Therapeutic Methods
「治療方法」
TCM encompasses several methods designed to help patients achieve and maintain health。 There are 6 modern therapeutic methods used in TCM， including acupuncture， moxibustion， tui na massage， cupping/scraping， Chinese herbs， and TCM nutrition。6 Acupuncture is the most often practiced component of TCM。
「中醫包括幾種幫助患者達到和保持健康的方法。現代中醫有6種治療方法，包括針刺、艾灸、推拿、拔火罐/刮痧、中草藥和中醫營養學。針灸是中醫臨床最常用的治療方法。」
1.
What is Acupuncture?
什麼是針刺？
Acupuncture is one of the oldest and most commonly used complementary and alternative medical treatments in the world。 It typically is not considered a stand-alone treatment but a part of TCM。 Despite having originated in China during the Shang Dynasty in 1600-1100 B。C。， it has only become popular in the Western hemisphere since 1971。
「針刺是世界上最古老和最常用的補充和替代療法之一。它通常不被認為是一種獨立的治療方法，而是中醫學的一部分。儘管它起源於公元前1600-1100年的中國商朝，但直到1971年才在西半球開始流行。」
Acupuncture began with the discovery that stimulating specific areas of the skin affected the physiologic functioning of the body， and it has evolved into a scientific system of healing that restores and maintains health。 In 1993， the US Food and Drug Administration estimated that Americans made 12 million visits per year to acupuncture practitioners。
「針刺始於人們發現刺激特定部位的面板會影響身體的生理功能，它已經發展成為一種科學的治療系統，用於恢復和保持健康。1993年，美國食品和藥物管理局估計，美國人每年拜訪針灸醫生的次數為1200萬次。」
圖片來源：Practical Paln Management （PPM）
Acupuncture is the practice of inserting and manipulating needles into the superficial skin， subcutaneous tissue， and muscles of the body at particular acupuncture points。 In TCM， there are as many as 2，000 acupuncture points on the human body， which are connected by 12 main meridians。8 These meridians conduct Qi between the surface of the body and its internal organs。 Acupuncture is believed to keep the balance between Yin （associated with the parasympathetic nervous system） and the Yang （associated with the sympathetic nervous system）。 This allows for the normal flow of Qi associated with neural transmission throughout the body and restores health to the mind and body。
「針刺是把針刺入（包括行針）位於面板淺層、皮下組織、和身體的肌肉的特定的穴位的操作。在中醫中，人體上有多達2000個穴位，它們與12條正經相連。這些經絡在體表和臟腑之間傳導氣。針刺被認為可以保持陰（與副交感神經系統有關）和陽（與交感神經系統有關）之間的平衡。這可以使氣與神經傳導得以正常輸布到全身並且恢復人體的身心健康。」
At times， electroacupuncture， the process in which an electrical current is applied to the needles once they are inserted， may be used to further stimulate the respective acupuncture points and often can be used to replace manipulation of needles。9 Electroacupuncture has been found to be especially effective in treating neuromuscular disorders。
「有時，電針，一種將電流施加到針上的過程，一旦進針之後，可進一步刺激每一個腧穴，並且經常用來代替行針操作。電針被發現對於治療神經肌肉疾病特別有效。」
Scientific Evidence for Acupuncture
針刺的科學依據
There is promising scientific evidence to support the use of acupuncture for chronic pain conditions， such as arthritis and headaches， and limited support for neck pain。10 Acupuncture also tends to provide a short-term， clinically relevant effect when compared with a control or when acupuncture is added to another intervention in the treatment of chronic low back pain。11 Acupuncture generally is safe when administered using clean needles， either disposable or sterilized。
「有很有前途的科學證據支援針刺用於慢性疼痛的治療，如關節炎和頭痛，以及對於頸部疼痛的治療有一定的作用。與對照組相比，或在治療慢性腰痛時將針刺加入到其他干預措施中，針刺也往往能夠提供短期的臨床相關效果。針刺通常是安全的，只要使用乾淨的針頭，無論是一次性或經過無菌消毒的。」
Many patients express concerns about acupuncture due to their needle phobia。 Unlike other needles， acupuncture needles are solid and hair-thin。 They generally are inserted no more than a half-inch to an inch depending on the type of treatment being delivered。 Acupressure， the application of pressure to key points with the fingers， and auricular acupuncture， the application of small needles， vicaria seeds， pellets， or ear tacks to specific points of the ear， may serve as alternatives for patients with needle phobia。
「許多患者因為害怕針而表達了對針刺治療的擔憂。與其他針不同的是，針灸針堅固而細如髮絲。根據提供的治療不同，針刺的深度一般不超過半英寸到一英寸。指壓療法，用手指按壓在關鍵腧穴上，耳穴療法，在耳朵的特定穴位上使用小針、王不留行種子、金屬小球或圖釘型皮內針，這兩種療法可以作為對針恐懼症患者的替代療法。」
In TCM， the ear is believed to be a microcosm of the body。 There are points throughout the ear， with each point related to an anatomical structure and named for the function of that structure。 The most commonly used points are the “hunger” point for weight loss， the “calming” point for stress management， and the “lung” point for smoking cessation。 Depending on the seriousness and duration of the condition being treated， the traditional acupuncture visit may take between 30 to 60 minutes。
「在中醫學中，耳朵被認為是身體的縮影。耳朵各處都有穴位，每個穴位都與一個解剖結構相關，並根據該結構的功能命名。最常用的是“飢餓”點用於減肥，“鎮定”點用於壓力管理，“肺”點用於戒菸。根據治療的嚴重程度和持續時間，傳統的針刺治療每次可能需要30到60分鐘。」
It may take several visits to see significant improvement of the chronic pain condition。 While each person experiences acupuncture differently， most people feel only a minimal amount of pain as the needles are first inserted。 When practiced by a licensed， trained acupuncturist， acupuncture is extremely safe。 Acupuncture often is accompanied by other TCM methods outlined below。
「可能需要多次就診才能看到慢性疼痛狀況的顯著改善。雖然每個人的針刺體驗都不一樣，但大多數人只是在剛剛進針的時候感到輕微的疼痛。當由一個有執照的，訓練有素的針灸師治療時，針刺治療是非常安全的。針刺治療經常和其他中醫方法同時使用，現概述如下。」
