推拿學全套課件

一指禪推法

PushingManipulationwithOne-fingerMeditation

一、概念Concept

用大拇指指端或羅紋面或偏峰著力于治療部位，沉肩、垂肘、懸腕，以周期性的肘關(guān)節(jié)屈伸，帶動前臂與腕關(guān)節(jié)作內(nèi)、外擺動，與拇指關(guān)節(jié)屈伸的聯(lián)合動作。

Pushingwithone-fingermeditationreferstothemanipulationofoperator’susingthetipofthethumb,orthewhorledsurfaceofthethumbtopushtheregiontobetreatedwiththeshoulderrelaxing,theelbowdropping,wristhanging,elbowflexingandstretchingcyclicallytopowertheforearnandwristjointtoswinginwardandoutward,withthecombinationofthumb’sflexionandextension.二、分類Classification

以拇指端峰為著力點操作的稱指峰推；操作時，拇指之間關(guān)節(jié)固定在背伸位，以羅紋面為著力點的稱羅紋推；以拇指橈側(cè)少商處為著力面的又叫偏峰推，此法操作時腕關(guān)節(jié)略屈，食、中、無名、小指向前自然伸開，成散手狀。

以上三種推法頻率均在120~160次/分左右。還有一種以指峰著力，擺幅小，頻率快達每分鐘240次以上者，稱纏推法或纏法。

Amongthem,operatingwiththepowerfromthetipofthethumbiscalledfinger-tippushing;inwhichtheinterphalangealjointofthethumbisfixedattheback-stretchingposition,operatingwiththeforcefromthewhorledsurfaceisShao-shangpointatthesideofthethumb-radiusiscalledlateralpushing,inthisoperation,theoperatorslightlyflexeshiswristjointwithindexfinger,middlefinfer,ringfingerandlittlefingernaturallystretchingforwardinthefinger-separatingpattern.

Thefrequencyofthethreetypesofpushingisabout120~160timesperminute.Thereisanothermanipulation,inwhichtheoperatorpusheswiththeforcefromthefingertip,withanarrowrangeandquickfrequencyofmorethan240timesperminute.Thatkindofmanipulationiscalledquickvibrating-pushingmanipulationorquickpushingmanipulation.注意事項Precaution本法操作時首先要強調(diào)自然著力原則；其次，在施術(shù)過程中，拇指的著力點要始終“吸定”再治療穴點上，不得在皮膚表面滑移或摩擦，擺動時，要做到本動作過度自然、平穩(wěn)，不得跳動，以使手法柔和。Inoperatingwiththistechnique,first,theprinciplofexertingforcenaturallyisemphasized;thenduringtheprocessofmanipulation,thepower-applyingpointofthethumbshouldbeconstantly“fixed”onthepointfortreatment,andslippingorrubbingonthesurfaceoftheskinshouldbeavoided.Intheswingingprocess,theshiftofmanipulationshouldbenatural,steadyandnotinajumpingmanner,sothatthemanipulationissoft.

臨床應用

ClinicalApplication

本法的特點是著力點面積小，作用力壓強大，深透行強，刺激量的大小可根據(jù)需要隨意調(diào)節(jié)，是一種持續(xù)的節(jié)律性的柔和刺激。該法使用于在全身各部經(jīng)絡、穴位操作，可治療內(nèi)、婦、骨傷、五官及兒科各種常見病證。Thecharacteristicsofthistechniqueisthattheareaofpower-applyingpointissmallbuttheappliedforcehasgreatpressureanddeepnessandthoroughness,andthestimulatingintensitycanbeadjustedatwillaccordingtothespecifiedrequirement,andthestimulusislasting,rhythmicalandsoft.Thistechniqueisappliedtotheoperationonallthechannelsandcollateralsandpointsalloverthebody.一、定義（Definition）

以小魚際及手背尺側(cè)為著力面，沉肩、垂肘、立臂、豎掌，肘關(guān)節(jié)與前臂做周期性的屈、伸與內(nèi)、外旋臂擺動，并帶動腕關(guān)節(jié)屈、伸，使弓成圓形的手背在施術(shù)部位上作來回滾動的手法即謂滾法。

Withtheminorthenareminanceanddorsoulnarusedastheforce-applyingsurface,thepractitionerlowershisshoulderanddropshiselbowwithhisarmerectedandhispalmsetupright,proceedscyclicalflexion,extensionandinwardandforearmaccompaniedwithextensionandflexionofthewristjointtorolltheroundbackofthehandtoandfroontheregiontobetreated.Suchmanipulationiscalledrollingmanipulation.二、手法要領(lǐng)

