针刺安全理论探源及框架构建
|
摘要
1.研究目的
针刺疗法具有治疗范围广泛、疗效独特等而日益成为现代医疗中的不可或缺的治疗手段。但是针刺疗法也是一门实践性很强的疗法,在实际操作中,具有一定危险性,不免会产生意外。近些年,针刺意外及其副作用逐渐受到重视,针刺安全的评价方法也日益成为中、西方医学界研究的热点和难点。针刺安全的评价方法一般是通过对针刺意外的研究来进行的。但是,现有研究大多局限于对针刺意外文献报道的分析、讨论,进而探讨针刺疗法安全性的高低,缺乏对导致针刺意外发生的本质原因的分析和总结,更没有系统性、理论性地探讨和总结针刺意外与针刺安全之间的关系。因此,应加强针刺安全的理论研究。
2.研究方法
本论文的研究方法包括：文献资料的搜集、整理、分析以及模型的建立。其中文献搜集主要通过：人工查阅图书馆、互联网上CNKI、VIP、MEDLINE等数据库。然后采用纵向和横向相结合的方式整理分析文献资料。之后对整理的文献资料运用内容分析法、比较法、实证法等找到针刺安全的构成因素,揭示针刺安全的内在构成因素及因素的普遍联系,归纳概括针刺安全的本质及其运行规律。在此基础上,建立相应的针刺安全理论模型,并对其进行进一步的验证。
3.研究结果
由于针刺安全与针刺意外之间具有对立统一的关系。因此,本论文的文献综述部分从文献学的角度,整理分析归纳了古今中外关于针刺意外的文献资料。在整理分析的过程中,笔者发现,在古代,《黄帝内经》中已出现针刺安全思想萌芽,但是散见于各篇章中。到现代,随着多种操作规范、诊疗手段、临床经验等的发展,针灸业界开始研究针刺安全。这些研究大都来源于临床经验,缺乏系统的总结和系统的理论指导。
在前期的文献资料研究过程中,笔者通过分析针刺临床治疗中的针刺意外,发现导致针刺意外发生的原因很复杂、多样。其中,主要涉及到医生、患者、针具、时间、环境。本论文研究主要针对针刺一次的诊疗过程。一般来说,针刺治疗的时间为30-60分钟,时间较短,并且针刺治疗在室内,环境较为稳定,因此我们认为,在针刺临床治疗中,时间、环境是常量,医生、针具、患者是变量。因此,针刺治疗的简化模型为医生、针具、环境以及之间的相互作用,医生、患者是主体,针具是二者之间的介质。并且医生、患者、针具三者之间的相互作用贯穿于针刺治疗的全过程中。通过分析三者之间的相互作用,提出整个针刺安全的实现,是由医生、患者两个主体与介质针具之间共同作用的结果,而不是某一个因素所实现的。针刺安全的实现是通过医生、患者、针具之间的相互作用实现的,这与三者的属性和行为有关。在医生、患者、针具三者之间的相互作用而构成的针刺安全理论模型的基础之上,我们进而构建了针刺安全理论框架。
在针刺安全理论框架中,医生的安全属性为安全意识、安全心态、安全技能。医生的安全意识是指医生对针刺意外危害程度的有全面认识的情况下,主观上形成的自我保护的意识。它是医生学习安全技能、产生安全心态、支配安全行为的思想保证。例如：医生必须具有无菌的意识,在针刺临床治疗中要切实做好消毒的工作,避免出现针刺感染等。医生的安全心态,是指医生在针刺临床治疗中心理状态,它是支配医生安全行为的直接决定因素。医生的安全心态可以反映医生的安全意识、安全技能在针刺临床治疗中安危动态变化中的适应性。例如：医生在发生针刺意外的情况下,务必保持冷静、高度负责的态度等。医生的安全技能,是指医生在针刺临床实践中所掌握的预防、控制针刺意外产生及发展的技术能力。它是医生安全心态、安全行为的技术保障。例如：医生必须掌握解剖学等知识等。医生的安全行为,是指在针刺临床实践中,具有安全意识、安全技能的医生在安全心态支配下的行动表现。具体体现在针刺临床治疗的全过程中,医生对患者以及针具的行为表现。它是产生安全效果的决定因素。由此可见,医生在针刺安全理论框架中,是由具有安全思想、安全技能、安全心态等安全属性的医生,支配其在针刺临床实践中的安全行为,进而产生安全效果的相序组合规律运动构成的。在针刺安全理论框架中,患者具有安全属性和安全行为。患者的安全属性主要是为安全心态这一主观属性,即是患者在针刺临床治疗中的心理状态等。患者的安全行为是指在安全心理支配下的患者的行为举止。具体体现为指在临床治疗中,与医生的配合程度等。由此可见,患者在针刺安全理论框架中,是由具有安全心态等安全属性的患者,支配其在针刺临床治疗中的安全行为,进而产生安全效果的相序组合规律运动构成的。在临床中应用中有很多种针具,毫针是古今临床应用最为广泛的针具,所以本课题主要研究的是针具是毫针。因此,在针刺安全理论框架中,毫针具有安全属性,主要是毫针的安全规格。例如：毫针的质量、粗细、长短等。由此可见,针刺安全理论框架,主要针刺安全理论模型,其中系统描述参与者的属性和相互作用,具有高度概括性和开放性。之后将这一理论分析现有案例,系统总结出临床实践中,医生所应遵循的操作规范。
之后,本论文用一章节的篇幅分析了针刺安全理论框架与《黄帝内经》中针刺意外与针刺安全研究的承续关系,此部分内容不仅强化了《黄帝内经》对针刺安全理论框架构建的理论指导意义,而且运用针刺安全理论框架中的构成因素,检验其在《黄帝内经》中的应用,进一步加深针刺安全理论框架的认识和理解。
本论文的最后一章节对针刺安全与针刺深度之间的关系的进行了初步探讨。其中,针刺安全深度作为针刺安全理论框架在针刺深度中的应用而提出。针刺安全深度就是在保证针刺安全的情况下,最大的针刺深度。针刺安全深度一般是通过危险深度乘以一个小于1的系数而得到的。为了防止针刺过深,我们应该采用针刺安全深度,即是在保证安全的情况下,实现针刺疗效的深度,这样,医生可以在保证安全的情况下追求针刺疗效。
4.研究结论
通过古籍和现代医学成果的归纳整理,对针刺安全理论进行文献探源研究。在对古籍和现代医学成果的归纳整理的基础上,我们对针刺意外和针刺安全做了系统研究,发现了导致针刺意外发生的五个相关因素,即医生、针具、患者、时间、环境。通过研究各因素的属性和相互作用,进而构建针刺安全理论框架。之后将并将这一理论应用于实践,提出了针刺安全深度的概念。综上所述,针刺安全理论框架的提出将针刺安全理论框架的提出将在减少针刺意外,建立针刺安全临床规范,改进针具,培养高质量医生等方面提供有益的线索和思路,起到指导作用。
(1) Research purposes
Because of its unique and wide-range efficacy, acupuncture therapy is becoming an indispensable means in modern clinical treatments. However, acupuncture is a practical therapy with some risks, and may lead to some accidents. In recent years, acupuncture accidents and its side effects have gradually being paid attention, evaluation methods of acupuncture safety are becoming hot and difficult spots in Chinese and foreign medical research. Nowadays, existing studies are mostly focusing on analyses on acupuncture accidents reported in literatures, and discussion on levels of acupuncture safety. Nevertheless, it lacks analyses and summarization of fundamental reasons of acupuncture accidents, as well as theoretical and systematical investigation on the relationship between accidents and safety in acupuncture therapy. Therefore, theoretical studies of acupuncture safety should be strengthened.
