Cupping Therapy (Ba Guan Liao Fa)

拔罐法 Cupping Therapy (Ba Guan Liao Fa)

Dr Igor Micunovic Ph.D

拔罐法是以罐为工具，利用燃烧或其他途径排除罐内空气，造成负压，使之吸附于皮肤，产生刺激，以达到防治疾病目的的方法。

Cupping Therapy is treatment in which a cup/guan is attached to the skin to cause local stimulation for disease treatment and prevention.

The secret is the negative pressure created by consuming the air inside the cup with ﬁre or other methods.

拔罐法，或称吸筒疗法，古称角法，在《五十二病方》中就已有记载，历代中医文献中亦多论述，起初主要为外科治疗痈肿疮疡时，用来吸血排脓，工具多为兽角或竹罐。

Cupping therapy, also known as “Jar Suction Therapy (Xi Tong Liao Fa)”, or the “Horn Method (Jiao Fa)” in ancient China, was recorded as early as in The Wu Shi Er Bing Fang (Fifty-Two Prescription)，a silk book unearthed in Emperor Ma’s tomb during the Han Dynasty. Also, a discussion about it can be found in the TCM literature of other dynasties.

一、罐的种类 Types of Cups

二、罐的吸附方法 Methods of Creating Suction Inside the Cup

三、拔罐的应用 Application of Cupping

四、拔罐的作用和适应范围 The Actions and Indications for Cupping

五、起罐方法和注意事项 Cup Removal and Precautions 4 一、罐的种类 Types of Cups

罐的种类很多，常用的有以下三种： Cups are made from a wide variety of materials, however, three types are most common used:

（一）竹罐 Bamboo Cups (Zhu Guan)

直径3～6cm坚固无损的竹子，制成6～9cm长的竹管，一端留节作底，另一端作罐口，用砂纸磨光，使罐口光滑平正。 A section of ﬁrm bamboo, 3～6cm in diameter and 6～9 cm in length, is cut to form a short cylinder. One end is used as the base; the other as the opening at the top. The rim of the cup should be made smooth with a piece of sandpaper.

（二）玻璃罐 Glass Cups (Bo Li Guan)

其形如球状，罐口平滑，分大、中、小三种型号，也可用广口罐头瓶代替。 These cups are shaped like a ball with smooth, open mouth. There are three different sizes: large, medium, and small

（三）抽气罐 Suction Cups (Chou Qi Guan)

多由透明塑料制成，上面加置抽气装置以便抽气。也有用特制的像皮囊排气罐，其规格大小不同。 Presently, suction cups, for the most part, are made of plastic. Each cup has a ﬁtting on the crown where a suctioning device is attached to remove the air out. Sometimes, different sized rubber-bag suction cups are also used.

二、罐的吸附方法 Methods of Creating Suction Inside the Cup

罐的吸附方法是指排空罐内的空气，使之产生负压而吸附在拔罐部位的方法，常用的有以下几种方法。 The following are popular ways of creating the negative pressure required for a cup to ﬁx itself to a speciﬁc treatment area as the result of suction:

（一）火吸法 Fire Cupping Method (Huo Xi Fa )

火吸法是利用火在罐内燃烧时产生的热力排出罐内空气，形成负压，使罐吸附在皮肤上的方法，具体有以下几种。

With this method, negative pressure is created by introducing an ignited material inside the cup to consume the air, thereby making the cup suck itself onto the skin. The following details pertain to different ways of creating suction using ﬁre:

1．闪火法 Fire-Twinkling Method (Shan Huo Fa)

用长纸条或用镊子夹酒精棉球，用火将纸条或酒精棉球点燃后，使火在罐内绕1～3圈后，迅速将火退出，并迅速将罐扣在选定的部位，即可吸附在皮肤上。

Light an alcohol soaked, cotton ball held with a clamp or forceps or use a strip of paper; place it inside the cup, quickly turn it around in 1～3circles and take it out immediately and press the cup on the selected area; the cup will attached itself to the skin.

