第一章　针法 Chapter 1　Acupuncture

第一节　眼针 Section 1　Periocular Acupuncture

眼针疗法是辽宁中医药大学附属医院彭静山教授首创的一种微针疗法。

Periocular acupuncture is a micro-needle therapy initiated by Professor Peng Jingshan from the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.

眼针疗法是在眼眶内外特定的穴区进行针刺等刺激，以治疗全身疾病的一种方法。

Periocular acupuncture is a method for treating whole body's disease by means of stimulating specific acupoint area inside and outside the orbit of eyes through needling.

治疗时按照脏腑辨证、经络辨证、三焦辨证及观眼识证4种取穴原则进行取穴。

During the treatment，the following four acupoint selection principles should be based on：syndrome differentiation of zang-fu organs，syndrome differentiation of meridians and collaterals，syndrome differentiation of sanjiao theory，and syndrome differentiation based on examining eyes.

一、眼针的分区定穴（图1-1）Ⅰ.Area Division and Acupoint Location for Periocular Acupuncture（Fig.1-1）

（一）分区（Ⅰ）Area Division

双眼平视正前方，以瞳孔为中心做水平线及垂线，即从瞳孔发出的上、下、内、外4条线将眼球等分为4个区域，再从该4个区域各引一条平分线，此时以瞳孔为中心的8条线将眼球等分为8个区域，该8条线称为分区定位线。

First，make a horizontal line and a vertical line in the center of pupil with eyes looking at front horizontally，such that eyeball is divided into four areas by four lines，i.e.，up，down，inside and outside given out from pupil.Then cite a bisector for each area，such that the eyeball is divided into eight areas in the center of pupil.The eight lines are called partition positioning lines.

内上方的平分线为分区定位1线。

The bisector in the medial superior quadrant of eyeball is partition positioning line 1.

瞳孔正上方的垂线为分区定位2线。

The vertical line just above pupil is partition positioning line 2.

外上方的平分线为分区定位3线。

The bisector in the lateral superior quadrant of eyeball is partition positioning line 3.

瞳孔至目外眦的水平线为分区定位4线。

The horizontal line from pupil to outer canthus is partition positioning line 4.

外下方的平分线为分区定位5线。

Tthe bisector in the lateral inferior quadrant of eyeball is partition positioning line 5.

瞳孔正下方的垂线为分区定位6线。

The vertical line just below pupil is partition positioning line 6.

内下方的平分线为分区定位7线。

The bisector in the medial inferior quadrant of eyeball is partition positioning line 7.

瞳孔至目内眦的水平线为分区定位8线。

The horizontal line from pupil to medial canthus is partition positioning line 8.

再以瞳孔为中心发出8条平分线，将上述8个区域等分为16个小区域。

At last，divide the above-mentioned 8 areas into 16 areas by the 8 bisectors giving out in the center of pupil.

分区时，以分区定位1线为中心，将其邻近的2个小区域划分为1区；以分区定位2线为中心，将其邻近的2个小区域划分为2区。

When dividing areas，partition positioning line 1 is taken as the center to combine 2 small adjacent areas to form Area 1；partition positioning line 2 is taken as the center to combine 2 small adjacent areas to form Area 2.

同理，陆续可以划分3区～8区。

Similarly，Areas 3-8 can form in succession.

（二）定穴（Ⅱ）Acupoint Location

沿自1区至8区的方向，划分如下：

Along the direction from Area 1 to Area 8，the visceral acupoint areas can be located as the following：

1区为肺大肠区。

Area 1 for lung and large intestine.

2区为肾膀胱区。

Area 2 for kidney and bladder.

3区为上焦区。

Area 3 for upper jiao.

4区为肝胆区。

Area 4 for liver and gallbladder.

5区为中焦区。

Area 5 for middle jiao.

6区为心小肠区。

Area 6 for heart and small intestine.

7区为脾胃区。

Area 7 for spleen and stomach.

8区为下焦区。

Area 8 for lower jiao.

图1-1　眼针分区定穴示意图

Fig.1-1　Schematic diagram of periocular acupuncture partition positioning

二、操作技术 Ⅱ.Operation Techniques

（一）操作前准备（Ⅰ）Preparation Before Operation

1.针具选择

宜用 29～33号（0.26～0.34mm），0.5～1寸（15～25mm）的一次性毫针。

1.Needling Instrument Selection

Disposable filiform needles for acupuncture from No.29-33（0.26-0.34mm）and 0.5-1 cun（a Chinese unit of length equals 1/3 decimeter）（15-25mm）.

所选择的毫针针身应光滑、无锈蚀，针尖应锐利、无倒钩。

The body of the filiform needles selected should be smooth with no rusting.The needle point should be sharp with no barb.

2.部位选择

在眼眶内外，选取穴区进行操作。

2.Position Selection

Select acupoint area inside and outside the orbit of eye.

3.体位选择

选择患者舒适，医者便于操作的治疗体位。

3.Posture Selection

Select a treatment position which is comfortable for patient and is easy for doctor to operate.