(2) Research methods
Research methods in this paper include collection, organization and analyses of literature as well as modeling. Literature is collected by manual access to libraries, looking up online digital databases, such as CNKI, VIP, MEDLINE and so on. Data from literature are analyzed by using both vertical and horizontal methods. By using content analysis, comparitive methds and positive law, constitutive factors of acupuncture safety and their internal connections are found, so that the essence of acupuncture safety and laws governing the operation are summed up. On this basis, the corresponding theoretical model of acupuncture safety is inferred, and further validated.
(3) Results
Based on the unity of opposites between the acupuncture safety and accidents, from the philological point of view, the ancient and modern literature on acupuncture accidents from China and foreign countries is collected, analyzed and summed up. As a result, it indicates that in ancient times, the thought about acupuncture safety is originated in "Huangdi Neijing", and, nevertheless, scattered throughout various chapters. Nowadays, with the development of a variety of practice standards, means of diagnosis and treatment and clinical experience, acupuncture practitioners and researchers begin to study acupuncture safety. Most of these studies are derived from clinical experience, and lack of systematic summarization and theoretical guidance.
Reasons of accupuncture accidents in clinical treamts are complex and diverse. They mainly involve six factors, i.e., practitioners, patients, needles, time and environment. In this work, we only consider one period of acupuncture treatment, typically, duration of which is 30-60 minutes or shorter, and environment of which is indoor and stable. Therefore, here we assume that time and environment are constant, practitioners, patients and needles are variables. As a result, the origianl model of acupuncture treatment is simplied to interactions among practitioners, patients and needles, in which practitioners and patients are subjects, and needles are the media between subjects. Interactions among the practitioner, the patient and the needles run through the whole process of acupuncture treatment. By analyzing interactions among these three factors, it suggests that realization of acupuncture safety is the result of interactions between the practitioner, the patient and the needles, but not only one factor. These interactions are related to attributes and behaviours of these three factors. Based on the proposed theoretical model of acupuncture safety, we further propose a theoretical framework of acupuncture safety.
In the proposed theoretical framework of acupuncture safety, safety attributes of the practitioner involve awareness, state of mind and skills. Safety awareness of a practitioner refers to the subjective self-protection awareness of the practitioner formed under circumstances that he/she comprehensively understands adverse effects of acupucture accidents. It is the premise for a practitioner to learn safety skills, produce safety states of mind, and control safety behaviours. For example, the practitioner must have a sense of sterility so as to disinfect very well in clinical treatments for avoiding infection during the acupuncture treatment. The safety state of mind of a practitioner refers to the psychological status of the practitioner during a clinical treatment. It directly determines safety behaviors of the practitioner, and reilects the adaptability of the practitioner's safety awareness and skills to the changing safety status during a clinical treatment. For example, in case of accidents, the practitioner should keep calm and high responsibility. Safety skills of a practitioner are the technical capability of the practitioner to prevent and control occurrence and development of acupuncture accidents during a clinical treatment. They are the technical support of a practitioner's safety awareness and behaviours. For example, the practitioner must master knowledge of anatomy and so on. Safety behavoiours of a practitioner are behaviours of the practitioner with safety awareness, state of mind and skills so as to minimize adverse effects of possible acupuncture accidents during a clinical treatment. These behaviours are applied by the practitioner to the patient and the needles. They are determinants for realizing safe consequence. Therefore, in the proposed theoretical framework, from the practitioner's point of view, acupuncture safety is realized by a sequence of safety behaviours applied by the practitioner with safety attitudes, such as awareness, state of mind and skills.
Similarly, in the proposed framework, a patient has safety attitudes and behaviours. Safety attitudes of a patient usually involve such a subjective attitude as safety state of mind, that is the psychological status of the patient during a clinical treatment. Safety behaviours of a patient are behaviours of the patient with safety state of mind to minimize adverse effects of acupuncture accidents during a clinical treatment. It usually embodies the degree that the patient coordinates with the practitioner. Therefore, from the patient's point of view, acupuncture safety is realized by a sequence of safety behaviours applied by the patient with safety attitudes.
Since the filiform needle is the most widely applied kind of needles in acupuncture clinical treatments, the needles considered in this work are filiform needles. In the proposed framework, needles possess safety attitudes, which mainly refer to the safety requirements, such as quality, thickness and length.
In short, in the proposed theoretical framework, especially, the proposed theoretical model of acupuncture safety, attitudes and interactions among various factors are systemactically described. The proposed framework and model have high generality and openness. Thereafer, based on this framework and model, we will analyze existing clinical cases, systematically summarize the operation standards followed by practitioners in their practice.
Later, the inheritance relationship between the proposed framework and "Huangdi Neijing" is studied. Some basic ideas about acupuncture accidents and safety derived from the proposed framework are described in "Huangdi Neijing", but scattered in various chapters. By applying factors of acupuncture safety proposed in the framework in cases described in "Huangdi Neijing", the insight and understanding of the proposed framework is deepen further.
