原则：①常规部位、重点部位与局部病变部位相结合的原则；②循经取穴与局部取穴相结合的原则；③经验取穴与常规取穴相结合的原则。

In determination of clinical treatment plan，usually the following three principles should be adhered to：① combining conventional positions，major positions and local lesion positions；② combining acupoint selection based on meridian course with local acupoint selection；③ combining acupoint selection according to experience with acupoint selection based on normal practice.

（四）施术手法（Ⅳ）Operation Skills

1.正刺法

临床最常用。

1.Moderate Tapping

It is the most commonly used in clinic.

就是在叩打时，用力介于轻、重刺法之间，采用既不轻也不重的叩打手法。

The force exerted in the moderate tapping is between that of the light and heavy tapping.

这种手法一般用于常规治疗以及四肢部位。

This kind of tapping is usually applied to normal treatment and four limbs.

2.轻刺法

为临床常用。

2.Light Tapping

It is commonly used in clinic.

用梅花针在特定的皮肤部位进行轻微叩打，使患者感到微痛。

Light tapping is conducted by exerting a slight force on specific sites of the skin with plum-blossom needle until the patient feels mild pain.

这种手法适用于口、眼、鼻区，头面部，颈部，小儿疾病及久病体弱的患者。

This kind of tapping is suitable for the patients with diseases in mouth，eyes，nose，head，face，neck and pediatric patients，as well as infirm patients with chronic diseases.

3.重刺法

为临床常用。

3.Heavy Tapping

It is commonly used in clinic.

叩打时用力较“轻刺法”稍重，刺激时有较明显的疼痛，有时也可见肌肉收缩，患者偶尔有躲闪，面部表情有时有变化或有出汗等现象，但要以患者能忍受为度。

Heavy tapping is usually conducted by exerting a little stronger force than“light tapping”.Upon operation，the patient may have evident pain，or sometimes have muscle contraction；the patient may occasionally dodge，or have abnormal facial expression，or sweat.However，the operation should be limited to the point of the patient's tolerance.

这种手法多用于胸背部及四肢等部位，一般适用于失去知觉（麻痹）的局部、病体的酸胀部及腰酸背痛、新病体强的患者。

This kind of tapping is usually used on the chest，back and limbs，and generally suitable for a local region with numbness（torpidity），or region with sore or swelling sensation，or with sore waist or backache，or for a strong patient newly suffering from a disease.

4.平刺法（又名划刺法）

这种手法不用叩打，而是用针尖轻轻地在皮肤上反复滑行刺激，虽然没有疼痛感觉，但是也能起到调整作用。

4.Horizontal Tapping（Also Called Scratching）

It is to make needle tips to repeatedly slide on the skin with gentle force.Actually，it is not a kind of tapping and generally does not induce pain，but it can play a role of regulation.

这种手法适于对针刺很敏感的患者，也可作为重刺激后的配合使用。

This technique is suitable for patients who are sensitive to tapping，and can also for patients who have received heavy tapping.

但划刺的时间应稍长一些。

The time of scratching should generally be a little longer.

5.放血刺法

对某些特殊的疾病，如高血压等，可用放血刺法。

5.Bleeding Tapping

It can be used for some special diseases，such as hypertension.

在叩打时，术者可用左手捏住刺激的部位，右手持针，用适当的力量叩打，然后用左手在刺激的局部挤压，挤出少量的血液，再用消毒的干棉球擦干局部即可。

The operator can pinch the part to be stimulated with left hand and hold a needle with right hand to do tapping with appropriate force，then squeeze the local stimulated site with left hand to get a little blood out，wipe the local part with sterilized dry cotton ball.

放血的部位，可在颈后区、手指、足趾、鼻尖、下腹部及乳房等处。

The bleeding site can be located at posterior neck，finger，toe，nasal tip，hypogastrium，breast，etc.

6.强刺法

临床偶尔使用或少用。

6.Strong Tapping

It is occasionally used in clinic.

刺激时疼痛比较明显，患者几乎不能忍受，多数患者有出汗现象。

There comes apparent pain at stimulation，the patients can hardly bear it，and most patients sweat.

多用于感觉迟钝或麻痹的患者。

It is usually suitable for patients with insensitivity and numbness.

7.超强刺法

紧急时用。

7.Ultra-strong Tapping

It is used in emergent situations.