4.环境要求

环境应清洁卫生，避免污染。

4.Environment Requirements

The environment should keep clean and hygienic with no contamination.

5.消毒 5.Sterilization

（1）针具消毒：

应选择高压蒸汽消毒法。

（1）Needle Sterilization：

High pressure steam sterilization should be selected.

（2）部位消毒：

应用含75%医用乙醇或0.5%～1%碘伏的棉签或棉球在施术部位消毒。

（2）Position Sterilization：

The cotton swab or cotton ball with 75% medical ethanol or 0.5%-1% iodophor should be used to sterilize the operated sites.

（3）医者消毒：

医者双手可先用肥皂水清洗干净，再用含75%医用乙醇或0.5%～1%碘伏的棉球擦拭。

（3）Sterilization of Doctor：

The doctor should wash hands with soap and water firstly，then brush hands with cotton balls of 75% medical ethanol or 0.5%-1% iodophor to sterilize.

（二）施术方法（Ⅱ）Application Methods

1.眶内直刺法

以押手固定眼球，持针在紧贴眼眶内缘的穴区，垂直进针0.5寸（15mm）。

1.Straight Acupuncture inside Orbit

Use the hands to press and fix the eyeball.Hold needle in acupoint area which is near inner rim of the orbit，and insert vertically with 0.5 cun（15mm）.

2.眶外平刺法

持针在距眼眶内缘2mm的穴区部位，进行平刺操作，刺入真皮，达至皮下组织，进针0.5寸（15mm），保持针体处于该穴区内。

2.Horizontal Acupuncture outside Orbit

Hold needle in the acupoint area where is 2mm far away from inner rim of the orbit，conduct horizontal insertion，and penetrate into derma，reach subcutaneous tissue.The depth of needling is about 0.5 cun（15mm），with the needle being kept in the acupoint area.

3.点刺法

以押手固定眼睑，使之绷紧，持针在眼睑部选取穴区轻轻点刺5～7次，以不出血为度。

3.Pricking Acupuncture

Use the hands to press and fix the eyelid，so as to make it tight.Use needle to prick slightly at the selected acupoint area in the eyelid 5-7 times with no bleeding.

4.双刺法

不论采取眶内直刺法或眶外平刺法，当刺入一针后，在其所处的穴区内，紧贴着针体旁，按同一方向，再刺入一针，均进针0.5寸（15mm）。

4.Double Acupuncture

For either of straight acupuncture inside the orbit or horizontal acupuncture outside the orbit，after inserting one needle，insert another one near the body of the needle at the same direction in the same acupoint area.Both should insert 0.5 cun（15mm）deep.

5.眶内外合刺法

于同一穴区内，在眶内、眶外各刺一针，均进针0.5寸（15mm）。

5.Combined Acupuncture inside and outside Orbit

In the same acupoint area，at both the inside and outside of the orbit，one needle is taken to puncture 0.5 cun（15mm）deep.

6.压穴法

于所选取的穴区内，使用点穴棒、三棱针柄等，按压眼眶内缘，以局部产生酸、麻、胀感为度，持续按压15～30分钟。

6.Pressing Acupoint

Press inner rim of eye 15-30 minutes continuously in the selected acupoint area by using an acupoint bar，or the handle of a threeedged needle.The intensity of operation should reach a point that the patient gets a sensation of local soreness，numbness and distension.

（三）施术后处理（Ⅲ）Treatment after Application

1.行针技术要求

一般情况下，进针后不需行针；如果进针后针感不明显，可施以刮柄法或将针体提出1/3，稍改变方向后再行刺入。

1.Technical Requirements for Manipulating Needles

Normally，after inserting needles，it's unnecessary to do any manipulations；if the needling sensation is not obvious after inserting needles，perform the technique of scraping the needle handle or change the direction slightly and then penetrate the needle again by taking one thirds of the needle body out.

2.留针技术要求 2.Technical Requirements for Retaining Needles

（1）静置留针法：

留针期间不施行任何针刺手法，让针体留置在穴区内。

（1）Static Needle Retaining Method：

In the period of retaining needle，don't do any manipulations，just let the needle body in the acupoint area.

一般情况下，留针时间宜在15～60分钟。

Normally，the needles should be retained for 15-60 minutes.

（2）刮柄刺激法：

留针期间内，如果局部得气感不明显，则可间歇重复施行刮柄法，以加强刺激。

（2）Handle-scraping Stimulation：

During the retention period，if regional sensation of arrival of qi is not obvious，this method can be repeated at interval to enhance stimulation.

一般情况下，在15～30分钟内，宜间歇行针1～2次，每次0.5～1分钟。

Normally，within 15-30 minutes，it is suitable to manipulate the needle 1-2 times，0.5-1 minutes each time.