PurportofOperation

1、本法在連續(xù)操作時，要特別注意，手背著力面須緊貼治療部位的皮膚,不能在上面來回拖檫與滑移。

2、力度與節(jié)律要均勻。

3、在擺動周期之間，術(shù)手不要抬起離開治療部位。4、手的掌指與指間關(guān)節(jié)一直保持自然屈曲姿勢。5、腕關(guān)節(jié)的屈伸交替要過渡自然，不要引起跳動。6、本法的頻率在120~160次之間。Whenthemanipulationisusedcontinuously,thefollowingshouldbecarefullyobserved:theoperator’shandbackshouldbekeptclosetotheskinoftheoperatedregion,scrubbingtoandfroandslippingonitshouldbeavoided.Theintensityoftheforceandrhythemshouldbeeven.Theoperatinghandshouldnotbeliftedupawayfromthetherapeuticregionbetweentheswingingperiodsincasetappingwillbecaused.Themetacarpophalangealandinterphalangealjointskeepinnaturalflexingpositionwithoutanyactivepinchingorclosingorextending.Thetransitionofthewristjoints’flexionandextensionshouldbenaturalwithoutanyjerk.Thefrequencyofthismanipulationis120~160timesperminute.三、作用

Function

本法具有舒筋通絡、祛風散寒、溫經(jīng)勝濕、活血化瘀、解痙止痛、松解粘連、滑利關(guān)節(jié)等功效，尤以治療運動系統(tǒng)與神經(jīng)系統(tǒng)疾病見長。

Thismanipulationhasthefollowingeffects:reflexingthemuscleandtendonanddredgingthechannel,expellingpathogenicwindangcold,warmingthechannel,expellingpathogenicdampness,promotingbloodcirculationtoremovebloodstasis,relievingspasmandpain,relaxingadhesion,lubricatingjoint,etc.anditisdoodattreatingthediseasesinmotorsystemandnervesystem.四、臨床應用ClinicalApplication

滾法刺激面積大，作用力強，深透作用明顯，是臨床最常用的手法之一。本法除頭面、前頸及胸腹外，其他部位均可使用，特別適用于腰背、腰臀及四肢肌肉較為豐厚的部位。

Rollingmanipulationwhichhasalargeareaofstimulationwithstrongeffect,evidentdeepnessandthoroughness,isoneofthemostcommonly-usedmanipulation.

以指、掌根、大魚際或肘尖為著力點，再治療部位做輕柔緩和的回旋動作即為揉法。

Thisisamanipulationperformedbykneadingslowlyandsoftlythetherapeuticregionto-andfrowithfingers,thebottomofthepalm,majorthenareminanceorthetipoftheelbow.

一、概念Concept二、分類Classification

根據(jù)著力部位的不同，可分為指揉法、掌根揉法、大魚際揉法和肘揉法等。

Accordingtothedifferentpartstobeoperated,itcanbedividedintofingerkneadingmanipulation,

palm-rootkneadingmanipulation,

major-thenarkneadingmanipulation,elbow-kneadingmanipulation,etc.三、注意事項Precaution

應用本法動作貴在柔和，揉轉(zhuǎn)的幅度要由小而大，用力應先輕漸重，術(shù)手要吸定在操作部位上，不得在皮膚表面摩擦與滑動，頻率在每分鐘100~160次之間。

Inthismanipulation,thewholemanipulationemphasizessoftness,andtherangeofkneadingandrotatingshouldbegraduallyextended,andtheforcegraduallyincreased.Theoperatinghandshouldbefixedonthetreatedregionwithoutanyrubbingorslippingontheskinsurface.Thefrequencyisabout100-160timesperminute.四、功效Effect

揉法有寬胸理氣、健脾和胃、活血散瘀、消腫止痛、祛風散寒、溫經(jīng)通絡、安神鎮(zhèn)驚等功效。

Kneadingmanipulationhasthefollowingeffects:soothingthechestoppressionandregulatingtheflowofqi,strengtheningthespleenandregulatingstomach,promotingbloodcirculationtoremovebloodstasis,subducingswellingandalleviatingpain,expellingpathogenicwindandcold,promotingtheflowofqibywarmingthechannel,tranquilizingthemindandrelievingconvulsion,etc.五、臨床應用ClinicalApplication

揉法作用力輕柔緩和而深透，通過揉動形成的內(nèi)摩擦，可在組織深層產(chǎn)生溫熱作用。適用于全身各部位操作，是推拿臨床常用手法之一。Theeffectofkneadingmanipulationislight,softandslowbutdeepandthorough.Warmeffectcanbecreatedinthedeeplayerofthetissuebytheinternalrubbingcausedbykneading.Thismanipulationcanbeappliedtoallpartsofthebody,andisoneofthecommonly-usedmanipulationofclinicalmassage.