刺激时非常疼痛，患者不能忍受，易晕针。

Serious pain appears at stimulation，the patients cannot bear it and is easy to faint during acupuncture.

多用于急救，如休克、昏迷、癔症或癫痫发作等。

It is usually used in emergency treatment，such as shock，coma，hysteria or epilepsy.

三、临床应用 Ⅲ.Clinical Application

（一）适应范围（Ⅰ）Application Range

1.内科

头痛、偏头痛、腹痛、胃脘痛、神经麻痹、痉挛、胃及十二指肠溃疡、高血压、冠心病、眩晕、风湿性关节炎、类风湿关节炎、神经衰弱、咳嗽、支气管哮喘、阳痿、早泄等。

1.In Internal Medicine

Headache，migraine，abdominal pain，epigastric pain，neural paralysis，spasm，gastroduodenal ulcer，hypertension，coronary artery heart disease，vertigo，rheumatic arthritis，rheumatoid arthritis，neurasthenia，cough，bronchial asthma，impotence and premature ejaculation，etc.

2.骨伤科

落枕、肌肉扭伤、骨折延期愈合等。

2.In Osteology and Traumatology

Stiff neck，muscle sprain，delayed union of fracture，etc.

3.妇科

月经病、功能失调性子宫出血等。

3.In Gynecology

Menopathy，dysfunctional uterine bleeding，etc.

4.儿科

小儿麻痹后遗症、消化不良、遗尿等。

4.In Pediatric

Sequelae of polio，dyspepsia，enuresis，etc.

5.皮肤科

脱发、神经性皮炎、丹毒、多汗症、皮肤瘙痒症、斑秃等。

5.In Dermatology

Alopecia，neurodermatitis，erysipelas，hyperhidrosis，cutaneous pruritus，alopecia areata，etc.

6.外科

淋巴结炎、淋巴结核、腱鞘炎、某些手术后遗症、尿潴留等。

6.In Surgery

Lymphadenitis，lymphadenoid tuberculosis，tenosynovitis，surgical sequelae，urinary retention，etc.

7.耳鼻喉科

鼻炎、感觉神经性耳聋、牙痛、屈光不正、睑腺炎、视神经萎缩等。

7.In Otorhinolaryngology

Rhinitis，sensorineural deafness，toothache，ametropia，hordeolum，optic atrophy，etc.

（二）处方示例（Ⅱ）Prescription Examples

1.高血压 1.Hypertension

（1）配方一：

重点刺激第1～5胸椎及其两侧与检查发现的异常部位。

（1）Prescription 1：

The 1st-5th thoracic vertebrae and the two sides of them as well as abnormal sites detected by examination are mainly stimulated.

采用轻刺法和正刺法。

Light tapping and moderate tapping are adopted.

先叩刺脊柱两侧3行2遍，再重点刺激第1～5胸椎及其两侧与检查发现的异常部位5行5遍，然后对上腹部、前后肋间区和病变部位做局部刺激。

Both sides of the spine are firstly tapped by three rows for two times，1st-5th thoracic vertebrae and their sides are tapped by five rows for five times，then abnormal sites are tapped，finally，the upper abdomen and anterior and posterior intercostal regions are locally tapped.

每日叩打1次，10次为1个疗程。

Tapping is conducted once every day，10 times for one course.

（2）配方二：

血压在 200～220/120～130mmHg 者，取颈部前后、骶部、耳甲、外耳道及耳后之乳突部、头顶部。

（2）Prescription 2：

For the patients with blood pressure of 200-220/120-130 mmHg，the anterior and posterior neck，sacral part，auricular concha，external auditory meatus，mastoid process at posterior ear and vertical part are tapped.

采用轻刺法、正刺法或重刺法。

Light tapping，moderate tapping or heavy tapping is adopted.

先轻刺骶部，休息数分钟后，再中度（正刺）刺激颈后部，休息一下，重刺颈前部，中刺耳甲、耳后之乳突部，再轻刺头顶部。

Light tapping is firstly conducted on the sacral part，several minutes later，moderate tapping is conducted on the posterior neck.After a rest，heavy tapping is conducted on the anterior neck，and moderate tapping is applied on the auricular concha and mastoid process at posterior ear.Finally，light tapping is applied on vertical part.

每日叩打1次。

Tapping is conducted once every day.

