毫针操作:针刺与补泻

凡是能鼓舞人体正气，使低下的功能恢复旺盛的叫补法；凡是能疏泄病邪，使亢进的功能恢复正常的叫泻法。它们都是通过刺激腧穴，激发经气来调节脏腑功能，达到阴阳平衡的。
针刺补泻效果的产生，主要取决于以下几个方面：

⑴机体的机能状态
在不同的病理状态下，针刺可以产生不同的调节作用即补泻效果。如当机体处于虚脱状态时，针刺可以起到回阳固脱的作用，当机体处于热邪壅闭的情况下，针刺又起到泄热启闭的效果。针刺对机体的这种调节作用，与人体正气的盛衰有着密切的关系，如机体正气充盛，则经气易于激发，针刺的调节作用就显著；若正气不足，经气不易激发，则针刺的调节作用就较差。

⑵腧穴特征
不同的腧穴在功能上具有相对的特异性，有些腧穴适宜补虚，有些腧穴适宜泻实。如气海、关元、命门、足三里、膏肓俞等穴，具有强壮作用，多用于虚损病证；而少商、十宣等穴具有清热、启闭的作用，多用于实热病症。

⑶针刺手法
① 捻转补泻：此法是捻转角度的大小和速度的快慢来区别补泻，针下得气后，捻转角度小，用力轻，频率慢，操作时间短者为补法。捻转角度大，用力重，频率快，操作时间长者为泻法。也有以左传时即拇指向前的角度大，用力重者为补；右转时即食指向前的角度大，用力重者为泻。

⑶Needling Methods
① Reinforcing or Reducing by Twirling and Rotating the Needle
The reinforcing and reducing of this kind can be differentiated by the amplitude and speed used. When the needle is inserted to a certain depth and the Qi arrives, rotating the needle gently and slowly with small amplitude for relatively a short period is called reinforcing, on the contrary, rotating the needle rapidly and heavily with large amplitude for relatively a long period is known as the reducing. It is also considered that rotating the needle with the thumb forward forcefully in large amplitude is reinforcing, while rotating the needle with the index finger forward forcefully in large amplitude is reducing.

② 提插补泻：此法是以提插时用力轻重和速度快慢来区分补泻。针刺得气后，提时用力较轻，速度较慢，而插时用力较重，速度较快为补法；提时用力较重，速度较快，而插时用力较轻，速度较慢为泻法。

② Reinforcing and Reducing by Lifting and Thrusting the Needle
In this method, the reinforcing and reducing can be differentiated by the force and speed used. After the needle is inserted to a given depth and the needling sensation appears, the reinforcing is obtained by lifting the needle gently and slowly, while thrusting the needle heavily and rapidly. The reducing is achieved by lifting the needle forcefully and rapidly while thrusting the needle gently and slowly.

③ 徐疾补泻：此法是以进针、退针过程的快慢来区分补泻。行补法时，进针要慢，逐步进针达到一定的深度，出针要快，迅速提至皮下，稍停片刻出针；行泻法时，进针要快，一次就插到所需的深度，出针要慢，逐步分层退出。

③ The Reinforcing and Reducing Achieved by Rapid and slow Insertion and with-drawal of the Needle
This sort of reinforcing and reducing method is distinguished by the speed of insertion and withdrawal of the needle. During manipulations, the reinforcing method is conducted by inserting the needle to a given depth slowly and lifting it rapidly just beneath the skin, and a moment later withdraw it. The reducing is performed by inserting the needle rapidly to the given depth in one step and withdrawing it slowly in a few steps.

④ 开合补泻：此法是以出针时是否按闭针孔来区分补泻。补法时，出针较快，出针后立即按闭针孔，意在使真气留存；行泻法时，出针时右手持针摇大针孔，一面摇一面推出，出针后不闭针孔。

④ The Reinforcing and Reducing Achieved by Keeping the Hole Open or Close
On withdrawing of the needle, pressing the needling hole quickly to close it and prevent the vital Qi from escaping is called reinforcing shaking the needle to enlarge the hole while withdrawing it, and keeping the hole open is known as reducing.

⑤ 迎随补泻：此法是以经脉循行的顺逆来定补泻，行补法，将针尖顺经而刺；行泻法时，针尖要逆经而刺。

⑤ The Reinforcing and Reducing Achieved by the Direction the Needle Tip Pointing to
The needle tip pointing in the direction of the meridian is known as reinforcing, and the needle tip pointing against the meridian direction is considered as reducing.

⑥ 呼吸补泻：与病人呼气时进针，吸气时出针为补法，吸气是进针，呼气时出针为泻法。

⑥ The Reinforcing and Reducing Achieved by Means of Respiration
In the method, the reinforcing is achieved by inserting the needle when the patient breathes in and withdrawing the needle when the patient breathes out. The reducing is achieved in an opposite way.

⑦ 平补平泻：进针得气后均匀地提插，捻转后即可出针。

⑦ Even Reinforcing and Reducing Movement
When the needle is inserted into the point and the needling sensation appears, lift, thrust and rotate the needle evenly, then withdraw the needle.