大魚際揉法多用于頭面、胸腹部及四肢由急性扭傷所致的局部腫痛處。掌根揉法多用于腰背、臀部及四肢肌肉豐厚處。指揉法可用于全身各部經(jīng)穴以及需要做點狀刺激的部位。肘揉法則適宜于對深層組織的治療。

Amongthekneadingmanipulation,majorthenarkneadingmanipulationisfrequentlyappliedtothecraniofacialand,thoracico-abdominalregionsandtheswellingorachingpartsofthelimbscausedbyacutesprainandcontusion.Palmar-bottomkneadingmanipulationisfrequentlyappliedtothelumbodorsalregion,buttockregionandthethickmuscularregionsofthelimbs.

Finger-kneadingmanipulationcanbeoperatedonallthechannelpointsthroughoutthebodyandtheregionsthatneeddigitalstimulation.Elbow-kneadingmanipulationissuitablefortreatingthedeeplayerofthetissue.

常用于治療頭痛、眩暈、失眠、面癱、脘腹脹痛、胸悶脅痛、便秘、泄瀉以及腰背、四肢軟組織損傷等病證?！靖拍睢緾oncept

用手掌或食、中、無名、小指掌面附著在治療部位上，以一定的節(jié)律做環(huán)形撫摩的手法稱為摩法。頻率平穩(wěn)適中一般在每分鐘100~120周左右。

Themanipulationperformedbyrhythmicallyrubbingthetherapeuticpartinacircularmotionwiththepalmorthepalmarsideoftheoperator’sfingersclosetothetherapeuticregioniscalledrubbingtechnique.Itsfrequencyshouldbemoderate,evenandsteady,about100-120circlesperminute.【分類】Classification以手掌著力者謂掌摩法；以四指掌面著力操作者稱指摩法。

Rubbingwiththeoperator’spalmiscalledrubbingmanipulationwiththepalm;rubbingwiththepalmarsideofthefingersiscalledrubbingmanipulationwithfingers.【功效】Effect

摩法主要適用于胸腹、脘腹部，具有疏肝理氣、溫中和胃、健脾助運、消積導滯及調(diào)節(jié)腸胃蠕動等功效。

Rubbingtechniqueismainlyappliedtooperatingonthechest,hypochondriumandtheepigastricregion,andithastheeffectsofrelievingthedepressedliverandregulatingthecirculationofqi,warmingthemiddle-jiaoandregulatingthestomach,invigoratingthespleen,promotingdigestionandremovingstagnantfood,regulatinggastrointestinalperistalsis,etc.【臨床應用】ClinicalApplication

常用于治療中焦虛寒、脘腹脹滿、腸鳴腹痛、胸悶氣滯、脅肋脹痛、胸脅迸傷、泄瀉、便秘、下元虛冷等病證。

Itiscommonlyusedtotreatsuchdiseasesascoldofinsufficiencytypeinthemiddle-jiao,fullnessintheepigastricregion,borborygmusandpainintheabdomen,oppressedfeelinginthechestandstagnationoftheflowofqi,distendingpaininthehypochondrium,injuryofthechestandhypochondrium,constipationanddiarrhea,coldofinsufficiencytypeoflower-jiao.

臨床使用本法時，根據(jù)操作的力度、頻率與方向的不同，可起到或補或瀉的作用。例如，“緩摩為補，急摩為瀉”；又如，在小腹部操作時，順時針方向摩運可通調(diào)腸腑積滯，其到瀉熱通便的作用；而逆時針方向摩運則能溫中止瀉，發(fā)揮溫補下元的功效。【概念Concept】

拇指外展與四指垂直，以手掌及拇指橈側(cè)緣著力，在施術(shù)部位上沿直線作來回的手法，稱平推法，亦稱掌推法。

Flat-pushingisthemanipulationperformedbyrectilinearlypushingandscrubbingtheoperatedparttoandfrowiththeoperator’spalmandthumbradialborder,withhisthumbabductedatarightanglewiththeotherfingers.Itisalsocalledpalmpushingmanipulation.【動作結(jié)構(gòu)

StructureofOperation

】

操作時，首先肩向前伸，同時肘關(guān)節(jié)順勢伸出，使手掌沿直線向前推去，拇指也在所經(jīng)過的部位上用力向前推蕩，并由外展位過度到向食橈側(cè)靠攏的位置。然后，肩再后伸，同時屈肘，使手掌沿原來的軌跡輕輕地擦到起始位置，并恢復到原來的掌式。

Inoperation,first,theoperatorprotrudeshisshoulder,meanwhileextendshiselbowjointoutwards,andpushestheoperatedpartrectilinearlywithhispalmand,withhisthumbpushingandmoppingforcefullyalongit,histhumbischangedfromabductiontobeingclosetotheindexfingers’radialborder.

