Introduction to Point Injection Therapy

    Point injection therapy utilizes the injection of liquid medicine into acupuncture points to prevent or treat diseases. It is one of the more integrated treatment strategies available to us in the 21st century. It combines the actions of acupuncture with the pharmacological effect of Chinese medicinal herbs or biomedical pharmaceuticals. It uses hypodermic needle techniques at acupuncture point locations so as to produce successful clinical outcomes.

I. Commonly Used Injectable Materials:

    Any medicinal liquid which can be used for inframuscular injection is suitable for point injection therapy.

    1. Commonly used Herbal Injectables:

    2. Western Medicinal Injections

    • Magnesium sulfate

    • Vitamin B1, B12, and K3

    • Injectio Califerol et Colloidalis

    • 0.25-2% procaine hydrochloride

    • Atropine

    • Reserpine

    • Normal saline

    • Antibiotics

II. Method

    1. Equipment

      Syringes that contain 1, 2, 5, 10, and 20 ml of injectable material are used. 5# gauge to 7# gauge injection needles are used for most acupoints. 9# gauge needles are used for deep points, when necessary.

    2. Selection of points

      According to the location and nature of the illness, local and distal points are selected. The number of points should be small, usually 2 to 4 points. Ashi points (points that are tender to the touch) as well as points located in muscular areas are best.

    3. The dosage of point injection

      The dosage should be used according to the directions supplied with the injectable material. Over dosage is obviously not advisable.

      Small dosage injections may be utilized. The smaller dosage is usually one fifth to one half of the routine dosage for muscular injection and is applicable to areas of the body that don't have as much inframuscular area to accept the injection. For example:

      1. points on the head and face: 0.3 to 0.5 ml.

      2. auricular points: 0.1 ml.

      3. points on the four limbs: 1 to 2 ml.

      4. points on the chest or back: 0.5 to 1 ml.

      5. points on the lower back and hip: 2 to 5 ml.

    4 Manipulations

      1. The patient should sit or lay in a comfortable position.

      2. Take a suitable sterilized syringe with a needle on to draw the liquid medicine.

      3. sterilize the acupoint to be used

      4. Hold the syringe with one hand, point to the selected needling location (or ashi-tender point).

      5. Pierce the skin swiftly then slowly insert it to the desired depth.

      6. When the qi sensation is obtained and there is no drawing of blood, inject the medicine.

      The speed of injection is based on the requirement of the treatment. For example: for an excess or heat syndrome, a slow injection speed is used. For a deficiency or cold syndrome, a quick speed injection is the indicated technique.

    5. Treatment Course

      For patients with acute diseases, 1 or 2 injections daily. For those with chronic diseases, once every day or every other day.

III. Indications

    This therapy may be used for all diseases which are suitable for acupuncture treatment. Point injection is indicated specifically in syndromes of pain in the lower back and leg, pain in the joints, and some chronic diseases.

IV. Precautions

    1. Care should be given as to the following variables:

    1. pharmacological action.

    2. dosage.

    3. quality.

    4. expiration date of the injectable material.

    5. incompatibility of injectable material with the patient's TCM or biomedical signs and symptoms.

    6. side-effects. Medicines with severe side-effects are not suitable for point injection. Injectables with powerful effects should be used with caution.

    7. allergic reactions of the medicines. Skin test should be given for medicines (penicillin, streptomycin, procaine hydrochloride) which may lead to allergic reaction.

    2. Pay attention to needle insertion depth.

      Needle insertion depth should be carefully controlled. This is especially important while using points where internal structures can be damaged by the needle. This applies to the neck, chest, or back.

      If the point is near a nerve trunk, be careful not to damage the nerve trunk with the injection (or insert to a shallow depth so as to avoid the nerve trunk's depth).

      If the nerve trunk is shallow, deep insertion avoiding the nerve trunk can be employed.

      If the needle tip touches the nerve trunk, the patient will experience a sensation of electric shock. Lift the needle a little bit and change the direction of the needle so as to avoid the nerve trunk and then inject the medicine.

      The dosage should be controlled with a slow speed injection.

    3. Pay attention to needle insertion locations.

      Medicines used as injectables are not suitable for injection into the blood vessels. When drawing blood into the injection, you must avoid the blood vessels and then inject the medicine.

      The medicine must not be injected into an articulating cavity or the spinal cord.

      If the medicine is injected into the articulating cavity, redness, swelling, heat and sensations of pain in the joint may appear.

      If medicine is injected into the spinal cord by mistake, this may injure the spinal cord. So, extreme care must obviously be taken.

    4. Point injection therapy contraindications

      As with acupuncture, point injection therapy is contraindicated for pregnant women in the following locations: points of the lower abdomen, lumbosacral region, Spleen 6 (Sanyinjiao), LI 4 (Hegu), and Gall Bladder 21 (Jianjing).

      For elderly individuals, children and individuals with a weak constitution or deficiency syndrome, less points and smaller dosages of medicine is advisable.

      As mentioned above, the injectable material must be tested for allergic response, especially when using penicillin, streptomycin, or procaine hydrochloride

    5. The syringes, needles, and the injection areas must be strictly sterilized.

    6. Adverse reactions to point injection therapy

      If the patient faints, the management of the patient is the same as with needle shock in acupuncture or a vasovagal reaction in the biomedical clinic.

      As with acupuncture, avoid bending or breaking the needle while it is in the patient.

Source: Therapeutics of Acupuncture and Moxibustion
Medicine and Health Publishing Company

        

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