The application of acupuncture needles, guided by the principles of meridian theory and syndrome differentiation in Traditional Chinese Medicine (TCM), involves applying needles to specific acupoints or areas of the body through standardized procedures to achieve the therapeutic goals of unblocking meridians, harmonizing Qi and blood, and balancing Yin and Yang. The method system encompasses acupoint selection, needle insertion, needle manipulation, needle retention, and needle withdrawal. Each step requires careful consideration based on the patient's condition, constitution, and treatment site to ensure efficacy and safety.
At the outset, acupoint selection is fundamental. Based on the diagnostic conclusions obtained through the four diagnostic methods (inspection, acupuncture, palpation, and palpation), the practitioner selects acupoints related to the affected organs and meridians. Common acupoint selection methods include local selection, distal selection, and selection based on symptoms. Local selection targets acupoints near the affected area to unblock local Qi and blood; distal selection selects key acupoints along the meridian pathways to mobilize overall regulatory power; and selection based on symptoms adds specific or empirical acupoints according to the pathogenesis and symptoms. After selecting acupoints, the depth and angle of needle insertion must be clearly defined to prevent damage to vital organs, blood vessels, and nerves.
The needle insertion method emphasizes stability, accuracy, gentleness, and speed. The practitioner uses the thumb, index, and middle fingers of the hand holding the needle to stabilize the needle handle, while the ring finger provides support near the needle body for positioning. During insertion, the practitioner chooses between rapid or slow insertion based on the skin structure. Rapid insertion is often used for areas with thin skin or where less pain is desired; the needle tip is quickly pressed into the skin after touching it. Slow insertion involves pausing briefly under the skin to allow the patient to adjust before slowly advancing the needle to the desired depth. The insertion angle is categorized as perpendicular, oblique, and horizontal based on the anatomical location of the acupoint. Perpendicular insertion is often used for areas with abundant muscle, oblique insertion avoids deep, important structures, and horizontal insertion is suitable for superficial areas or areas close to bone.
Needle manipulation is a crucial step in achieving the desired effect. Techniques such as lifting, thrusting, twisting, and vibration are used to stimulate the needling sensation. Lifting and thrusting involves small up-and-down movements of the needle to adjust the stimulation intensity; twisting involves rotating the needle handle left and right to enhance the sensation of Qi and guide the flow of Qi; vibration involves rapid, small-amplitude shaking of the needle to produce continuous stimulation. The sensation of Qi is felt by the patient as soreness, numbness, distension, or heaviness, and the practitioner also feels a tightness in their hand; it is an important basis for judging whether the acupuncture was performed correctly. Techniques should vary according to the individual and the disease, avoiding the pursuit of a strong needling sensation that could lead to discomfort.
Needle retention and removal also require standardized procedures. The retention time usually depends on the severity of the condition and the needling method, ranging from several minutes to tens of minutes, during which intermittent manipulation can be performed to maintain stimulation. When removing the needle, it should be withdrawn slowly, and the puncture site should be gently pressed with a sterile dry cotton ball for a moment to prevent bleeding and Qi leakage. Special caution should be exercised at sites prone to bleeding or for patients with abnormal coagulation function.
In modern applications, the widespread use of disposable sterile needles has improved hygiene and safety, and standardized aseptic procedures are followed throughout the treatment process. Acupuncture can also be combined with moxibustion, electroacupuncture, and warm needling techniques to form a complementary and synergistic approach.
Overall, the acupuncture system integrates traditional wisdom with modern standards, emphasizing individualized treatment based on syndrome differentiation, precise operation, and safety assurance. Only with a solid theoretical foundation and skillful operational techniques can the unique value of acupuncture in disease prevention, treatment, and health maintenance be fully realized.