2.便秘 2.Constipation

（1）配方一：

取脊柱两侧、下腹部、脐周围区、腰骶部及其两侧。

（1）Prescription 1：

Both sides of the spine，the hypogastrium，the part surrounding the umbilicus，the lumbosacral parts and their sides.

采用轻刺法或正刺法。

Light tapping or moderate tapping is adopted.

先叩刺脊柱两侧3行1或2遍，再重点刺激腰骶部及其两侧5行各4～5遍，然后对下腹部、脐周围区做局部刺激。

Both sides of the spine are tapped by 3 rows for 1 or 2 times，lumbosacral parts and their sides are tapped by 5 rows for 4-5 times，and then hypogastrium and part surrounding the umbilicus are locally tapped.

每日叩打1次，至大便正常为度。

Tapping is conducted once every day until stool can be discharged normally.

（2）配方二：

顽固性便秘（肠狭窄）取脊柱两侧、下腹部（脐眼直下之中线和双侧天枢直下之侧线）、下肢外侧区、腰骶部及其两侧。

（2）Prescription 2：

For obstipation（intestinal stenosis），the both sides of spine，the hypogastrium（the midline downright from the umbilicus and lateral line downright from Tianshu of both sides），the lateral regions of lower limbs，the lumbosacral parts and their sides should be operated.

采用轻刺法或正刺法。

Light tapping or moderate tapping is adopted.

先叩刺脊柱两侧3行各3遍，再重点刺激腰骶部及其两侧5行各往返3次，后对下腹部、下肢外侧区做局部刺激往返3次。

Both sides of spine are tapped by 3 rows for 3 times，the lumbosacral parts and their sides are tapped by 5 rows for 3 times，and then the hypogastrium and lateral regions of lower limbs are locally tapped for 3 times.

每日叩打1次，持续1个月。

Tapping is conducted once every day，for a successive month.

3.癃闭 3.Retention of Urine

取脊柱两侧，并重点叩刺第1～3胸椎或第11～12胸椎，或腰骶椎及其两侧，下腹部正中线（任脉）、腘窝处、肺俞、脾俞、肾俞、三焦俞、膀胱俞、中极。

Both sides of the spine，particularly 1st-3th thoracic vertebrae or 11th-12th thoracic vertebrae，or lumbosacral vertebrae and their sides，median line of hypogastrium（Ren meridian），popliteal fossa，Feishu，Pishu，Shenshu，Sanjiaoshu，Pangguangshu，Zhongji are tapped.

采用正刺法。

Moderate tapping is adopted.

对所选部位和穴位施以中度手法叩刺3～5行（重点区为5行），每穴20～30下，至皮肤出现潮红，微见出血为度。

Moderate tapping is conducted on selected sites and acupoints by 3-5 rows（5 rows in major areas），20-30 times for each acupoint，till skin is flushed with slight bleeding.

叩刺后指压“利尿穴”（神阙至曲骨连线的中点即是），并逐渐加大力度，压到一定程度即可排尿，继续按压至尿完全排出为止。

After tapping，“Diuretic acupoint”（the midpoint of Shenque to Qugu line）is pressed with finger，and as force is gradually increased，urine can be discharged.Do not stop pressing till urine is fully discharged.

每日叩打1次，中病即止。

Tapping is performed once per day and discontinued as soon as it gets effect.

（三）禁忌证（Ⅲ）Contraindications

1.凡是外伤、难产、急腹症、急性出血、诊断未明确的高热和急性传染病、严重器质性疾病、重度贫血、严重心脏病、癌症晚期及叩刺后容易引起出血的疾病，应列为禁忌证。

1.Contraindications include trauma，dystocia，acute abdomen disease，acute bleeding，high fever with no clear diagnosis and acute infectious disease，severe organic disease，severe anemia，serious heart disease，terminal cancer and other diseases which can result in bleeding after tapping.

2.下列情况也应慎用，如咯血、呕血、尿血、便血和外伤性大出血疾病，应避免叩刺出血部位，以防叩刺后加重出血。

2.For hemoptysis，hematemesis，hematuria，hematochezia and traumatic hemorrhage diseases，tapping should be cautiously used.Tapping cannot be applied on bleeding sites to prevent worsening bleeding.

3.各种骨折，忌在患部叩刺，可在患部附近用轻手法叩刺。

3.Tapping on fractured sites should be avoided，while light tapping can be conducted near fractured sites.

