Acupoints Selection and Needling Program Techniques in Current Clinical Oncology

English
中文

Ruan Jin Zhao

Abstract

Acupuncture has increasingly been incorporated into clinical oncology, yielding positive outcomes and feedback. However, research indicates that the majority of clinical trials have concentrated on addressing side effects associated with radiation therapy and chemotherapy. Acupuncture has not yet been fully and systematically integrated into standard oncology care. In fact, introducing acupuncture into clinical oncology at an earlier stage may improve outcomes for cancer patients. Building a strong and stable platform for radiation therapy, chemotherapy, and immunotherapy could increase patients’ tolerance for these demanding treatments and allow these therapies to perform at their best. According to the principles of Shen Xiang Wen Tong Therapy, acupoints are selected in accordance with four key rules and can be adjusted to address clinical complications. The systematic arrangement of acupoints creates an interconnected network, which—when paired with precise needling techniques guided by biophysical theory—can alter the tumor microenvironment. This approach may modify immune responses and fundamentally change the conditions conducive to tumor growth.

Keywords: Acupuncture, Cancer, Shen Xiang Wen Tong Therapy, Needling technique, Biophysiology

Acupuncture is increasingly recognized as a valuable adjunct in contemporary cancer treatment₁. Its clinically approved efficacy has been well received by patients, and its distinct therapeutic advantages are becoming more widely acknowledged by oncologists. Notably, acupuncture is a non-pharmacological intervention and is compatible with both radiation therapy and chemotherapy, without conflicting with other modalities. As acupuncture transitions from a supplementary role, it is anticipated to gain greater prominence and potentially emerge as a major therapeutic option in future clinical oncology practice.

PubMed features numerous studies on acupuncture in oncology; however, most of these publications focus on managing side effects that arise during conventional cancer treatments. These include chemotherapy-induced peripheral neuropathy₂, gastrointestinal symptoms such as nausea₃, vomiting, diarrhea, and loss of appetite, postoperative care, fatigue₃, and treatment-related cytopenias₄.

These articles and studies contribute to increasing awareness of the beneficial role acupuncture can play in clinical oncology, reaching both patients and oncologists. By highlighting acupuncture as a valuable therapeutic option, they help inform cancer patients seeking additional support ₅.

Because there is no established core theory and a lack of systematic theoretical guidance, acupuncture has not been recognized as a comprehensive therapy. To effectively use acupuncture throughout all stages of cancer treatment, to address patients’ diverse clinical symptoms, and to maximize the benefits of needling, strong theoretical support and practical approaches are essential.

Acupuncture involves physical stimulation designed to trigger a series of biological effects or initiate natural healing processes, aiming to balance neurotransmitters, reshape neuronal synapses, and modulate immune responses. These mechanisms are increasingly supported by laboratory findings and clinical practice.

Acupoint selection and needling techniques should not be determined solely by individual clinical symptoms. From a holistic perspective—one of the key principles of Traditional Chinese Medicine (TCM)—the fundamental pathology of cancer must be addressed. In TCM, cancer is believed to arise from Heart Qi deficiency₆ and disturbances of the heart Shen, which then result in a loss of control and imbalance between Ying Qi (nutrient energy) and Wei Qi (defensive energy). This dysregulation of Qi flow, along with phlegm accumulation, ultimately leads to the formation of lumps. The primary approach involves warming and tonifying the heart Yang Qi, thereby enhancing cardiac energy while simultaneously supporting mental clarity (Shen). In addition, harmonizing Ying and Wei Qi, regulating the flow of Qi, transforming phlegm, and resolving stasis are important therapeutic objectives. Rather than solely targeting cancer cells, the focus should be on reconstructing the biological environment and altering conditions that support cancer cell proliferation. Integrating acupuncture at the onset of cancer therapy is recommended as a complementary strategy alongside conventional oncological treatments₇.

Principles for Acupoint Selection: The primary objectives are to warm and tonify heart Yang, enhance cardiac energy, and revitalise Shen.

Acupoints Selection and Needling Program Techniques in Current Clinical Oncology

Selected Acupoints: Bai Hui, Si Sheng Cong, Shen Men (HT7), Shen Ting (GB13)

Needling Technique: The needle should be inserted using a guiding tube. Allow the needle and guiding tube to remain on the surface of the selected point for approximately six seconds; then, gently depress the needle handle so that the needle penetrates through the epidermal and dermal layer by about 1 to 1.5 mm. This procedure minimizes discomfort during needling. After removing the guiding tube, firmly hold the needle handle and twist the needle, ensuring that the tip remains positioned within the same layer throughout. Gently vibrate the needle at a frequency of approximately 8Hz for 12 seconds to induce resonance, which will optimize the impact.