Next, we discuss the relationship between acupuncture safety and needling depth. Needling safety depth is proposed as an application of the proposed framework to needling depth. Needling safety depth refers to the maximum needling depth ensuring acupuncture safety. Needling safety depth is usually obtained by the dangerous needling depth multiplying a positive coefficient of less than 1. The needling safety depth is applied to prevent from needling too deeply, that is to say, the needling safety depth is the needling depth that keeps both acupuncture efficacy and safety. Hence, the practitioner should achieve efficacy under circumstances that guarantee acupuncture safety.
(4) Conclusion
By collecting and summarizing ancient and modern acupuncture research, the literature origin of acupuncture safety theory is studied. Based on the systematic study of acupuncture accidents and safety, five factors leading to acupuncture accidents are proposed. These five factors are practitioners, patients, needles, time and environment. By studying their attitudes and interactions, a theoretical framework of acupuncture safety is proposed. Furthermore, by applying this framework to practice, needling safety depth is proposed. In summary, the theoretical framework of acupuncture safety is proposed to provide guiding clues and ideas for reducing acupuncture accidents, setting up clinical operation standards of acupuncture safety, improving needles, and clutivating high-quality practitioners.
针刺疗法具有治疗范围广泛、疗效独特等而日益成为现代医疗中的不可或缺的治疗手段。但是针刺疗法也是一门实践性很强的疗法,在实际操作中,具有一定危险性,不免会产生意外。近些年,针刺意外及其副作用逐渐受到重视,针刺安全的评价方法也日益成为中、西方医学界研究的热点和难点。针刺安全的评价方法一般是通过对针刺意外的研究来进行的。但是,现有研究大多局限于对针刺意外文献报道的分析、讨论,进而探讨针刺疗法安全性的高低,缺乏对导致针刺意外发生的本质原因的分析和总结,更没有系统性、理论性地探讨和总结针刺意外与针刺安全之间的关系。因此,应加强针刺安全的理论研究。
2.研究方法
本论文的研究方法包括：文献资料的搜集、整理、分析以及模型的建立。其中文献搜集主要通过：人工查阅图书馆、互联网上CNKI、VIP、MEDLINE等数据库。然后采用纵向和横向相结合的方式整理分析文献资料。之后对整理的文献资料运用内容分析法、比较法、实证法等找到针刺安全的构成因素,揭示针刺安全的内在构成因素及因素的普遍联系,归纳概括针刺安全的本质及其运行规律。在此基础上,建立相应的针刺安全理论模型,并对其进行进一步的验证。
3.研究结果
由于针刺安全与针刺意外之间具有对立统一的关系。因此,本论文的文献综述部分从文献学的角度,整理分析归纳了古今中外关于针刺意外的文献资料。在整理分析的过程中,笔者发现,在古代,《黄帝内经》中已出现针刺安全思想萌芽,但是散见于各篇章中。到现代,随着多种操作规范、诊疗手段、临床经验等的发展,针灸业界开始研究针刺安全。这些研究大都来源于临床经验,缺乏系统的总结和系统的理论指导。
在前期的文献资料研究过程中,笔者通过分析针刺临床治疗中的针刺意外,发现导致针刺意外发生的原因很复杂、多样。其中,主要涉及到医生、患者、针具、时间、环境。本论文研究主要针对针刺一次的诊疗过程。一般来说,针刺治疗的时间为30-60分钟,时间较短,并且针刺治疗在室内,环境较为稳定,因此我们认为,在针刺临床治疗中,时间、环境是常量,医生、针具、患者是变量。因此,针刺治疗的简化模型为医生、针具、环境以及之间的相互作用,医生、患者是主体,针具是二者之间的介质。并且医生、患者、针具三者之间的相互作用贯穿于针刺治疗的全过程中。通过分析三者之间的相互作用,提出整个针刺安全的实现,是由医生、患者两个主体与介质针具之间共同作用的结果,而不是某一个因素所实现的。针刺安全的实现是通过医生、患者、针具之间的相互作用实现的,这与三者的属性和行为有关。在医生、患者、针具三者之间的相互作用而构成的针刺安全理论模型的基础之上,我们进而构建了针刺安全理论框架。
在针刺安全理论框架中,医生的安全属性为安全意识、安全心态、安全技能。医生的安全意识是指医生对针刺意外危害程度的有全面认识的情况下,主观上形成的自我保护的意识。它是医生学习安全技能、产生安全心态、支配安全行为的思想保证。例如：医生必须具有无菌的意识,在针刺临床治疗中要切实做好消毒的工作,避免出现针刺感染等。医生的安全心态,是指医生在针刺临床治疗中心理状态,它是支配医生安全行为的直接决定因素。医生的安全心态可以反映医生的安全意识、安全技能在针刺临床治疗中安危动态变化中的适应性。例如：医生在发生针刺意外的情况下,务必保持冷静、高度负责的态度等。医生的安全技能,是指医生在针刺临床实践中所掌握的预防、控制针刺意外产生及发展的技术能力。它是医生安全心态、安全行为的技术保障。例如：医生必须掌握解剖学等知识等。医生的安全行为,是指在针刺临床实践中,具有安全意识、安全技能的医生在安全心态支配下的行动表现。具体体现在针刺临床治疗的全过程中,医生对患者以及针具的行为表现。它是产生安全效果的决定因素。由此可见,医生在针刺安全理论框架中,是由具有安全思想、安全技能、安全心态等安全属性的医生,支配其在针刺临床实践中的安全行为,进而产生安全效果的相序组合规律运动构成的。在针刺安全理论框架中,患者具有安全属性和安全行为。患者的安全属性主要是为安全心态这一主观属性,即是患者在针刺临床治疗中的心理状态等。患者的安全行为是指在安全心理支配下的患者的行为举止。具体体现为指在临床治疗中,与医生的配合程度等。由此可见,患者在针刺安全理论框架中,是由具有安全心态等安全属性的患者,支配其在针刺临床治疗中的安全行为,进而产生安全效果的相序组合规律运动构成的。在临床中应用中有很多种针具,毫针是古今临床应用最为广泛的针具,所以本课题主要研究的是针具是毫针。因此,在针刺安全理论框架中,毫针具有安全属性,主要是毫针的安全规格。例如：毫针的质量、粗细、长短等。由此可见,针刺安全理论框架,主要针刺安全理论模型,其中系统描述参与者的属性和相互作用,具有高度概括性和开放性。之后将这一理论分析现有案例,系统总结出临床实践中,医生所应遵循的操作规范。
之后,本论文用一章节的篇幅分析了针刺安全理论框架与《黄帝内经》中针刺意外与针刺安全研究的承续关系,此部分内容不仅强化了《黄帝内经》对针刺安全理论框架构建的理论指导意义,而且运用针刺安全理论框架中的构成因素,检验其在《黄帝内经》中的应用,进一步加深针刺安全理论框架的认识和理解。
本论文的最后一章节对针刺安全与针刺深度之间的关系的进行了初步探讨。其中,针刺安全深度作为针刺安全理论框架在针刺深度中的应用而提出。针刺安全深度就是在保证针刺安全的情况下,最大的针刺深度。针刺安全深度一般是通过危险深度乘以一个小于1的系数而得到的。为了防止针刺过深,我们应该采用针刺安全深度,即是在保证安全的情况下,实现针刺疗效的深度,这样,医生可以在保证安全的情况下追求针刺疗效。
4.研究结论
通过古籍和现代医学成果的归纳整理,对针刺安全理论进行文献探源研究。在对古籍和现代医学成果的归纳整理的基础上,我们对针刺意外和针刺安全做了系统研究,发现了导致针刺意外发生的五个相关因素,即医生、针具、患者、时间、环境。通过研究各因素的属性和相互作用,进而构建针刺安全理论框架。之后将并将这一理论应用于实践,提出了针刺安全深度的概念。综上所述,针刺安全理论框架的提出将针刺安全理论框架的提出将在减少针刺意外,建立针刺安全临床规范,改进针具,培养高质量医生等方面提供有益的线索和思路,起到指导作用。
(1) Research purposes
Because of its unique and wide-range efficacy, acupuncture therapy is becoming an indispensable means in modern clinical treatments. However, acupuncture is a practical therapy with some risks, and may lead to some accidents. In recent years, acupuncture accidents and its side effects have gradually being paid attention, evaluation methods of acupuncture safety are becoming hot and difficult spots in Chinese and foreign medical research. Nowadays, existing studies are mostly focusing on analyses on acupuncture accidents reported in literatures, and discussion on levels of acupuncture safety. Nevertheless, it lacks analyses and summarization of fundamental reasons of acupuncture accidents, as well as theoretical and systematical investigation on the relationship between accidents and safety in acupuncture therapy. Therefore, theoretical studies of acupuncture safety should be strengthened.
(2) Research methods