4.妇女怀孕期间应慎用。

4.For women who are in pregnancy，tapping should be cautiously used.

5.各种皮肤病、疖肿、皮肤感染，不宜在患部叩刺。

5.For dermatosis，furuncles and skin infection，tapping on affected sites should be avoided.

（四）注意事项（Ⅳ）Precautions

1.治疗前应详细询问病史，仔细检查，必要时应配合理化检查，求得较明确的诊断，这既有利于治疗，又便于今后总结及避免医疗事故的发生。

1.Before treatment，medical history should be carefully inquired about and examinations should be carefully conducted，and physicochemical examination can be taken to get clearer diagnosis，which is beneficial to treatment，and can facilitate future summary and avoid occurrence of medical accidents.

2.术前需要患者稍微休息，一般休息10分钟即可，消除紧张情绪，使全身肌肉放松，方可施治。

2.Before treatment，patients should have a rest，generally for 10 minutes，to remove their nervousness and make the whole-body muscle relaxed，and then treatment can be conducted.

否则可能会因情绪紧张、肌肉不放松而影响治疗效果，疲劳过度的患者也不要立即施治，要先休息，恢复常态后再予施治。

Otherwise treatment effects will be affected due to emotional tension and unrelaxed muscle.The overtired patients should have a rest first，and then receive treatment.

3.要根据患者体质、性别、年龄和神经型与非神经型及疾病的病情不同等情况来选择最佳的叩刺手法。

3.The tapping techniques should be appropriately selected according to the patients' constitution，gender，age，pathological state and different conditions of disease.

4.根据治疗方案确定刺激部位。

4.The stimulating parts should be determined based on the treatment plan.

施治时，刺激部位和面积不宜过多过大，对于过多的刺激部位、过大的刺激面积可适当配合，轮换使用，不必一次全用。

During treatment，the stimulating parts should not be too many and the areas should not be too large.All stimulating parts or areas where the operation should be applied can be conducted coordinately and alternately，but not necessarily selected in one time.

5.术时要注意室内环境和气温，避开风口，以免因受凉而加重病情，影响治疗。

5.During operation，indoor environment and temperature should be noted.Operation should not be conducted at windy places to avoid catching cold to worsen the condition and affect the effect.

有些疾病如高血压，应在安静的室内进行治疗，以免影响患者的情绪，而影响治疗效果。

For some diseases like hypertension，the patients should be treated in a quiet room so as not to affect the patient's emotions and treatment efficacy.

6.根据病情的轻重缓急，注意在治疗过程中的间隔及疗程，注意观察有效的刺激部位，同时在病历和病情记录上应尽量详细记录。

6.According to the disease severity and emergency degree，interval and treatment course should be noted during the treatment，and effective stimulating parts should be observed.Meanwhile，relevant information should be recorded in medical cases and disease progress.

7.叩刺部位的皮肤和针具，术前要进行常规消毒，以防感染。

7.The skin to be tapped and the needles to be used should be sterilized before treatment to prevent infection.

同时术前要检查针具，针尖必须平齐、无弯钩、无锈蚀。

The operator must examine whether tips of needles are sharp，smooth，and free from any hooks and rustiness.

8.初次接受治疗的患者和小儿，宜用轻刺法，以后再根据病情逐渐加重。

8.For patients and children receiving treatment for the first time，light tapping should be applied，and then other tapping techniques can be adopted according to the condition of disease.

9.在施治时，要关心患者，要严肃认真地小心操作，切忌麻痹大意，并随时询问患者的感觉，如发现异常情况，应及时变换叩刺手法或中止治疗进行观察，并加以必要的处理。

9.During treatment，the operator should care for patients and implement treatment strictly and carefully，carelessness should be avoided，and patient's feeling should be inquired about at any time.In case of any abnormal situation，tapping technique should be changed in time or treatment should be stopped for observation，and necessary treatment should be implemented.

10.叩刺时，要注意按叩刺方向和顺序进行，以免倒置或疏密不均。

10.Tapping should be conducted in a given direction and sequence so as to avoid inversion or uneven density.

叩刺后，应嘱患者休息数分钟后再走，以免在返家途中发生意外。

After tapping，the patient should first have a rest for several minutes to prevent occurrence of accidents when returning home.

11.手法快慢、刺激强度要根据病情、体质和叩刺部位而决定。

11.Tapping speed and intensity should be determined according to the patients' disease conditions，constitution and tapping sites.