Mechanism: The stratum spinosum of the skin contains many dendritic cells₈, which serve as antigen-presenting cells crucial to immune responses. Mechanical vibration may activate these cells, potentially restore immune recognition of cancer cells and preventing them from evading immune attack.

Preserving stomach energy is considered essential for sustaining life. The presence of stomach energy is believed to be closely associated with vitality, while its absence may correspond to adverse health outcomes. In particular, when treating cancer patients, it is important to prioritise the protection of stomach energy. Alongside prescribing herbal medicines designed to enhance stomach function and recommending probiotics, acupuncture can play a valuable role in supporting stomach energy.

Principles for Acupoint Selection: Tonify stomach energy and support digestion.

Selected Acupoints: Ren.12, P.6, St.36.

Needling Techniques: For needling Ren.12, first position the needle with a guiding tube at the selected point on the surface for about six seconds. Then, gently press the needle through the skin, remove the guiding tube, and firmly hold the needle handle. Insert the needle to a depth of 1 cm, ensuring the tip rests within the adipose layer. Gently depress the needle handle against the skin and maneuver the needle back and forth in a 360-degree rotation for approximately 12 seconds. For needling at point P.6, employ the same insertion technique as described above. After removing the guide tube, firmly hold the needle handle, rotate the needle clockwise, and allow it to remain within the superficial fascia layer, vibrating for about 12 seconds. When needling St.36, first use the standard insertion technique. Hold the needle handle firmly and press it into the superficial fascia. Twist the needle clockwise until you feel it become trapped, then twist counterclockwise. Next, advance the needle to the deep fascia level and twist it clockwise again until the tip is trapped; then, reverse the twist slightly. Finally, continue pushing the needle into the muscle membrane layer. Repeat the twisting technique; once you have finished inserting and twisting, firmly hold the needle handle and move it back and forth vertically at a speed of 8 to 10 Hz for about 12 seconds.

Mechanism: Needle stimulation at Ren.12 is intended to activate and mobilize quiescent stem cells within the adipose layer₉, thereby enhancing stomach energy. Stimulation of P6 may activate skin dendritic cells and mast cells, thereby inhibiting retrograde gastric motility and alleviating symptoms of nausea and vomiting. The goal of needling St.36 is to create micro-electric signals that boost stomach energy and help the intestines move more smoothly.

To highlight the eight essential aspects: ensuring that eight key departments function properly is vital for sustaining life. This supports smooth Qi (energy) flow, healthy blood circulation and nourishment, supple tendons, a soft and clear pulse, strong and dense bones, rich and healthy bone marrow, effective storage by the Zang organs, and efficient cleansing and elimination by the Fu organs.

Principles of Acupoint Selection: Enhance Qi and nourish the blood, strengthen the heart and promote mental calmness, and support tendon fortification and bone development.

Selected Acupoints: Ren.17, U.B.17, G.B.34, Lu.7, U.B.11, Ren.12, Liv.13, G.B.39

Needling Technique: Use gentle tonifying manipulation for these points. Insert the needle using standard technique, hold the handle firmly, and twist clockwise to press the tip into the superficial fascia. Continue twisting until the tip is secured; if not, shake the handle forward-backward or left-right, then twist clockwise again until the tip is held by fascia fibers. Gently vibrate the needle at a frequency of 8Hz while keeping it at that precise layer. When inserting the needle into Ren.17, U.B.17, Liv.13, and U.B.11, use a horizontal or transverse insertion; apply the same technique as previously described. These points should be selected based on each patient’s condition. For example, use U.B.11 for bone metastasis and Liv.13 for organ metastasis; it is not necessary to apply all points at once.

Mechanism: The needle tip precisely targets and remains within the superficial fascia, an area where immune cells accumulate. To reactivate dormant immune responses and maintain immunological vigilance in preventing cancer cell metastasis, low-frequency vibration is advantageous; it induces resonance that maximizes stimulation.

To resolve separation and guide defensive energy to the area affected by illness, it is important to disperse tumors and lumps. A primary cause of cancer development and progression is the obstruction or stagnation of energy—especially when defensive energy becomes divided and trapped, preventing it from reaching the site of disease. Therefore, it is essential to remove these blockages to inhibit harmful factors.