Research methods in this paper include collection, organization and analyses of literature as well as modeling. Literature is collected by manual access to libraries, looking up online digital databases, such as CNKI, VIP, MEDLINE and so on. Data from literature are analyzed by using both vertical and horizontal methods. By using content analysis, comparitive methds and positive law, constitutive factors of acupuncture safety and their internal connections are found, so that the essence of acupuncture safety and laws governing the operation are summed up. On this basis, the corresponding theoretical model of acupuncture safety is inferred, and further validated.
(3) Results
Based on the unity of opposites between the acupuncture safety and accidents, from the philological point of view, the ancient and modern literature on acupuncture accidents from China and foreign countries is collected, analyzed and summed up. As a result, it indicates that in ancient times, the thought about acupuncture safety is originated in "Huangdi Neijing", and, nevertheless, scattered throughout various chapters. Nowadays, with the development of a variety of practice standards, means of diagnosis and treatment and clinical experience, acupuncture practitioners and researchers begin to study acupuncture safety. Most of these studies are derived from clinical experience, and lack of systematic summarization and theoretical guidance.
Reasons of accupuncture accidents in clinical treamts are complex and diverse. They mainly involve six factors, i.e., practitioners, patients, needles, time and environment. In this work, we only consider one period of acupuncture treatment, typically, duration of which is 30-60 minutes or shorter, and environment of which is indoor and stable. Therefore, here we assume that time and environment are constant, practitioners, patients and needles are variables. As a result, the origianl model of acupuncture treatment is simplied to interactions among practitioners, patients and needles, in which practitioners and patients are subjects, and needles are the media between subjects. Interactions among the practitioner, the patient and the needles run through the whole process of acupuncture treatment. By analyzing interactions among these three factors, it suggests that realization of acupuncture safety is the result of interactions between the practitioner, the patient and the needles, but not only one factor. These interactions are related to attributes and behaviours of these three factors. Based on the proposed theoretical model of acupuncture safety, we further propose a theoretical framework of acupuncture safety.
In the proposed theoretical framework of acupuncture safety, safety attributes of the practitioner involve awareness, state of mind and skills. Safety awareness of a practitioner refers to the subjective self-protection awareness of the practitioner formed under circumstances that he/she comprehensively understands adverse effects of acupucture accidents. It is the premise for a practitioner to learn safety skills, produce safety states of mind, and control safety behaviours. For example, the practitioner must have a sense of sterility so as to disinfect very well in clinical treatments for avoiding infection during the acupuncture treatment. The safety state of mind of a practitioner refers to the psychological status of the practitioner during a clinical treatment. It directly determines safety behaviors of the practitioner, and reilects the adaptability of the practitioner's safety awareness and skills to the changing safety status during a clinical treatment. For example, in case of accidents, the practitioner should keep calm and high responsibility. Safety skills of a practitioner are the technical capability of the practitioner to prevent and control occurrence and development of acupuncture accidents during a clinical treatment. They are the technical support of a practitioner's safety awareness and behaviours. For example, the practitioner must master knowledge of anatomy and so on. Safety behavoiours of a practitioner are behaviours of the practitioner with safety awareness, state of mind and skills so as to minimize adverse effects of possible acupuncture accidents during a clinical treatment. These behaviours are applied by the practitioner to the patient and the needles. They are determinants for realizing safe consequence. Therefore, in the proposed theoretical framework, from the practitioner's point of view, acupuncture safety is realized by a sequence of safety behaviours applied by the practitioner with safety attitudes, such as awareness, state of mind and skills.
Similarly, in the proposed framework, a patient has safety attitudes and behaviours. Safety attitudes of a patient usually involve such a subjective attitude as safety state of mind, that is the psychological status of the patient during a clinical treatment. Safety behaviours of a patient are behaviours of the patient with safety state of mind to minimize adverse effects of acupuncture accidents during a clinical treatment. It usually embodies the degree that the patient coordinates with the practitioner. Therefore, from the patient's point of view, acupuncture safety is realized by a sequence of safety behaviours applied by the patient with safety attitudes.
Since the filiform needle is the most widely applied kind of needles in acupuncture clinical treatments, the needles considered in this work are filiform needles. In the proposed framework, needles possess safety attitudes, which mainly refer to the safety requirements, such as quality, thickness and length.