11 2．投火法 Fire-Throwing Method (Tou Huo Fa)

用易燃纸片或棉花，点燃后投入罐内，燃烧片刻，迅速将罐扣在选定的部位，即可吸附在皮肤上。 An alcohol soaked cotton ball or piece of paper is ignited and placed into the cup. After a short time, the cup is rapidly placed ﬁrmly against the skin on the desired location.

3．滴酒法 Alcohol-Firing Method (Di Jiu Fa)

用95%酒精或白酒，滴入罐内1～3滴(切勿滴酒过多，以免拔罐时流出，烧伤皮肤)，沿罐内壁摇匀，用火点燃后，稍等片刻迅速将罐扣在选定的部位。 Place one to three drops of alcohol into a cup (only a small amount should be used, to prevent it from dripping out of the cup and burning the skin.), turn the cup to distribute the alcohol evenly on the surface of the walls. Promptly place the cup on the area to be treated after igniting the alcohol for a few seconds.

4．贴棉法 Cotton-Sticking Method (Tie Mian Fa)

用大小适宜的酒精棉花一块，贴在罐内壁，用火将酒精棉花点燃后，迅速扣在应拔的部位。

Stick an appropriate-sized alcohol soaked, cotton ball on the inner wall of the cup; ignite the cotton ball and quickly place the cup on the area to be treated.

（二）水吸法 Water Suction Method (Shui Xi Fa)

水吸法是利用沸水排出罐内空气，形成负压，使罐吸附在皮肤上的方法。 Wit this method, the negative pressure is created when boiling water draws the air out of the cup so that it can attach to the skin.

（三）抽气吸法 Suction Cup Method (Chou Qi Xi Fa)

将备好的抽气罐紧扣在选定的部位，通过抽气装置抽出罐内空气，使其产生负压，即能吸住。 A suction cup is placed ﬁrmly on the chosen area, where a device is used to withdraw the air. When a sufﬁcient amount of negative pressure is produced, the cup will attach itself to the skin.

三、拔罐的应用 Application of Cupping

 留罐法

 走罐法

 闪罐法

 血罐法

 针罐法

 药罐法 17

（一）留罐法 The Cup-Retention Method (Liu Guan Fa)

留罐又称坐罐，即将罐吸附在体表后，使罐子吸拔留置于施术部位10min~15min，然后将罐起下。 This could also be called the Cup-Waiting Method, as it involves keeping the cup on the selected location for 10-15 minutes before removal.

（二）走罐法 Moving Cupping (Zou Guan)

走罐亦称推罐，即拔罐时先在所拔部位的皮肤或罐口上涂一层凡士林等润滑剂后，将罐拔住，然后，医者握住罐子，上下左右推移，至所拔部位的皮肤红润、充血，甚或瘀血时，将罐起下。 This is also known as “sliding cupping”. A lubricant should be applied to the skin over the treatment area prior to using this method. Once suction has been created, the cup is held and slid across the skin until it becomes rosy and congested, or even blood stagnation is seen.

（三）闪罐法 Swift/Flash Cupping (Shang Guan)

闪罐即将罐拔上后，立即起下，再迅速拔上，如此反复多次地拔上起下，起下拔上。

This method is done by rapidly placing and removing the cup repeatedly over the same place.

（四）刺血拔罐法 Bloodletting Cupping Therapy (Si Xue Ba Guan)

刺血拔罐又称刺络拔罐，即将选定的部位的皮肤消毒后，用三棱针点刺出血或用皮肤针叩打后，再将火罐吸拔于点刺的部位，使之出血，可使用于各种疾病。 This is also referred to as collateral-pricking and cupping. After the disinfecting the treatment area, it is punctured with a three-edged needle to cause bleeding, or tapped it with a plum- blossom needle; the cup is then applied to induce more bleeding. This method may be used to treat all kinds of illness.

21 （五）留针拔罐法 Needle-Retention Cupping(Liu Zhen Ba Guan)

留针拔罐简称针罐，即在针刺留针时，将罐拔在以针为中心的部位上，待皮肤红润、充血或瘀血时，将罐起下。 Sometimes referred to as needle cupping for short, this method is done by applying a cup over the center of the site where a needle has been inserted. The cup is removed when the skin turns rosy, congested and blood stagnation appears.