Thenheextendshisshouldbackwards,flexeshiselbowanduseshispalmtopushandrubalongtheoriginaltracebacktotheinitialposition,andhispalmarpostureisreturnedtoitsoriginalone.【注意事項

Precaution】

應注意，本法在向前推去時用實力，而往回推至原位時用虛勁。整個動作要舒展，操作路線要拉長，在發(fā)力動作時，呼吸要自然，切忌屏氣。另外，受術(shù)部位要暴露，為便于操作與保護皮膚，操作時要用介質(zhì)。平推法的頻率每分鐘100次左右。

Thefollowingshouldbeemphasizedinthismanipulation:inpushingforwardsastrongforceshouldbeusedandinpushingbacktotheoriginalpositionaweakforce;themovementshouldbesmooth,andtheoperationrouteshouldbelong;ingeneratingforce,theoperatorshouldbreathenormallyandavoidholdinghisbreath.

Inaddition,theoperatedregionshouldbeexposed,andacertainmediumcanbeusedinoperationinordertomaketheoperationeasyandprotecttheskin.Itsfrequencymanipulationisabout100timesperminute.【功效

Effect】本法是一種“溫、力”并行的方法，故有良好的溫經(jīng)通絡。行氣活血等治療作用。Thismanipulationisacombinationof“warmthandforce”,soithasagoodeffectonwarminganddredgingthechannelsandcollaterals,promotingcirculationofbloodandqi,etc.有開胸利氣止咳平喘之功。Ithastheeffectofrelievingthecheststuffiness,promotingcirculationofqi,relievingcoughandasthma.

具健脾和胃疏肝理氣之效。Itfunctionsininvigoratingthespleenandregulatingthestomach,andrelievingdepressedliverandregulatingthecirculationofqi.

壯腰健腎。Ithastheeffectofinvigoratingtheloinsandstrengtheningthekidney.【臨床應用

ClinicalApplication】適宜于在胸背及腰背部操作。

Itissuitablefortheoperationonthethoracodorsalregionandlumbo-abdominalregion.概念Concept

以手掌掌面小魚際或大魚際為著力面，在治療部位沿直線進行往返摩擦的方法，謂之擦法。

Themanipulationofrubbingandscrubbingthetherapeuticpartofandfroastraightlinewiththeoperator’spalmarface,minorormajorthenareminanceiscalledscrubbingmanipulation.分類Classification

根據(jù)著力部位不同，本法可分為掌擦法、小魚際擦法和大魚際擦法三種。

Accordingtothedifferentoperatingparts,thismanipulationcanbedividedintothreetypes:plam-scrubbing,minor-thenarscrubbingandmajor-thenarscrubbing.動作結(jié)構(gòu)

StructureofOperation

本法操作時，術(shù)者多取戰(zhàn)勢。預備姿勢為：沉肩、垂肘，掌擦時，前臂內(nèi)側(cè)與治療部位相對，腕掌與五指伸直，以全掌附著在治療部位；小魚際擦時，前臂取中立位，腕掌與手指用力伸直，五指并攏，以小魚際著力；大魚際擦時，前臂取旋前位，掌面朝下，拇指與第一掌骨內(nèi)收，以隆起的大魚際肌腹附著在治療部位。Intheoperationofthismanipulation,theoperatorisusuallyinastandingposition.thepreparatoryisasfollows:theoperatorlowshisshoulder,dropshiselbow.

InPalm-scrubbingmanipulation,withthemedialaspectofhisforearmfacingthetherapeuticpart，heextendshiswrist,palm,thumbandfingersstraightlywithhiswholepalmpressingcloselyontheterapeuticpart,inminor-thenarscrubbingmanipulation,hisforearmisinamoderatelyercctingposition,heextendshiswrist，palmandfingersnstraightlyandputshisfingerstogether,andrubsthetherapeuticpartwithminorthenarforce.

Inmajor-thenarscrubbingmanipulation,hisforearmisintheproneposition，withhispalmfacingdownwards,histhumbandfirstmetacarpalboneabducted，andtheprotuberantmuscularbellyofmajorthenareminancecloselyappliedtothetherapeuticpart．注意事項

Precaution

本法的動作幅度要大，使推擦的部位盡量的拉長。在操作過程中，著力面始終與受術(shù)部位的皮膚貼緊，用力均勻適中。

Thismanipulationshouldbeoperatedwithinalargerange,andtheoperatorshouldtrytolengthenthedistanceofpushingandscrubbing.Duringtheoperation,theoperatingpartshouldbekeptclosetotheskinofthetherapeuticregion,andtherubbingforceshouldbeevenandmoderate.