In short, in the proposed theoretical framework, especially, the proposed theoretical model of acupuncture safety, attitudes and interactions among various factors are systemactically described. The proposed framework and model have high generality and openness. Thereafer, based on this framework and model, we will analyze existing clinical cases, systematically summarize the operation standards followed by practitioners in their practice.
Later, the inheritance relationship between the proposed framework and "Huangdi Neijing" is studied. Some basic ideas about acupuncture accidents and safety derived from the proposed framework are described in "Huangdi Neijing", but scattered in various chapters. By applying factors of acupuncture safety proposed in the framework in cases described in "Huangdi Neijing", the insight and understanding of the proposed framework is deepen further.
Next, we discuss the relationship between acupuncture safety and needling depth. Needling safety depth is proposed as an application of the proposed framework to needling depth. Needling safety depth refers to the maximum needling depth ensuring acupuncture safety. Needling safety depth is usually obtained by the dangerous needling depth multiplying a positive coefficient of less than 1. The needling safety depth is applied to prevent from needling too deeply, that is to say, the needling safety depth is the needling depth that keeps both acupuncture efficacy and safety. Hence, the practitioner should achieve efficacy under circumstances that guarantee acupuncture safety.
(4) Conclusion
By collecting and summarizing ancient and modern acupuncture research, the literature origin of acupuncture safety theory is studied. Based on the systematic study of acupuncture accidents and safety, five factors leading to acupuncture accidents are proposed. These five factors are practitioners, patients, needles, time and environment. By studying their attitudes and interactions, a theoretical framework of acupuncture safety is proposed. Furthermore, by applying this framework to practice, needling safety depth is proposed. In summary, the theoretical framework of acupuncture safety is proposed to provide guiding clues and ideas for reducing acupuncture accidents, setting up clinical operation standards of acupuncture safety, improving needles, and clutivating high-quality practitioners.
引文
[1]黄帝内经灵枢[M].北京：人民卫生出版社.1963
[2]张志聪,黄帝内经集注[M].浙江：浙江古籍出版社.2002,48
[3]黄帝内经素问[M].北京：人民卫生出版社.1963
[4]唐·孙思邈.备急千金要方[M].北京：人民卫生出版社.1997,16
[5]晋·皇甫谧.针灸甲乙经[M].北京：人民卫生出版社.2006,29
[6]唐·孙思邈.备急千金要方[M].北京：人民卫生出版社.1982,24
[7]宋·王惟一.铜人腧穴针灸图经[M].北京：人民卫生出版社.1956,16
[8]宋·王执中.针灸资生经[M].上海：上海科学技术出版社.1959
[9]明·徐凤.针灸大全[M].上海：上海科学技术出版社.1967,22-43.
[10]明·高武.针灸聚英[M].北京：中国中医药出版社.1997,36-37
[11]明·汪机.针灸问对[M].北京：科学技术文献出版社.2002,32-33
[]2]明·陈言.杨敬斋针灸全集[M].北京：中医古籍出版社,1992,16
[13]明·吴谦刺法心法要诀[M].北京：人民卫生出版社.1993,33.
[14]清·李学川.针灸逢源[M].上海：上海科学技术出版社.1987,120.
[15]清·廖润鸿.针灸集成[M].北京：学苑出版社.1959,29.
[16]明·朱梓.普济方[M].北京：学苑出版社.1997,37
[17]明·杨继洲.针灸大成[M].北京：人民卫生出版社.1957,28.
[18]明·张介宾.类经图翼[M].北京：人民卫生出版社.1993,103.
[19]晋·王叔和.脉经[M].北京：科学技术文献出版社.2005,25
[20]清·阎纯玺.胎产心法[M].北京：人民卫生出版社.1988,201.
[21]清·李守先.针灸易学[M].福建：福建科学技术出版社.1993,63.
[22]元·杜思敬.济生拔萃[M].北京：学苑出版社.1959,99.
[23]晋·陈寿.三国志[M].武汉：崇文书局2010,362
[24]明·江瓘.名医类案[M].北京：人民卫生出版社.2005,39
[1]陆寿康.刺法灸法学[M].中国中医药出版社(北京),2003,49
[2]刘玉书.浅谈针疗事故的严重性[J].内蒙古中医药,1986,(4)：30-32
[3]丛华.腹部针刺失误浅析[J].长春医学院学报,1990,6(4)：49-50
[4]李玲.对针灸意外病例的统计和分析[J].中医药图书情报,1991,4：8-11
[5]刘炎,张斌渊.针灸临床意外107例分析[J].针灸临床杂志,1997,13(3)：49-53
[6]王克非.关于针刺意外的几点思考[J].针灸临床杂志,1999,15(5)：57-58
[7]金平林.浅谈针灸意外及其防治[J].中华实用中西医杂志,2005,5(18)：765
[8]蔡用治,王礼清.深刺致大量血胸[J].中国医刊,1982,(6)：54
[9]彭玉格.电针过敏一例报告[J].江西中医药,1982,(3)：19
[10]张传英,郑淑梅,裴延辅.针刺不当导致内脏意外损伤5例报告[J].,黑龙江中医药,1992(1)：38
[11]马丽,张纯娟.针刺导致气胸的临床浅析[J].针灸临床杂志,1997,13(2)：40
[12]丁蔚英.针刺胸背部引起外伤性气胸10例[J].中原医刊,1986,(4)：39
[13]蒋水成,陈惜秋.针刺风池穴引起死亡1例[J].中国法医杂志,1987,2(2)：116-117
[14]朱望太,李新锁,张永涛,李玮娜.针灸致心脏破裂死亡1例[J].法医学杂志,2008,24(4)：312
[15]丁喜艳,刘顺益,朱江.临床针灸意外1例[J].中国针灸,2008,28(11)：817-818
[16]高清山,郑亚君.亳针过敏2例[J].中国针灸,2008,28(11)：818
[17]罗春燕,黄红云.针刺引发肌束震颤二例[J].中国针灸,2006,26(6)：460
[18]唐韬,李强.临床针灸意外一例[J].中国针灸,2006,26(6)：459460
[19]陈安.针灸意外4例医案分析[J].上海针灸杂志,2009,28(2)：112-113
[20]蒋作贤.针刺异常100例分析[J].陕西中医学院学报,1988,(01)：25-29
[21]宋南昌.晕针32例分析[J].江西中医药,1989,(3)：39
[22]戴萦萦.晕针之24例之分析[J].针灸临床杂志,1995,11(3)：46
[23]徐贵平,袁永梅.82例针刺晕针患者的急救与护理[J].中国医疗前沿,2007,2(13)：125
[24]Cassedy JH. Early uses of acupuncture in the United States, with an addendum (1826) by Franklin Bache, M. D. Bull N Y Acad Med 1974; 50(8): 892-906
[25]Wang H, Hong Q, Wang Bai-song, et al. Is acupuncture beneficial in depression? A meta-analysis of 8 randomized controlled trials. J Affect Disord 2008;111:1-10.