Here is the needle. 22

1. 将竹罐于药液中煮沸10min ～ 15min后，使之吸附于患部； 2. 将药液贮于抽气罐内后，使之吸附于患部。  Bamboo cup: boil a bamboo cup in an herbal decoction for 10 to 15 minutes and place it on the affected area;  Suction cup: put the herbal decoction in the suction cup and apply it to the affected location.

四、拔罐的作用和适应范围 The Actions and Indications for Cupping

作用：通经活络、行气活血、消肿止痛、祛风散寒等， Actions: warming the meridians, invigorating qi and blood circulation, relieving blood stagnation, alleviating pain and swelling and dispelling damp and cold.

适应范围：一般多用于风寒湿痹、腰背肩臂腿痛、软组织闪挫扭伤、伤风感冒、头痛、咳嗽、哮喘、胃脘痛、腹痛、痛经等。 Indications: commonly applied for wind cold-damp Bi syndrome, lumbar pain, shoulder and back pain, aching low extremities, soft tissue sprains and contusions, common colds, headaches, cough, asthma, stomachaches, abdominal pain and dysmenorrhea. 24 五、拔罐常选用的部位 Cupping area usually selected

25 Causes 原因

Taiyang meridian The vessels reflection Governs the surface of was distributed along the whole body. the first lateral line. Once the external Stimulating the points pathogenic invading， Could regulate vessel Taiyang meridian was function. affected first. 太阳主一身之表，第一侧线分布有十外邪侵袭人体，太阳经二脏腑的背俞穴，可调常先受病。整脏腑功能。

26 26

六、起罐方法和注意事项 Cup Removal Precautions

（一）起罐方法 Cup Removal Precautions

起罐时，一般先用左手握持火罐，右手拇指或食指从罐口旁边按压皮肤，使气体进入罐内，即可将罐取下。 When removing a cup, it should be held in one hand, while the index ﬁnger and thumb of the opposite hand, presses the skin around the mouth of the cup, to break the seal created by the suction. In this way, the air is let in and the cup is released. 27 （二）注意事项 Precautions

1.1 拔罐应选择肌肉丰满的部位，选择体位应适当。 Generally, large, thickly muscled areas are selected. Patients should be comfortably positioned.

1.2 骨骼凹凸不平、毛发较多的部位，火罐容易脱落。 The cups are prone to drop off bone edges and hairy areas.

1.3 在拔罐过程中，不能变换体位或移动，以防火罐脱落。 To avoid the loss of suction, which will result in the cups falling off, patients should remain still when manipulating the cups. 28

2.1 拔罐时要根据所拔部位的面积大小而选择大小适宜的罐。 Using cups of different sizes is determined by the cupping location.

2.2 不易吸拔的部位，可采用闪罐。 Flash cupping should be used on areas that are difﬁcult for cups to stick.

3.1 应注意勿灼伤或烫伤皮肤。若烫伤或留罐时间太长而皮肤起水泡时，小水泡一般可敷以消毒纱布，防止擦破即可。水泡较大时，宜用消毒针将水放出，涂以消毒药水，或用消毒纱布包敷，以防感染。 Precautions should be taken to avoid scalding the skin. Prolonged retention and overheating of the mouth of the cup may cause blisters to arise.

3.2 若起罐后局部青紫，甚至发黑，可用毛巾热敷；或在局部揉按，以促进血液循环，使青紫逐渐减轻。 In the event that this occurs, small blisters should be covered with sterile gauze to avoid scraping; bigger ones should be aspirated with a sterile syringe, followed by the application of a disinfectant or sterile gauze.

4.1 皮肤有过敏、溃疡、水肿，心前区、大血管分布部位，高热抽搐者，不宜拔罐。 Cupping is contraindicated on patients with skin allergies, ulcers, or edema, as well as on the pericardium and places supplied with large blood vessels.

4.1 孕妇的腹部、腰骶部位，亦不宜拔罐。 It is also contraindicated for those that have high fevers accompanied by convulsions, and on the abdominal and sacral areas of pregnant women. 完 32