Principles for Choosing Acupoints: To clear stagnation, break up lumps, and dissolve carbuncles.

Acupoints: Tumor-surrounding points

Needling Technique: Insert the needle with the assistance of a guiding tube. Position the needle and guiding tube on the target point for approximately six seconds before gently pressing the needle handle to facilitate needle penetration through the skin. Hold the needle handle and pierce the tumor membrane using the sparrow pecking technique, intentionally creating multiple perforations in the membrane. Each needle can produce more than 20 punctures, with approximately 1 cm between each entry point. Repeat this procedure around the entire perimeter of the tumor. This is the traditional technique named “Wei Ci”₁₀.

Mechanism: This intervention is designed to create multiple perforations in the tumor membrane, disrupt the fibrous barrier, and facilitate the activation of gasdermin D ₁₁ and perforin₁₂, thereby inducing tumor apoptosis. The creation of these pores helps to disrupt the tumor-associated immunological microenvironment, allowing immune cells and cytokines to enter the tumor area and change conditions that would otherwise promote tumor cell growth. For greater efficiency, the Fine needle (Hao Zhen) can be replaced by a Pi needle, which creates a larger opening to enhance immune system involvement and accelerate the disappearance of tumor cells.

Based on theoretical principles and clinical experience, acupuncture offers a valuable platform for modern oncology, supporting surgery, radiation therapy, chemotherapy, and immunotherapy to achieve optimal results. This form of acupuncture therapy may be employed independently to reconstruct the patient’s micro-environment and eliminate underlying factors contributing to tumor growth. However, due to the diversity of cancer types and variations in individual patient constitution, treatment should be modified according to clinical circumstances.

Fatigue and lethargy are common in cancer patients₁₃, with no effective therapy available. In advanced stages, some patients lack the strength even to walk. These symptoms often result from spleen and kidney Qi deficiency and can include muscle weakness, bone fragility, and pain. The proper therapy is enhancing spleen energy and consolidating essence, and fortifying kidney function. Numerous acupoints along the spleen and kidney meridians are found on the abdominal region, serving tonic purposes. Examples include Sp.14, Sp.15, Sp.16 for the spleen meridian, and Kid.13, Kid.16, Kid.20 for the kidney meridian.

The needling technique is particularly crucial for abdominal acupoints and should be adjusted as needed. Use a 1.5-inch needle and follow the insertion methods outlined earlier. After inserting the needle, keep the handle parallel to the skin and push it into the adipose layer. Move the handle side-to-side while pushing and pulling to increase stimulation and activate quiescent stem cells in the adipose tissue. To ensure the patient’s comfort during this procedure, which will facilitate the patient’s full recovery of energy.

Limb lymphatic edema often results from surgery or lymph node biopsy and poses significant clinical challenges ₁₄. Clinicians frequently avoid acupuncture for lymphatic edema due to concerns about acute cellulitis, but in reality, acupuncture can be an effective treatment ₁₅. Acupoints do not need to be located directly on the affected limbs or areas of edema. Treating the underlying cause is most important. The basic acupoints chosen for cancer treatment can be supplemented with points for edema, especially those on the shoulder, groin, and upper thigh of the affected limb. For example, in cases of lymphatic edema in the upper limb, Lu.3, S.I.9, S.I.10, and L.I.15 are recommended acupoints.

For lymphatic edema in the legs, a similar approach should be taken. Acupuncture points on the thigh and groin—such as Li.11, Liv.12, St.27, St.28, St.29, St.30, G.B.28, and G.B.29—should be chosen for treatment.

Needling Technique: Insert the needle horizontally under the skin, pointing toward the heart for one inch. Keep it at the cutaneous level and move it side to side for 12 seconds, resembling a dragon’s tail motion. Then, adjust the direction by 30 degrees and repeat. Each acupoint can be needled up to six times, covering a 90-degree area.

Mechanism: The objective of this technique is to facilitate access to the tissue fluid pathway beneath the cutaneous layer. When combined with lymphatic massage, it enables the redirection of stagnant lymph fluid into the lymphatic circulation system.

For severe lymphatic edema, with informed patient consent, treatment may involve the use of a plum blossom needle on the affected region, followed by cupping therapy applied to the needled area to facilitate removal of excess interstitial fluid. This approach aims to restore normal cutaneous tissue fluid pathways.

Caution: Before performing plum blossom needling, a consent form must be signed and strict sterilization procedures should be followed.