[26]NIH Consensus Conference. Acupuncture. JAMA 1998; 280(17):1518-1524
[27]Turner JS. The regulation of acupuncture needles by the United States Food and Drug Administration. J Altern Complement Med 1995; 1(1):15-16
[28]Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults:United States,2002. Adv Data 2004; 2004(343):1-19
[29]Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children:United States,2007. Natl Health Stat Report 2009; (12):1-23
[30]Rampes H, James R. Complications of acupuncture. Acupunct Med 1995;13:26-33.
[31]Jeffreys DB, Smith S, Brennand-Roper DA, Curry PVL. Acupuncture needles as a cause of bacterial endocarditis. BMJ 1983:287:326-327.
[32]Lixing Lao, Gayle R Hamilton, Jianping Fu, Brian M Berman. Is acupuncture safe? A systematic review of case reports Alternative Therapies in Health and Medicine; Jan/Feb 2003; 9,1:72-83
[33]Adrian White.A cumulative review of the range and incidence of significant adverse events associated with acupuncture ACUPUNCTURE IN MEDICINE 2004:22(3):122-133.
[34]E. Ernst, Myeong Soo Lee, Tae-Young Choi E. Ernst et al. Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews /PAIN 2011; (152):755-764
[35]E. Ernst, Deaths after acupuncture:A systematic review International Journal of Risk& Safety in Medicine 2010;(22) 131-136
[36]HITOSHI YAMASHITA, HIROSHI TSUKAYAMA, YASUO TANNO, KAZUSHI NISHIJO. Adverse Events in Acupuncture and Moxibustion Treatment:A Six-year Survey at a National Clinic in Japan, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE 1999;3(5):229-236
[37]Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97,733 patients. Arch Intern Med 2004:164:104-105.
[38]E Eenet, Acupuncture Research-The First 10 years in Exeter. ACUPUNCTURE IN MEDICINE.2003;21(3):100-104.
[39]E Ernst, A White.Acupuncture:safety first Training programmes should include basic medical knowledge and experience BMJ 1997;314:1362
[40]Jorge Vas, Emilio Perea-Mill, Camila Me'ndez, Cayetana Sa'nchez Navarro, Jose'Mari, Leo'n Rubio, Mauricio Brioso, Inmaculada Garc i, Obrero, Efficacy and safety of acupuncture for chronic uncomplicated neck pain:A randomised controlled study Pain 2006; (126):245-255
[41]Wang H, Hong Q, Wang Bai-song, et al. Is acupuncture beneficial in depression? A meta-analysis of 8 randomized controlled trials. J Affect Disord 2008:111:1-10.
[42]Mona Potter, MDa, AlanaMoses, BAb, Janet Wozniak, MDa,* Alternative Treatments in Pediatric Bipolar Disorder Child Adolesc Psychiatric Clin N Am 2009; (18):499-500
[43]LIXING LAO, Ph.D., L.Ac. Safety Issues in Acupuncture. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE.1996;2(1):27-31
[44]Hitoshi Yamashita and Hiroshi Tsukayama, Safety of Acupuncture Practice in Japan:Patient Reactions, Therapist Negligence and Error Reduction Strategies. eCAM 2008;5(4):391-398
[45]Sabina Lim, Seunghun Lee,Seung-Ho Yi, Yang-Sun Son,Sung-min Choi and Young-Kon Kim. The Biological Safety of Stainless Steel Needles Used in Warm-needling. eCAM 2010;7(2):259-264
[46]Gerhard Litscher, Weibo Zhang, Seung-Ho Yi,Lu Wang, Tao Huang, Ingrid Gaischek, Yu Ying Tian and Guang Jun Wang. The Future of Acupuncture Moxibustion:A Transcontinental Three-Center Pilot Study Using High-Tech Methods. MEDICAL ACUPUNCTURE.2009; 21(2):115-121
[47]Pratt RJ, Hoffman PN, Robb FF. The need for skin preparation prior to injection:point-counterpoint. British Journal of Infection Control AUGUST 2005;6(4):18-20
[48]工晴霞.针刺意外损伤的原因及预防,咸宁学院学报,2007,6(21)：464
[49]Mike Cummings, Frankie Reid BMAS policy statements in some controversial areas of acupuncture practice ACUPUNCTURE IN MEDICINE 2004;22(3):134-136.
[50]Elisabet Stener-Victorn, Matts Wikland, Urban Waldenstrom and Thomas Lundeberg Alternative treatments in reproductive medicine:much ado about nothing. Acupuncture-a method of treatment in reproductive medicine:lack of evidence of an effect does not equal evidence of the lack of an effect Human Reproduction.2002;17(8):1945-1946
[51]Guidelines on basic training and safety in acupuncture. Geneva:World Health Organization; 1999:1-31.
[52]HUGH MacPHERSON. Fatal and Adverse Events from Acupuncture:Allegation, Evidence, and the Implications, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE 1999;5(1):47-56
[53]ADRIAN WHITE. The Safety of Acupuncture Techniques, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE,2007; 13(1):9-10
[54]MacPherson H, Thomas K, Walters S, Fitter M. The York acupuncture safety study:prospective survey of 34000 treatments by traditional acupuncturists. BMJ 2001;323:486-487.
[55]Claudia M. Witt, Daniel Pach, Thomas Reinhold, Katja Wruck, Benno Brinkhaus, Sigrid Mank, Stefan N. Willich. Treatment of the adverse effects from acupuncture and their economic impact:A prospective study in 73,406 patients with low back or neck pain. European Journal of Pain 2011;15:193-197
[56]Vanita Jindal, Adeline Ge, and Patrick J. Mansky. Safety and Efficacy of Acupuncture in Children A Review of the Evidence. J Pediatr Hematol Oncol 2008;30(6):431-442
[1]贺君,唐庆芬,庄礼兴.晕针疗效的分析及机制初探[J].中国针灸,2004,08：553-555
[2]宗维军,李志实.白发性气胸88例临床分析[J].中华实用中西医杂志,2003,(2)：203.