2. What is Moxibution?
什麼是艾灸？
Moxibustion is a therapy that involves burning moxa， mugwort root， made from dried Artimesia vulgaris， a spongy herb， to facilitate healing。 Burning moxa produces a great deal of smoke and a pungent odor that can be confused with that of cannabis。 The purpose of moxibustion is to warm and invigorate the blood， stimulate the flow of Qi， strengthen the kidney Yang， expel wind and disperse cold， and dissolve stagnation。
「艾灸是一種點燃乾燥的海綿狀草本植物製成的艾葉，從而促進癒合的治療方法。燃燒艾條會產生大量的煙霧和一種可以與大麻混淆的刺鼻氣味。艾灸的目的是溫補氣血，理氣活血，強壯腎陽，祛風散寒，化瘀散瘀。」
There are 2 types of moxibustion， direct and indirect。 In direct moxibustion， a small， cone-shaped amount of moxa is placed on top of an acupuncture point and burned。 The patient will experience a pleasant heating sensation that penetrates deep into the skin using this technique。
「灸法有直接灸法和間接灸法兩種。在直接灸法中，把一小塊錐形的艾柱放在一個穴位上，然後點燃。使用這種技術，患者會體驗到一種滲透面板深處的舒適的溫熱感覺。」
Indirect moxibustion is the more popular form of care。 In indirect moxibustion， a practitioner lights one end of a moxa stick and holds it close to the area being treated for several minutes until the area turns red。 Historically， this therapy had been used to treat menstrual pain。
「間接灸法是一種比較流行的治療方式。在間接艾灸中，一個醫生點燃艾條的一端，並將其保持在治療區域附近幾分鐘，直到該區域變紅。歷史上，這種療法曾被用來治療通經。」
A substitute for moxibustion may be the Teding Diancibo Pu （TDP） lamp， another method of using warming therapy。 The TDP lamp has become a new fixture in many practices because it is as effective as moxa but does not cause respiratory difficulties in sensitive patients。 Unlike a traditional heating lamp， the TDP lamp features a plate coated with a mineral formation consisting of 33 elements。
「特定電磁波譜照射燈（TDP）可能成為艾灸療法的替代品，這是另一種溫熱治療方法。TDP燈已經成為許多醫療實踐中的一種新裝置，因為它與艾條一樣有效，但不會造成敏感患者的呼吸困難。與傳統的加熱燈不同，TDP燈的特點是具有一個塗有由33種元素組成的礦物層的金屬板。」
3. What Is Tui Na Massage?
什麼是推拿？
The name for this method of TCM comes from two of the actions of the therapy， tui meaning “to push” and na meaning “to lift and squeeze。” Tui na， a combination of massage， acupressure， and other forms of body manipulation， is a form of Asian bodywork therapy that has been used in China for centuries。 The details of tui na’s techniques and uses were originally documented in The Yellow Emperor’s Classics of Internal Medicine，15 which was written about 2，500 years ago。
「這種中醫治療方法的名稱來自於治療的兩個動作，“推”的意思是“推”，“拿”的意思是“提和捏”。推拿是一種結合了按摩、穴位按摩和其他身體手法的療法，是一種亞洲身體療法，在中國已經使用了幾個世紀。推拿技術和使用的細節最早記載在《黃帝內經》中，距今大約2500年。」
In a typical tui na session， the patient remains clothed and sits on a chair。 The practitioner will ask a series of questions and then begin treatment。 The type of massage delivered by a tui na practitioner can be quite vigorous at times。 Practitioners may sometimes use herbal compresses， ointments， and heat to enhance these techniques。 Tui na is best suited for rectifying chronic pain and musculoskeletal conditions。 Tui na is considered one of the “external” medical therapies of TCM， another being cupping/scraping。
「在一個典型的推拿治療過程中，病人仍然穿著衣服，坐在椅子上。醫生會詢問一系列問題，然後開始治療。推拿師所提供的按摩有時會非常有力。醫生有時會使用膏藥、軟膏和熱敷來加強治療效果。」
「推拿手法最適合用於治療慢性疼痛和肌肉骨骼疾病。推拿手法被認為是中醫的“外”治法之一，另外還有拔火罐/刮痧。」
素材來源：Practical Paln Management （PPM）
本文特別感謝：David Cosio，PhD， ABPP
Erica H。 Lin，PharmD，BCACP
By：宏小醫
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