一般用轻刺法或正刺法，以皮肤没有红晕或以不出血为宜。

Generally speaking，light tapping or moderate tapping should be adopted，and cause no skin blushing or bleeding.

用重刺法时，应以轻微出血为度。

Heavy tapping should be conducted until slight bleeding occurs.

对于体质虚弱、贫血及有心脏病的患者，操作手法要快些、轻些。

For patients with weak constitution，anemia and heart diseases，tapping should be quickly and slightly conducted.

初诊时叩刺面积不应太大，以后逐渐增加面积。

Tapping area for the first time should not be too large，and then it can be gradually increased.

12.对久治不愈的患者，应研究刺激的部位、强度、间隔时间等情况是否恰当，必要时可配合其他疗法或会诊，制定新的治疗方案，以免延误患者的治疗。

12.For patients without obvious improvement after the treatment，the doctor should research whether stimulating parts，intensity and intervals are proper，and formulate new treatment plan by combining other therapy or through consultation so as not to delay the treatment.

13.在治疗时，应注意患者与术者体位的配合，否则将会影响治疗的效果，妨碍叩刺操作的发挥，同时也给患者治疗带来不必要的影响。

13.During the treatment，the postures of the patient and operator should be coordinated，otherwise efficacy may be affected，the tapping cannot be normally conducted，and unnecessary influence will be brought to the patient.

患者体位既要舒适，又要便于操作。

The posture of the patient should be comfortable and facilitate the treatment.

（五）意外的处理方法（Ⅴ）Treatment for Accidents

1.晕针的处理

在叩刺过程中，如患者感到头晕、眼花，出冷汗，严重时面色苍白、脉搏微细、手脚发凉，甚至晕倒，考虑晕针发生，应立即停止针刺，让患者平卧休息，并给予温开水或糖水，严重者予以吸氧、补液等急救措施。

1.Treatment of Fainting During Acupuncture

If the patient has symptoms of dizziness，blurred vision，cold sweat，even pale face，weak and thread pulse，cold hands and feet and fall in a faint during tapping，fainting during acupuncture is considered.At this time，acupuncture should be stopped immediately，and let the patient lie in supine position，give him/her warm boiled water or sugar water，and such emergency treatment as oxygen inhalation and fluid infusion should be given to severe patients.

2.头痛、失眠、食欲减退的处理

经过3～5次的针刺后，患者可能出现头痛、失眠、食欲减退的现象，应向患者做必要的解释，并注意刺激间隔时间不要过短，避免手法过强及刺激部位过多。

2.Treatment of Headache，Insomnia and Anorexia

After tapping for 3-5 times，the patient may possibly have headache，insomnia and anorexia，and the operator should give necessary descriptions to the patient，and tapping intervals should not be too short to avoid strong force and excessive stimulating parts.

3.过敏反应的处理

经过3～5次的针刺后，可能在刺激局部出现皮肤丘疹、发痒等过敏现象，这对身体并无明显影响。

3.Treatment of Allergy

After tapping for 3-5 times，papulae，itching and other allergies may possibly appear at the locally stimulated skin，which has no apparent influence on the body.

故应向患者做必要解释，或嘱患者休息数日后再行针，过敏反应严重者应停止治疗。

Nevertheless，the doctor should give necessary descriptions to the patient，and ask them to have a rest for several days，then the operation can be done further.The operation should be stopped immediately for patients with severe allergy.

4.血肿的处理

少量的皮下出血或局部小块青紫，一般不必处理，可自行消退。

4.Treatment of Hematoma

A small amount of subcutaneous hemorrhage or local small pieces of cyanosis are not necessarily to be treated，generally they can disappear automatically.

若局部肿胀疼痛较剧，青紫面积大，可先做冷敷24～48小时，再做热敷，以促进局部血肿消散吸收。

For the conditions of local swelling，pain and large cyanosis area，cold compressing can be implemented for 20-48 hours first，and then hot compressing so as to promote local hematoma dissipation and absorption.

参考文献 References

［1］程爵棠.梅花针疗法治百病［M］.5版.北京：人民军医出版社，2015.

［2］曲晖.梅花针疗法［M］.北京：金盾出版社，2013.

［3］申永寿，黄亮，裴巍.梅花针治百病［M］.北京：科学技术文献出版社，2009.