[3]P.M. Barnes, E. Powell-Triner, K. McFann and R. L. Nahin, Complementary and alternative medicine use among adults:United States,2002, Advance Data 2004:1-20.
[4]Susan Q. Wilburn, MPH, RN.针刺意外损伤的预防[J].护理实践与研究,2006,3(1)：1-3
[5]Ernst E. The risks of acupuncture[J]. Int J Risk Safety Med 1995,6:179-186.
[6]金平林.浅谈针灸意外及其防治,中华实用中西医杂志[J].2005,5(18)：765
[7]张传英,郑淑梅,裴延辅.针刺不当导致内脏意外损伤5例报告[J].黑龙江中医药,1992(1)：38
[8]马丽,张纯娟.针刺导致气胸的临床浅析,针灸临床杂志[J].1997,13(2)：40
[9]朱望太,李新锁,张永涛,李玮娜.针灸致心脏破裂死亡1例[J].法医学杂志,2008,24(4)：312
[10]Val Hopwood, Maureen Lovesey, Sara Mokone. Acupuncture& Related Techniques in Physical Therapy, [M]NEW YORK Edinburgh London Madrid Melbourne San Francisco and Tokyo,1997:62-74
[11]Norheim AJ. Adverse effects of acupuncture:a study of the literature for the years 1981-1994. J Altern Complement Med 1996; 2:291-7doi: 10.1089/acm.1996.2.291 pmid:9395661.
[12]Peuker ET, White A, Ernst E, Pera F, Filler TJ. Traumatic complications of acupuncture. Therapists need to know humananatomy. Arch Fam Med 1999; 8:553-8 doi:10.1001/archfami.8.6.553 pmid:10575398.
[13]Yamashita H, Tsukayama H, White AR, Tanno Y, Sugishita C, ErnstE. Systematic review of adverse events following acupuncture:the Japanese literature. Complement Ther Med 2001; 9:98-104 doi:10.1054/ctim.2001.0446 pmid:11444889.
[14]Ernst E, Sherman KJ. Is acupuncture a risk factor forhepatitis ystematic review of epidemiological studies. J Gastroenterol Hepatol 2003; 18:1231-6 doi:10.1046/j.1440-1746.2003.03135. xpmid:14535978.
[15]徐贵平,袁永梅.82例针刺晕针患者的急救与护理[J].中国医疗前沿,2007,2(13)：125
[16]肖炜,黄泳,卓鹰,陈俊琦,廖韧赞,夏冒李.慎刺穴位的局部解剖及安全操作[J].中国医学研究与临床,2008,6(5)：47-50
[17]李鼎.针灸学释难[M].上海：上海中医药大学出版社,1998,1-26
[18]罗玉芬.腧穴学[M].上海：上海科学技术出版社,1996,1-168
[19]严振国.中医应用腧穴解剖学[M].上海：上海中医药大学出版社,2001,1-37
[20]郑魁山.郑氏针灸全集[M].北京：人民卫生出版社,2000,1-29
[21]刘信基.4例针刺治疗精神分裂症的意外事故[J].神经精神病杂志,1981,5(317)：92
[22]王启才,李映平.针刺断针一例报告[J].江苏中医,1988,9(29)：355
[23]朱汲.针刺天突窒息死亡一例[J].江苏中医,1986,2(28)：138
[24]朱秋娇,指针在晕针中的运用[J].福建中医药,1992,6(31)：321
[25]伦新等.针灸意外案例选析[M].北京：人民卫生出版社,1997,96
[1]刘潜.一个发展中的交叉科学领域——安全科学[J].中国安全科学学报,1991(2)：59-67
[2]Hales BM, Pronovost PJ. The checklist-a tool for error management and performance improvement [J].J Crit Care,2006,21 (3):231-235
[3]辞海第六版彩图本[M].上海：上海辞书出版社,2009：35
[4]西汉·焦延寿,民国·尚秉和.焦氏易林注[M].北京：光明日报出版社,2005：94
[5]唐·房玄龄.晋书[M].上海：中华书局,2011：2082
[6]新牛津英汉双解大词典[M].上海：上海外语教育出版社,2007：1872
[7]新牛津英汉双解大词典[M].上海：上海外语教育出版社,2007：1924
[8]苏长和.从国家安全到世界安全——现实主义及其后[J].欧洲,1997(1)：43-48
[9]周法超,余宏明.试论安全观[J].中国公共安全·学术版,2010,4(21)：9-12
[10]林伯泉.安全学原理[M].北京：煤碳工业出版社,2002
[11]张景林.构思“安全学”[J].中国安全科学学报,2004,14(10)：7-12
[12]陆忠伟.非传统安全论[M].北京：时事出版社,2003
[13]张弘.加拿大职业健康与安全体系特点浅析[J].重庆科技学院学报(社会科学版),2011(10)：63-66
[14]范六一,曹金福,王宏,张明,薛良辉.发展中国家食品安全体系的构建[J].中国公共卫生管理,2007,23(5)：470-471
[15]张建耕.构建临床输血安全体系的设想[J].中国医学伦理学,2005,18(3)：4-6
[16]卢礼,宋锦,邓锋,戴红卫,高翔.基于医院信息系统和Oracle9i数据库的网络化口腔电子病历安全体系的研究[J].口腔医学,2008,28(12)：634-636
[17]龚翔.加快分类管理进程完善安全评价体系——我国药物政策中药品安全体系现状浅析[J].中国医药报,2004：1-4
[18]胡一芳.建立“以病人为中心”护理服务安全体系的探讨[J].全科护理,20097(5)：1388-1389
[19]何俊华,韩德军.论构建农村食品安全体系[J].医学动物防治,2006,22(3)：200-201
[20]冯尚坤.论建立农村食品安全体系的必要性[J].四川省卫生管理干部学院学报,2004,23(2)：126-127