Acupuncture is highly beneficial for treating peripheral neuropathy caused by chemotherapy (CIPN) ₁₆. Because of its unique pathophysiology, CIPN differs significantly from other forms of neuropathy, such as those associated with diabetes, stroke, or certain neuromuscular disorders. CIPN leads to hypersensitivity of nerve endings. When administering acupuncture therapy for individuals with CIPN, it is advised that needling be conducted with care and precision. In Traditional Chinese Medicine (TCM), CIPN is understood as either Jue syndrome resulting from internal Yang Qi obstruction or as an interior wind syndrome. To rebalance energy within Yin and Yang meridians, acupoints are chosen to stimulate heart Yang Qi, awaken the mind, and open orifices. Acupoints are added at the fingertips and toes in pairs along interior and exterior meridians. On the hand, this includes points like L.I.1 paired with Lu.11, S.J.1 with P.9, Ht.9 with S.I.1, and P.8 with S.J.2. On the foot, similar pairings are applied: Liv.1 with G.B.44, Sp.1 with St.45, and Kid.1 with U.B.67.

Gastro-intestine Disorders

Stomach energy is vital for life, and preserving it is essential in clinical oncology. Ren12, P.6, and St.36 are key acupuncture points for treating digestive disorders as previously discussed. It is important to note that St.25 should be used if a patient experiences diarrhea, while U.B.57 is recommended for constipation or lack of bowel movement. Because analgesic medications are often given to cancer patients, constipation tends to occur more frequently in this group ₁₇. For U.B. 57 needling, use a 1.5-inch needle. Touch the surface for 6 seconds, press the needle bottom, and remove the guide tube. Hold the handle and insert the needle at a 45-degree angle toward the foot to reach the deep fascia. Twist clockwise so the tip engages with the fascia fibers and membrane. Maintain vibrations at a 6 Hz frequency with gentle intensity, ensuring the needle tip stays at the correct layer without penetrating deeply into the calf muscle for 12 seconds. This technique aims to induce resonance, which is believed to significantly stimulate U.B.57 and promote the flow of intestinal energy.

Shrink the Tumor Size

Can acupuncture treatment reduce tumor size? For tumors that are palpable or located near the surface of the body, as well as some enlarged lymph nodes, acupuncture may potentially decrease their size or aid in their resolution. Beyond fine-needling techniques and use of Pi needles to trigger Gasdermin D and perforin release for apoptosis or pyro ptosis, there are two other specialized methods for directly shrinking tumors: micro-fire needle₁₈ and electro-chemical needle. Both treatments are effective and result in minimal trauma. They have the same indications, which include tumors located on the body surface or those that can be palpated and are situated away from major arteries, vessels, and nerves, as well as away from the chest to prevent pneumothorax.

The micro-fire needle ₁₉is a specially designed tool with a thick handle that resists burning and a sturdy, thick needle that does not easily bend. Before use, the needling area and points must be thoroughly sterilized twice. Mark points around the tumor’s edge and center for needle insertion. Firmly hold the needle handle and heat the needle over an alcohol lamp flame. Once the needle is thoroughly heated, insert it quickly into the marked point and remove it promptly. If the patient is physically strong, repeat the insertion 2 to 8 times as needed. Adjust the frequency and intensity based on the patient’s condition, as this process is quite intense. After the procedure, ensure the needling points remain clean and dry.

Electro-chemo needling ₂₀requires specialized needles and equipment. The recommended needle should be 1 inch or 1.5 inches in length, 34 gauge, and constructed from white gold, which is resistant to breakage by electric current; stainless steel needles are not suitable for this procedure. Additionally, a micro-current instrument or device is necessary. The output power is set to 9V and 3 mA. Needles are placed at four per square centimeter of the tumor, with depth adjusted based on tumor size. After insertion, each needle is connected to the micro-current device using clips. First, activate the switch and gradually increase the electrical output to a level the patient can tolerate. Depending on the size of the tumor, each session can target different areas of the tumor. This treatment works by using electricity to break down tumor tissue and shrink its size. However, one limitation is that it cannot be used for tumors that are inaccessible from outside the body.

Summary

Modern biophysical insights allow acupuncture to be used for tumour treatment with a coherent theory and practical methods. This helps practitioners choose appropriate acupoints and needle techniques effectively.