本法在操作時受術(shù)部位要充分暴露，開始幾次推擦宜緩和稍慢，以后速度可稍快。每次治療以局部發(fā)熱為度，操作次數(shù)不宜太多，時間也不應長，以免造成局部過熱、發(fā)燙起泡。一般每次以十次左右為宜。為防止擦破皮膚并有助于產(chǎn)熱與增強療效，施用本法時，一般要使用介質(zhì)。Inoperation,theaffectedpartshouldbeexposedfully.Theoperatorstartsrubbingsoftlyandslowly,thenabitmorequickly.Eachtreatmentisaccomplishedwhentheoperatedpartbecomeswarm.Itshouldnotbeoperatedfortoomanytimes,andthetimeshouldnotbetoolongincasethetherapeuticregionbecomessohotthatscaldblisterswillbecaused.

About10timesisusuallysuitabletoeachtreatment.Inordertopreventtheskinfrombeingabraded,producegreaterwarmthandenhancetherapeuticeffect,acertainmediumisoftenusedinthismanipulation.功效

Effect

有寬胸利氣、溫經(jīng)止痛、祛風散結(jié)、行氣活血、祛痹勝濕等功效。

Themanipulationhasthefollowingeffects:relievingcheststuffinessandregulatingthecirculationofqi,warmingthechannelsandalleviatingpain,expellingpathogenicwindandcold,relievingswellingandremovingobstructionofthechannels,promotingflowofqiandbloodcirculation,relievingarthralgiaandremovingdampness,etc.臨床應用ClinicalApplication本法的摩擦力強、動作幅度大，故具有明顯的溫熱效應與推蕩消散作用。Thismanipulationhasstrongrubbingforcewithalargerangeofmovement,ithasevidentwarmingeffectandthefunctionofremovingobstruction.適用與全身各部位施術(shù)。其中，掌擦法宜在胸背與腹部面積較大的部位施術(shù)，可產(chǎn)生較緩和的熱效應。

Itcanbeappliedtoallpartsofthebody.Palm-scrubbingmanipulationissuitablefortheoperationonlargeregionssuchaschestandback,theabdominalregion,anditcancreatesoftwarmingeffect.小魚際擦法，主要用于腰骶八髎穴、夾脊穴及骶棘肌，由于其作用面積小，故可產(chǎn)生較為集中的高熱效應。Minor-thenarscrubbingmanipulationismainlyappliedtothelumbosacralBaliaopoints,Jiajipointsandsacrospinalmuscle;becauseofitssmalleffectarea,concentratedhighheateffectcanbecreated.概念Concept

用雙手掌相對用力，對被挾持的肢體做快速的來回搓揉，并同時作上下往返移動的手法，稱為搓法。

Twopalmsfacingeachotherrapidlyroll-kneadtheheldpartofthebodywithrelativeforceandmoveupwardsanddownwardsrepeatedly.Thismanipulationiscalledfoulage.動作結(jié)構(gòu)

StructureofOperation

術(shù)者取馬步，雙腿下蹲，上身略前傾，雙手向前伸出，對稱用力挾持住治療肢體。搓動時，雙手來回搓動的頻率要快，幅度要均勻；但上下移動的行進速度則宜稍慢，整個動作要求做到“快搓慢移”。

Thedoctorisinhalf-squattingposition,withupperbodyslightlyincliningforwards;holdstheoperatedlimbwithsymmetricforcebytwoforward-stretchinghands.Infoulaging,thefrequencyofthehandsshouldberapid,andamplitudeshouldbeeven;buttheupanddownmovingoughttobeslower.Theentireoperationdemands“rapidfoulagingandslowmoving”.功效

Effect

具有調(diào)和氣血、理順組織、舒筋通絡與放松肌肉的作用。

Ithasthefunctionofregulatingqi,bloodandtissues,relaxingmuscleandtendonsandremovingobstructioninthechannels.臨床應用ClinicalApplication

本法是推拿常用的輔助手法之一，主要用于上肢、脅肋部也可用于腰與下肢，作為治療最后的結(jié)束手法。

概念

Concept用雙手或單手拇指指面，緊貼于治療部位，沿直線輕輕地做上下或左右反復摩擦的手法，稱為抹法。Amanipulationofmassage,performedbysoftlyrubbingtheskinoftheaffectedpartwiththesurfaceofonethumborsurfacesoftwothumbsupanddown,orrightandleft,straightly.動作結(jié)構(gòu)