3.出针技术要求

以刺手的拇、示二指捏持针柄，轻轻转动后缓慢出针1/2，然后慢慢拔出，拔针后即刻用干棉球按压针孔，宜按压1～3分钟。

3.Technical Requirements for Drawing out Needles

Use thumb and index finger to hold the handle of needle，draw one half of needle out after gently rotating and then draw the rest out slowly.After drawing all the needle out，use cotton ball to press the acupuncture hole immediately，perfectly 1-3 minutes.

4.眼针治疗间隔及疗程

眼针技术治疗时，宜每日1次，连续治疗10～14天为1个疗程，休息2天后，可进行下一疗程。

4.Interval and Course of Treatment of Periocular Acupuncture

Periocular acupuncture treatment should be done once a day and 10-14 days treatment in succession makes a course of treatment.After two-day rest，next course can be carried out.

三、临床应用 Ⅲ.Clinical Application

（一）适应范围（Ⅰ）Application Range

1.内科

中风、头痛、眩晕、面瘫、失眠、高血压、三叉神经痛、膈肌痉挛、血管性痴呆、抑郁症、癫痫、重症肌无力、眼肌麻痹、不宁腿综合征、吉兰-巴雷综合征、支气管哮喘、面肌痉挛、胆囊炎、溃疡性结肠炎、急性胃肠炎、胆道蛔虫病等。

1.In Internal Medicine

Apoplexy，headache，vertigo，facial paralysis，insomnia，hypertension，trigeminal neuralgia，diaphragmatic spasm，vascular dementia，depressive disorder，epilepsy，myasthenia gravis，ophthalmoplegia，restless leg syndrome，Guillain-Barré syndrome，bronchial asthma，facial spasm，cholecystitis，ulcerative colitis，acute gastroenteritis，biliary ascariasis，etc.

2.骨伤科

颈椎病、肩周炎、腰椎间盘突出症、坐骨神经痛、落枕、急性腰扭伤等。

2.In Osteology and Traumatology

Cervical spondylosis，scapulohumeral periarthritis，prolapse of lumber intervertebral disc，sciatica，stiff neck，acute lumbar muscle sprain，etc.

3.妇科

痛经、月经不调等。

3.In Gynecology

Dysmenorrhea，menstrual disorders，etc.

4.儿科

疳积、小儿腹泻、百日咳等。

4.In Pediatric

Infantile malnutrition，infantile diarrhea，whooping cough，etc.

5.皮肤科

黄褐斑、蝴蝶斑、痤疮、带状疱疹等。

5.In Dermatology

Chloasma，butterfly rash，acne，herpes zoster，etc.

6.外科

肾结石、胆结石、血栓闭塞性脉管炎等。

6.In Surgery

Renal calculus，gallstone，thromboangiitis obliterans，etc.

7.五官科

突发性耳聋、中心性视网膜炎、近视、眼肌麻痹、弱视等。

7.In Ophthalmology and Otorhinolaryngology

Sudden deafness，central serous chorioretinopathy，near sight，ophthalmoplegia，amblyopia，etc.

（二）处方示例（Ⅱ）Prescription Samples

1.中风 1.Apoplexy

（1）中经络（1）Apoplexy Involving Meridians and Collaterals

1）风痰阻络证

1）Wind-phlegm Obstructing Collaterals

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：脾区、肝区。

Supplement Acupoints：Spleen area，liver area.

2）肝阳暴亢证

2）Hyperactivity of Liver Yang

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：肝区、肾区。

Supplement Acupoints：Liver area，kidney area.

3）痰热腑实证

3）Syndrome of Excessive Fu-Viscera Caused by Phlegm-Heat

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：脾区、大肠区。

Supplement Acupoints：Spleen area，large intestine area.

4）气虚血瘀证

4）Syndrome of Blood Stasis Due to Qi Deficiency

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：心区、脾区。

Supplement Acupoints：Heart area，spleen area.

5）阴虚风动证

5）Syndrome of Wind Stirring Due to Yin Deficiency

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：肝区、肾区。

Supplement Acupoints：Liver area，kidney area.

（2）中脏腑（2）Apoplexy Involving Zang-Fu Organs

1）风火闭窍证

1）Syndrome of Wind-Fire Blocking Orifices

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：心区、肝区。

Supplement Acupoints：Heart area，liver area.

2）痰火闭窍证

2）Syndrome of Phlegm-Fire Blocking Orifices

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：心区、脾区。

Supplement Acupoints：Heart area，spleen area.

3）痰湿蒙窍证

3）Apoplexy with Syndrome of Phlegm-Damp Clouding Orifices

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：脾区、肝区。

Supplement Acupoints：Spleen area，liver area.

4）元气衰败证

4）Syndrome of Primordial Qi Decline

主穴：上焦区、下焦区。

Major Acupoints：Upper jiao area，lower jiao area.

配穴：肾区、心区、脾区。

Supplement Acupoints：Kidney area，heart area，spleen area.

2.眩晕 2.Vertigo

（1）肝阳上亢证（1）Syndrome of Upper Hyperactivity of Liver Yang

主穴：上焦区。