Fine needle (stainless steel), Pi Needle, Micro-Fire needle, and Electric Chemical needle can stimulate acupoint tissue in various ways. They affect pressure sensors, pulling sensors, bio-factors in interstitial tissue, and fluid; create openings in the fascia membrane; trigger gasdermine and perforin release; and induce resonance through vibration. Needle movement generates micro-electric currents that catalyze biochemical reactions and influence ion channels, while specific needle techniques target tertiary lymph nodes. The arrangement of acupoints forms a network that enhances biochemical efficacy, and repeated acupuncture sessions help to achieve optimal biological effects.

Needling stimulation produces biophysical and biochemical signals that may activate the immune response and alter the tumor microenvironment, which is important for cancer treatment and prevention.

Clinical oncology practice shows that acupuncture is safe, with no side effects or risk of cancer metastasis.

Reference

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[期刊论文] -《现代预防医学》北大核心CSTPCD2006年5期

針灸（刺）的選穴與手法在現代腫瘤臨床上的具體應用

趙軟金

摘要

針灸逐漸被廣泛地應用於腫瘤臨床，並取得良好的效果和反饋。但是目前文獻上顯示多是將針灸用於放療和化療副作用治療上。沒有將針灸從整體的角度整合入腫瘤臨床。事實上針灸治療早期介入於癌症病人的臨床治療，其臨床效果更為卓著。它能夠為放療、化療和免疫療法建立一個穩固的治療平台。提高病人對這些療法的耐受度，並可能使這些療法發揮到極致。以神香溫通療法理念來指導針灸的選穴，遵循四條大原則的前提下，再針對常見的放療和化療副作用的治療作出相應的穴位加減。以組穴的方式，構建一個整體的治療網絡，結合生物物理學知識來準確運用針刺手法，會極大地改變腫瘤生長的微環境，重新編輯免疫應答，清除腫瘤生長的土壤。

關鍵詞：針灸，癌症，神像溫通療法，針刺手法，生物物理學

針灸在目前癌症臨床上的作用被日益得到重視。其確定無疑的療效被病人肯定和接受，其獨特的臨床優勢也得到癌症臨床醫生的注意和認可。特別是因為这种非藥物療法，與化療藥和放射治療聯用無任何拮抗，更是受到人們的青睞。從原來的僅僅使用于對放療和化療副作用的治療的小角色，慢慢可能成為在癌症臨床治療中不可或缺的治療方法之一.

Pubmed有很多關於針灸與癌症的文章，但基本上都是針對常規癌症臨床治療過程中的一些副作用而作的總結和研究,多集中在對放化療副作用和術後的管護上，比如周圍神經損傷、胃腸道症狀的改善如噁心、嘔吐或食慾不振，拉肚子，無力，血細胞底低下等。

這些文章和研究的作用使人們認識到針灸在癌症臨床中有幫助作用，擴大了病人和醫療人員眼界，讓人們知道在癌症病人的醫療中針灸是一種有用的療法。

只是缺乏系統性思想的指導，缺乏綱領理論。從而忽略了針灸作為一種系統療法的基本核心。但如何使用針灸針對腫瘤治療的各個階段，針對腫瘤病人的臨床具體症狀，正確使用針刺治療，使針灸治療發揮出其最大的潛力，仍需要足夠的理論支撐和具體實踐指導規范。

針灸是基於物理刺激而引起的連鎖生物物理效應或能量轉化效應所激發的自愈程序。能夠平衡神經遞質，重塑神經觸突結構；重新編程免疫系統應答程序。在實驗室和實踐中都逐漸得到實證。

針灸的選穴和手法不能只是著眼對於某個症狀上，要根據中醫學對癌症的病機病理的系統詮釋和認知上，要有整體的佈局，因為整體觀是中醫學的基本治療觀。心氣虧虛，心神被擾或者虛弱不堪，失去了對於營衛之氣的控制和協調，是癌症的產生的本源。而氣機失調，痰淤積內阻集結成塊則是其標。在溫補心陽，強心醒神的大原則下，調和營衛之氣，梳理氣機，化痰消瘀。不應該也不需要追逐著癌細胞打，要重塑一個環境徹底消滅癌症產生的土壤。所以從癌症的初期診斷入手，與現代醫學對腫瘤治療同步，針灸治療就應該介入，基本法則要悉遵照神香溫通療法。

基本取穴法則：溫補心陽，強心醒神

穴位：百會，四神聰，神門，神庭。

手法：用針管進針，將針管轻抵在穴位皮膚表面約六秒，輕輕擊打針柄頭，讓針尖盡量停在真皮層（約1-1.5毫米）處。这样就避免了下針時候的疼痛。去掉針管後，手握針柄，捻針將針尖穩住在那層面，輕柔振顫，約每秒8次的頻率振動約12秒，期望引起共振讓信號達到極致。