StructureofOperation

雙手抹時，如果朝一個方向操作，雙手要沿直線一起一落地交替進行；如向左右分抹時雙手要同時操作，頻率要均勻，每分鐘在100~120次左右。

Intwo-hand-wiping,ifinonedirection,thetwohandsshouldoperatealongastraightline,andupanddownalternatively;ifintwodirections,thetwohandsoperatesimultaneously.Frequencyshouldbeeven,about100~120timesperminute.注意事項

Precaution用力要適中，不可太重以免動作滯澀；又不可太輕而使動作飄浮。為防止擦破皮膚，施術(shù)時，可用滑石粉等介質(zhì)。

Theforceusedshouldbemoderate,nottoogreatsoastoavoidstagnatingandastringentoperation;nortoolightsoastopreventsuperficialoperation.Toavoidskinscratches,mediumssuchastalcpowdercanbeusedinoperation.功效

Effect具有開竅鎮(zhèn)靜、醒腦明目、安神止痛舒筋活血等作用。Ithasthefunctionofinducingresuscitation,tranquilizingthemind,restoringconsciousness,improvingvision,alleviatingpain,andrelaxingmusclesandtendonstopromotebloodcirculation.臨床應用ClinicalApplication本法是一種刺激量較輕的手法，主要用于頭面、五官及頸項部。Wipingisamanipulationoflighterstimulus,mainlyappliedtohead,face,fivesenseorgans,andcervicalpart.一、概念Concept

以指端、掌、掌根或肘尖著力，先輕漸重、由淺而深地反復按壓治療部位的手法。

Pressingisthemanipulationperformedbypressingthetherapeuticregioncontinuouslywiththeoperator’sfinger-tip,palm,palm-rootorthetipofhiselbow,fromlightlytoheavily,shallowlytodeeply.二、分類

Classification

根據(jù)其著力部位不同，可分為拇指按法、中指按法、指節(jié)按法、掌根按法、掌按法與肘按法等。

Accordingtothedifferentmanipulatingparts,itcanbedividedintothumb-pressingmanipulation,middle-finger-pressingmanipulation,phalangeal-joint-pressingmanipulation,palm-root-pressingmanipulation,palm-pressingmanipulation,elbow-pressingmanipulation,etc.三、動作結(jié)構(gòu)

StructureofOperation

1、為了便于發(fā)力，輕按時術(shù)者可取坐勢；重按時則應取站勢。施術(shù)時，術(shù)者要呼吸自然，不得屏氣，用力平穩(wěn)，由輕而重逐漸加力，當達到一定深度，患者有明顯的痛、脹、麻、放射等“得氣感”時，停留約5~10秒鐘左右，再將手慢慢抬起。

１．Inordertogenerateforceeasily,theoperatorcanadoptsittingpostureinlightpressuremanipulation,andstandingpostureinheavypressuremanipulation.Inoperation,theoperatorshouldbreatheinanormalway(neverholdhisbreath)andpresssteadilyfromlighttoheavytillacertaindeepnessisachieved.Whenthepatienthasexperiencedevidentsensationssuchassoreness,distention,numbnessandradiation,theoperatorshouldretainhishandontheoperatedpartforabout5to10minutes,thenslowlylifthishandup.

2、本法在需要較大力度與反復多次操作時，宜用疊揉法。

3、本法利用自身重力來施加壓力，手或臂無需主動用力，故作用力強而術(shù)者省力。Ifthemanipulationisrequiredtocarrygreatforceandneedsoperatingcontinuouslyformanytimes,thesuperposedkneadingmanipulationcanbeadopted.Inthismanipulation,theoperatorpressestheoperatedpartwiththepressurefromhisowngravity,andhishandorarmdoesnotneedtogenerateforceactively,sothemanipulationsaystheoperatoraloteffortsofstrengthbuthasgreateffect.四、功效

Effect

本法具有安神鎮(zhèn)靜、解痙止痛、開竅閉塞、舒筋活血、蠲痹通絡與壯筋養(yǎng)肌等作用。

Thismanipulationhasthefollowingeffects:tranquilizingthemindandallayingexcitement,relievingspasmandpain,inducingresuscitation,relaxingmusclesandtendonsandpromotingbloodcirculation,relievingarthralgiaandremovingobstructioninthechannel,strengtheningthetendonandmuscles,etc.五、臨床應用ClinicalApplication按法是一種古老的傳統(tǒng)手法，其適用范圍很廣，可在全身各部操作施術(shù)。Pressingmanipulationisatraditionalmanipulationwhichdatesbacktotheancienttimes,ithasmanyindicationsandcanbeappliedtooperatingonallthepointsoverthebody.指按法適用于全身各部經(jīng)穴，可“以指代針”發(fā)揮針刺樣的治療作用，故又有“指針法”之稱；Finger-pressingmanipulationisappliedtoallthechannel-pointsanditcanachieveacupunctureeffect“withthefingerinsteadofneedle”;soitisalsocalled“finger-pressuretherapy”;掌按法主要用于腹部；掌根按適用于腰背及臂部面積較大肌肉又豐厚的部位；肘按法又稱肘壓法，需作重力刺激時常用此法。常用以治療頭痛、失眠、胃脘痛、痹證肢體麻木、酸痛癱瘓等證。Palm-pressingmanipulationischieflyappliedtotheabdominalregion;Palm-root-pressingmanipulationissuitablefortheoperationontheregionsoflargeandthickmusclessuchasthelumbodorsalregionandthebuttockregion;一、概念Concept