原理：真皮的棘層有豐富的樹突状細胞或抗原呈遞細胞，這些細胞能夠將侵入身體的病理因子傳遞給免疫系統。在機械振動下能夠使這些細胞更加活躍。洽如同增強衛氣衛外而為固也。使免疫系统能够认清肿瘤细胞，不让它们逃逸。

顧護胃氣，胃氣乃生之根本，有胃氣則生，無胃氣則死。特別是在治療腫瘤和癌症時，對於胃氣的保護是治療的必須，除了給與適當的助消化提高胃氣的藥物和腸道益生菌外，针灸是不可或缺的。

取穴法則：補益胃氣，強助消化。

穴位：中脘，內關，足三里

手法：針刺中脘之時，用针管进针，將針管抵放在穴位表皮約6秒鐘，尔后將針慢慢打入皮膚，去掉針管，手握針柄將針輕輕刺入皮下約1釐米深，将针停留在皮下脂肪层，压针柄尽量平刺，以360度方位，从不同角度在脂肪層來回提插扫动約12秒。針刺內關時，將針管輕放在穴位表皮，將針輕輕打入皮層，去掉針管，手握針柄向右捻針，針尖滯留在皮膚淺層後，輕輕振動，約12秒鐘；針入足三里時，針管進針時，將針管停留在足三里穴表面約6秒鐘，將針慢慢打入穴位，去掉針管後，手握針柄將針刺透皮膚，針尖留在淺筋膜層，單向右旋捻轉直至纏針到滯針，然後輕微逆時針捻轉後，將針向深層推進至深筋膜層，單向右旋捻轉直至纏針到滯針，將針尖續向下推進之肌膜層，重複如上手法程序，之後將針提到皮層，保持針體垂直，上下提插，速度控制在每秒8~10次頻率，約12秒左右。

原理：通過中脘的針刺來激活腹部皮下脂肪幹細胞，起到裨益胃氣作用。針刺內關，激發皮下樹突狀細胞和肥大細胞，抑制胃部逆蠕動，降逆平沖。對足三裡的針刺则能於誘發生物微電流，補益胃氣，通暢府氣。

重用八會穴，保證機體八個關鍵部門的正常運行。氣的暢通無阻、血的溫煦營養、筋的柔韌彈性、脈的柔和通暢無阻、骨的堅固、髓的豐盈和充實，維持臟的儲藏之功能和腑的正常排洩。

取穴法則：補氣養血，養心安神，強筋健骨

穴位：膻中，膈俞，陽陵泉，太淵，大杼，中脘，章門，絕骨

手法：對這些穴位採用平補之法。將針管放在穴位表面輕輕施壓約六秒鐘，將針輕輕打入穴位後，手持針柄順時針捻針，並輕輕將針刺入淺筋膜層，繼續單向順時針捻針旋轉直至滯針，如果沒有滯針發生，可左右搖晃針柄，再行單向捻轉，滯針使針尖停留在淺筋膜層，爾後以每秒8次的頻率使針振動。針刺膻中，膈俞，章門和大杼時要將針平刺。這些穴位不需要一次全用，要根據病人的具體情況來選擇，如癌症轉移到臟器，就選用章門，轉移到骨，就選用大杼。

原理：針尖滯留在淺筋膜層利於激發免疫應答，在腫瘤臨床上叫醒免疫係統，使免疫係統處於清醒的戒備狀態有利於防止腫瘤細胞的轉移。低頻振動有利於誘發諧振的產生，讓針刺的刺激量得到最大值。

打開格拒，引導正氣攻入邪氣居留處，散瘤消臃。腫瘤發生和長大的主要病理之一是正邪格拒。唯有打開格拒，正氣才能遏制邪氣的增長。

取穴法則：破結解郁，散瘤消癰

穴位：腫塊局部取穴，沿著腫瘤周邊圍刺

手法：用針管進針，將針管放在穴位皮膚表面約六秒鐘，然後輕輕將真打入穴位，然後手握針柄，以雀啄手法沿著腫瘤周邊快速淺刺，針尖留在皮內，每刺要改變方向刺入（破）腫塊表皮，意圖在腫瘤皮膜上造出盡可能多的孔洞，每根針約刺激二十次。針刺穴位之間間距1釐米，每針操作相同，這也是傳統針法中的圍刺法。

原理：這種操作方法目的是要在腫瘤皮膜上造出很多孔，刺破纖維膜，促進多孔素和穿孔蛋白，誘導腫瘤細胞死亡。利於穿孔打破格拒，打破腫瘤局部免疫系統微環境，使大體的免疫系統的免疫因子和抗體能夠大量進（滲）入到腫瘤局部，改變腫瘤生長的舒適環境。為了更好地達到這個目的，針具選擇上可以用毫鈹針代替毫針，使切割孔面更大。創造更有利於免疫系統整合的環境，使腫瘤細胞消亡。

基於如上理念和臨床實踐，針灸既為現代腫瘤的治療提供一個堅實的平台，幫助手術、放療、化療和免疫療法的正常應用並使其發揮到極致，又可獨立地從整體角度改變病人機體的內環境，消滅腫瘤的生長原動力和根源。但臨床上癌症種類繁多，病人個體差異和臨床症狀的多變性，要隨症而治，作出如下法權變之法。

疲勞無力

疲憊無力感是癌症病人最常見的主訴，而且現代醫學沒有好的方法和藥物，特別是癌症後期病人無力抬腿走路。疲憊無力是脾腎氣虛，肌肉筋骨乏力。補脾益氣，強精固腎是治療的原則。腹部脾腎經的腧穴要多用，如脾經的腹結(Sp.14), 大橫（Sp.15）, 腹哀（Sp.16）；腎經腧穴如，氣穴（Kid.13），肓腧（Kid.16），和腹通谷（Kid.20）。

針刺手法：特別是腹部穴位的針刺手法要極為講究，使用1.5寸的針，如同前所述，在針刺入皮膚後馬上改為平刺，講針身停留在皮下脂肪層，手握針柄靠針身處，左右大幅度搖晃，並多次在水平面提插掃散。其原理是希望極大地刺激到腹部皮下脂肪中的靜止狀態中的幹細胞，並企圖使他們活化。這個操作手法盡量不會令病人感到不適。每星期一次，會幫助病人力氣的恢復和增加。

癌症病人淋巴水腫

肢體的淋巴水腫是癌症臨床常見的合並症，往往來自淋巴結的穿刺和清除術後，是極具有挑戰性的臨床課題。在臨床治療時，人們往往馬上將針灸排除在外，以為針灸對於淋巴水腫的治療會引起急性蜂窩組織炎。其實針灸對於淋巴水腫的治療有著不可忽視的優勢，因為針刺部位不一定要在患肢之上。治病要治本，在如上對腫瘤治療的選穴位基礎上，可以加上水腫患肢根部的穴位，如上肢水腫加天府（Lu.3）,肩貞（S.I.9），臑腧（S.I.10）和肩髃（L.I.15）。

下肢水腫的病人，可以用相同的法則，在大腿根部和盆腔周圍選取：陰廉（Liv.11）急脈（Liv.12）,氣沖（St.30））歸來（St.29），水道（St.28）,五樞（G.B.27）,維道（G.B.28）,和居髎（G.B.29）。

針刺手法是採取淺刺進針後，針尖向心方向斜刺如皮下後改為平刺，可將針推進1寸，爾後較大幅度地左右搖晃針柄約12秒鐘，再將針拔到皮下改換30度方向水平刺入1寸，重複擺動針柄。每個穴位可以重複3 次，針尖覆蓋約90度。

原理：重在打通皮下筋膜層的組織液流通通道，配合淋巴按摩師的輕輕推按，瘀滯的淋巴液在肢體根部可以通過皮下組織液的流通回歸淋巴循環。

對於頑固性的淋巴水腫病人，在征得病人的同意後，可以在患肢水腫部位採用梅花針後拔罐法，罐後會吸出大量的粘液，淋巴水腫將得到較為有效的治療。其原理也在於打通皮下組織液的通道。

需要註意的是在做梅花針後拔罐療法時需要病人簽署同意書和執行嚴格消毒。

化療引起的周圍神經損傷

化療引起的周圍神經損傷是針灸治療的一個優勢病症，由於其發生的獨特性和病理，治療上不同於其他的周圍神經損傷，如源於糖尿病的，中風後遺症和其他神經肌肉疾病等。它是一種末梢神經處於高度敏感狀態的不適，所以在針刺和行針時候需要格外輕柔。一般以陽氣郁閉的陽微厥證或虛風內動來論治，使相表裡的陰陽經氣相互銜接。選穴時候除了溫補心陽，醒神開竅之針法之外，加用四肢末端的對穴，如：手指的商陽配少商，關沖配中沖；少沖配少澤；和勞宮配液門。足部穴位取穴也遵守這樣的法則，大墩配足竅陰；隱白配內庭；湧泉配至陰等。