以拇指與食、中二指或其他四指，緩緩地對稱用力，將治療部位挾持、提起，并同時捻搓揉捏的手法稱為拿法。

Graspingmanipulationisperformedbysymmetricallyandslowlyliftingandsqueezingthetherapeuticpartandmeanwhileholdingandtwisting,foulaging,kneadingandpinchingitwiththeoperator’sthumbandindexfingerandmiddlefingerorwithfivefingers.二、分類Classification

以拇指與食、中二指操作的稱三指拿法；與其他四指操作的謂五指拿法。

Operatingwiththeoperator’sthumbandindexfingerandmiddlefingeriscalledthemanipulationofthree-fingersgrasping;themanipulationwithfivefingersiscalledfive-fingersgrasping.三、動作結(jié)構(gòu)

本法施術(shù)時多取站士，沉肩，肩關(guān)節(jié)外展30°~45°，前伸30°左右，屈肘約90°~110°，腕關(guān)節(jié)略屈，拇指與其余二指或四指各指間關(guān)節(jié)伸直，掌指關(guān)節(jié)屈曲約110°~120°，以指面挾持住治療部位的肌腱或肌束，然后提起，并同時捻揉，刺激數(shù)次后再放下，如次反復操作。StructureofOperation

Inusingthismanipulation,theoperatorisofeninstandingposition,andlowershisshoulderwithhisshouldjointabducted30degreesto45degreesandprotrudedbout30degrees,flexeshiselbowabout90to110degreeswithhiswristjointslightlyflexed;andextendstheinterphalangealjointsofhisthumbandothertwofingersorfourfingerswiththemetacarpophalangealjointsflexedabout110to120degrees.

Thenheholdthetendonormusclebundleofthetherapeuticpart,liftsitupandmeanwhiletwirlsandkneadsit,andreleasesitafterstimulatingitseveraltimes.Theoperationisdonerepeatedly.四、注意事項

Precaution

操作過程中，各動作環(huán)節(jié)要協(xié)調(diào)，并富于節(jié)律。提拿的部位主要是人體深層的肌腱、韌帶與肌束等條索狀組織，故不要緊挾持表皮，更不能用指甲著力摳掐治療部位，以免引起疼痛等不適感。

Duringtheoperation,everymovementshouldecoordinatedandoperatedrhythmatically.Thepartbeingliftedandgraspedischieflythecordtissuesuchastendon,ligamentandmusclebundleofdeeplayersofthebody,soholdingtheepidermorevendiggingandnippingtheoperatedpartwithfingernailshouldbeavoidedincasediscomfortssuchaspainwillbecaused.五、功效Effect

具有開竅醒神、發(fā)汗解表、祛風散寒、舒筋活血、解痙止痛等功效。

Ithasthefollowingeffects:inducingresuscitationandrestoringconsciousness,relievingsuperficiessyndromebymeansofdiaphoresis,expellingpathogenicwindandcold,relaxingmusclesandtendonstopromotebloodcirculation,relievingspasmandpain,etc.五、臨床應用1、本法刺激深重而柔和。主要用于頸項、肩背、側(cè)腹部及四肢部肌肉、肌腱等條索狀軟組織部位。

Thismanipulationisdeepandheavybutsoftstimulation.Itischieflyappliedtothecordsofttissuessuchasthemusclesandtendonsoftheneck,shoulder,back,lateralabdomen,upperandlowerlimbs,etc.

ClinicalApplication

概念Concept用拇指與食指挾持住受術(shù)者的指、趾等治療部位，并相對用力做來回搓揉動作，稱為捻法。Holdingtheoperatedpartssuchasfingersandtoeswiththethumbandtheforefingerandtolling-kneadingtoandfrowithrelativeforceiscalledholding-twisting.

動作結(jié)構(gòu)

StructureofOperation

本法挾持住受術(shù)者的指、趾的手勢有三種：一是用拇、食指指面；二是用拇指指面與食、中二指指面；三是用拇指指面與屈曲成弓形的食指中節(jié)橈側(cè)面。

Therearethreewaysofpinchingfingersandtoesofthepatient:withpalmarsidesofthethumbandtheindexfinger;withpalmarsidesofthethumb,indexandmiddlefingers;withthepalmarsidesofthethumbandradialsurfaceofthemiddlejointofthefirstindexfingerwhichisflexedintotheshapeofabow.