消化系統功能障礙

因為胃氣是生命的根本，從始至終一定要顧護胃氣。中脘，內關和足三里也是治療消化道症狀是要穴，唯一可以補充的是，病人洩瀉拉肚子的時候要注重天樞的運用；便閉和大便秘結是重用承山穴（U.B.57），因為大量的止痛藥使用，便閉和大便秘結是癌症病人常見的症狀，針法：用1.5寸針，令針管和針在穴位表面矗立停留6秒鐘，輕輕將針打入皮層，去掉針管後，手握針柄加力使針尖向下45度刺入達到深筋膜層，順時針方向捻轉直至手上覺得針尖被纖維纏繞或滯針，輕輕上下提插，頻率在6赫茲，振動幅度要很小，保證針尖停留在深筋膜層面而不穿透到肌膜層（進入肌肉）。其原理是引起諧振，極大地刺激承山穴，達到府氣通暢的效果。

腫瘤塊的消除

針灸治療是否可以將腫瘤消除？其實對於在體表可以觸及到的腫塊和因癌症轉移的淋巴結，針灸是可以將腫瘤縮小，甚至消除的，除了上面提到的針刺和鈹針療法來增加穿孔素和穿孔蛋白釋放等的手法外，有另外兩種針法可以用與縮小和消除腫瘤，一種是毫火針，另一種是電化學針法，這兩種針法非常實用而且創傷性很小的療法。兩種針法的適應症適應症是一樣的，是針對於在體表可觸及到的腫塊，遠離大血管和神經幹，遠離胸腔且不會因為腫瘤縮小而導致氣胸的部位。

毫火針：針具是要特殊的針具，針柄比較粗有隔熱的效果，針體略粗（30號）比較堅硬，不易彎曲。具體操作是將腫瘤周圍皮膚進行兩次消毒，標記好針刺部位，可以在腫瘤邊沿進針，也可以在瘤體上直接施針。施針者手握火針柄，將針尖和針體在酒精燈上將微火針加熱燒至通紅，然後快速將針刺入標誌好的穴位，並迅速出針。根據病人的身體強弱和耐受程度，每次可以針兩針或八針。因為刺激量過大，一定要根據病人身體的強弱來決定下針的多少。針刺後的穴位要保持清潔，避免沾水和感染。

電化學針法的具體操作: 需要專門的針刺設備。針具是1寸或1.5寸的白金針，不能有普通不鏽鋼針。確保通電後不會被燒斷。一台可調控的直流電微電流儀，微電流輸出功率等於但不高於9伏，3毫安。在腫塊上每平方釐米正方形的每角刺入一根金針，根據腫瘤大小決定刺入的深度。然後將微電流儀輸出線的夾子夾住針柄，確認病人沒有不適感後，打開儀器開關，慢慢增加電流量，達到病人的耐受度即可。根據腫瘤大小，每次可以劃分不同的治療部位，分區治療。這種方法原理是通過直流電直接電解腫瘤組織而達到消除腫塊的目的。其短板是對位於體內、觸摸不到的腫瘤無能為力。

小結

將現代生物物理學知識運用到針灸治療腫瘤中，發現並建立了相對自洽的理論架構和療效穩定的具體針刺操作的方法，從而來指導選穴和行針。

毫针、鈹針、毫火針和電化學針法，透過不同的刺激方式來改變穴位週邊組織的壓力（壓力感受器的活化程度）；活化牽引感受器；對細胞間質或組織液眾多因子的驅動效應。也透過針刺在包膜上穿孔，誘導多孔素和穿孔蛋白的釋放；針尖在穴位特定層次組織上（皮肉筋脈骨）的振動頻率、幅度和時長，以及可能誘導的諧振發生；透過毫針的旋轉和提插所形成生物微電流的改變，以及穴週組織電壓的負載，有可能大幅加速多重生化反應和多種離子通道的變化；以及針刺對第三淋巴組織的特異刺激效應；組穴所形成的同步加強效應和每次針灸效應的疊加。

所有這些由針刺激發的生物物理和生物化學刺激都有可能有效地誘導免疫應答，改變腫瘤周圍微環境，對腫瘤的臨床治療和預防有非常積極的作用。

從多年的臨床實踐證明，针灸对于癌症病人的治療没有副作用，也绝不会导致癌症转移。

參考文獻