注意事項

Precaution

捻動時，動作要靈活、稍快，相對指的搓捻動作要配合默契，用力稍重但要均勻而適度。

Theholding-twistingshouldbedexterousandquicker.Atacitagreementisneededbetweentheactsoftheholdingthumbandfingers.Andtheforceusedshouldbeabitgreater,butevenandmoderate.

功效

Effect具有滑利關(guān)節(jié)、消腫止痛、舒筋活血的功效。Ithasthefunctionoflubricatingjoints,subduingswelling,alleviatingpain,andrelaxingmusclesandtendonstopromotebloodcirculation.

臨床應用

ClinicalApplication本法主要用于手指、腳趾小關(guān)節(jié)及指端末梢

Thismanipulationisprimarilyappliedtosmalljointsoffingersandtoes,andfinger-tips.主治指、趾關(guān)節(jié)酸痛、腫脹、屈伸不利與扭傷等病證；

Itismainlyusedtotreatsymptomsofachingpain,swelling,inconvenientflexingandstretching,andsprainoffingerandtoejoints.概念Concept用虛掌拍打體表的手法，稱為拍法或拍打法。Themanipulationofpatting-beatingwithemptypalmonthebodysurfaceiscalledpattingmanipulationorpatting-hittingmanipulation.

動作結(jié)構(gòu)StructureofOperation

操作時五指并攏，手指伸直，掌指關(guān)節(jié)略屈，使掌心凹成“虛掌”，先將術(shù)手抬起，對準治療部位以一種富有彈性的巧勁向下拍打后，隨即“彈起”，并順勢將術(shù)手抬起到動作開始的位置，以便于進行下一個拍打動作。

Whileoperating,thedoctor’sfingersareclosed-upandstraightly-stretched.Themetacarpophalangealjointsareslightlyflexedastoconcavethepalmtoformanemptypalm.Thedoctorliftsuptheoperatinghand,andpatdownthetherapeuticregionwithelasticandskillfulstrength,thenthehandbouncesuprightaway,andrestorestoitsinitialpostionforoperationsoastoperformthenextpatting.功效Effect

強而長時間的拍打具有鎮(zhèn)靜止痛、活血祛瘀、解痙及強壯等作用。輕而短時間的拍打有清腦醒神、興奮神經(jīng)、調(diào)理腸胃、寬胸理氣等功效。Lastingandstrongpattinghastheeffectofsedation,analgesia,promotingbloodcirculationandremovingbloodstasis,spasmolysis,strengtheningthebody,etc.

shortandlightpattinghascephalocatharticandneurotoniceffectandtheeffectsofexcitingthenerve,regulatingthefunctionofthestomachandintestine,soothingthechestoppression,regulatingtheflowofqi,etc.臨床應用ClinicalApplication1、本法主要用于肩背、腰骶與大腿部，輕拍也可用于胸腹部與頭部。

Thismanipulationismainlyusedontheshouldandback,lumbosacralportionandthethigh.Lightpattingcanalsobeusedonthoracico-abdominalregionandthehead.

2、本法常用于治療各種風濕痹痛、陳傷勞損、新傷血瘀、肌肉萎縮、感覺減退、腸麻痹、胸悶胸痛、頭暈頭沉以及氣功偏差所致的大動不已等病證。概念Concept

用拳背、掌根、掌心、小魚際、指端，或桑枝棒叩擊體表的手法，稱為叩擊法或擊法。

Themanipulationofusingthebackoffist,palmarroot,palmarcenter,minorthenareminence,fingertip,orthestickmadeofmulberrytwigstopoundandhitthebodysurfaceiscalledtappingmanipulationorstrikingmanipulation.動作結(jié)構(gòu)

StructureofOperation1、拳擊法：沉肩、垂肘，前臂呈旋后位，外側(cè)面對向受術(shù)者，術(shù)手握成空拳，腕關(guān)節(jié)伸直，以拳背對準待擊部位。

Fist-hittingmanipulation:theoperatorlowershisshoulder,dropstheelbow,withhisforearminabackwardrotatingposition,anditslateralsidefacingthepatient,theoperatinghandturnedintoanemptyfist,thewristjointstraightened,andthefistbackfacingthelocationtobetapped.2、掌擊法包括掌心擊法與掌根擊法兩種。

掌根擊時，四指并攏，拇指外展呈自然屈曲狀，腕關(guān)節(jié)背伸約45°，使掌根