[21]林俭.浅谈职业健康安全体系的持续改进要求[J].中国航天报,2010,3：1-2
[22]田磊.危害分析关键控制点是食品安全体系建设的重要环节[J].淮海医药,2005,23(2)：162-163
[23]陈晓勐,张建国.医疗信息安全体系架构设计[J].红外与毫米波学报,2005,24(1)：71-75
[24]时洪洋,刘仁民.中外食品安全监管比较及中国食品安全体系建构思考[J].中国卫生事业管理,2006,(3)：186-188
[25]林伯泉.安全学原理[M].北京：煤炭工业出版社,2002
[26]张景林,崔国璋.安全系统工程[M].北京：煤炭工业出版社,2002
[27]吴穹,许开立.安全管理学[M].北京：煤炭工业出版社,2002
[28]洪寿海,王然芸,郭义,李桂兰,郭永明,陈泽林,蔡青.针灸标准化的研究现状及思考[J].湖南中医杂志,2011,27(3)：123-124
[29]何玉长,倪稼民,曹士海.知识就是力量：走向前沿的知识经济学[M].湛江：广东旅游出版社,1999
[30]胡一芳.建立”以病人为中心”护理服务安全体系的探讨[J].全科护理,20097(5)：1388-1389
[31]杨庆.浅议中医针刺针的消毒及针刺无菌操作[J].云南中医中药杂志,2007,28(7)：59
[32]Susan Q. Wilburn, MPH, RN.针刺意外损伤的预防[J].护理实践与研究,2006,3(1)：1-3
[33]刘辉,刘晓辉.针灸操作中血肿的预防及处理[J].中国误诊学杂志.2007,7(29)：59
[34]姚玉红,席玉红,邓耀辉.意外针刺伤临床预防与处理[J].医药论坛杂志.2006,27(4)：91-92
[35]杨荣坤.医务工作者发生针刺伤原因及安全防护措施[J].基层医学论坛.2008,(12)：1128-1129
[36]徐军,蒋鹏程,王鑫扬,余飞鹏.医疗不良事件报告体系研究[J].中国卫生质量管理,2009,16(1)：23-25
[37]马铁明.试析针刺操作基本流程[J].福建中医学院学报,2004,14(2)：22-23
[38]朱林贞.学习《内经》“刺禁”理论的体会[J].四川中医,1997,15(6)：14-15
[39]徐晖,许银珊,刘清国.《内经》刺禁初探[J].山西中医.2007,23(1)：42-45
[40]孙国杰.腧穴学[M].上海：上海科学技术出版社,1997
[41]中国中医研究院.针灸学简编[M].北京：人民卫生出版社,1978
[42]天津中医学院第一附属医院针灸科.实用针灸学[M].天津：天津科学技术出版社,1981
[43]杨甲三.腧穴学[M].上海：上海科学技术出版社,1984
[44]邱茂良.针灸学[M].上海：上海科学技术出版社,1985
[45]赖新生,陈兴华.简明针灸学[M].北京：中国中医药出版社,2008
[46]孙国杰.针灸学[M].北京：人民卫生出版社,2011
[47]陆寿康.刺法灸法学[M].北京：中国中医药出版社,2004
[48]冯淑兰.刺法灸法学技能实训[M].北京：中国中医药出版社,2011
[49]方剑乔.刺法灸法学[M].北京：科学出版社,2004
[50]王富春.刺法灸法学[M].上海：上海科学技术出版社,2009
[51]张仁.针刺意外事故防治[M].上海：上海科学技术出版社,2004
[52]李珊.临床常用腧穴针灸意外预防手册[M].北京：人民军医出版社,2003
[53]杨占林,马贵宝,杨学智,牛欣.临床针刺事故防范[M].北京：人民卫生出版社,2010
[54]赵华,米勇,马忠.针灸操作记录规范化探索[J].新疆中医药,2007,25(4)：58-59
[55]刘伍立,朱文锋.针灸方法、手法规范化研究[J].针灸临床杂志,1999,15(11)：2-3
[56]张英.浅谈针灸临床亟待解决的几个问题[J].湖北中医学院学报,2000,2(4)：43-44
[57]Hsiao-Neng Chen, Jaung-Geng Lin, Albert D. Yang, Shu-Kuei Chang. Safe depth of abdominal acupoints in pediatric patients[J]. Complementary Therapies in Medicine,2008(16):331-335
[58]ADRIAN WHITE. The Safety of Acupuncture Techniques, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE,2007;13(1):9-10
[59]Vincent C. The safety of acupuncture [J]. BMJ 2001:323:467-468.
[60]British Medical Association Board of Science and Education. Acupuncture: efficacy, safety and practice[M]. London:Harwood Academic Publishers,2000.
[61]刘信基.4例针刺治疗精神分裂症的意外事故[J].神经精神病杂志,1981,5(317)：92
[62]王启才,李映平.针刺断针一例报告[J].江苏中医,1988,9(29)：355
[63]朱汲.针刺天突窒息死亡一例[J].江苏中医,1986,2(28)：138
[64]朱秋娇,指针在晕针中的运用[J].福建中医药,1992,6(31)：321页
[65]伦新等.针灸意外案例选析[M].北京：人民卫生出版社,1997,96
[1]黄帝内经灵枢[M].北京：人民卫生出版社,1963
[2]黄帝内经素问[M].北京：人民卫生出版社,1963
[3]明·马莳.黄帝内经素问注证法微[M].北京：科技文献出版社,1999
[4]清·张志聪.黄帝内经集注[M].浙江：浙江古籍出版社,2002
[5]唐·王冰.重广补注黄帝内经素问[M].人民卫生出版社,1963
[1]张仁.针刺意外事故防治[M].上海：上海科学技术出版社,2004：17
[2]宋·王惟一.铜人腧穴针灸图经[M].北京：人民卫生出版社,1956
[3]宋·琼瑶真人.针灸神书[M].北京：中医古籍出版社,2007
[4]晋·皇甫谧.针灸甲乙经[M].北京：人民卫生出版社,2006
[5]针灸学[M].南京：江苏人民出版社,1957
[6]针灸学[M].长沙：湖南科技出版社,1987
[7]针灸学[M].贵阳：贵州科技出版社,1993
[8]针灸学[M].北京：人民卫生出版社,1999
[9]针灸学[M].北京：人民卫生出版社,2002
[10]针灸学[M].北京：北京中医药出版社,2004
[11]国际针灸学教程[M].北京：华夏出版社,2004
[12]宋·王怀隐.太平圣惠方[M].北京：人民卫生出版社,1982
[13]宋·赵佶.圣济总录[M].北京：人民卫生出版社,2004
[14]清·廖润鸿.针灸集成[M].北京：学苑出版社.1956
[15]张建华,余安胜等.肩井穴的解剖结构与其针刺安全深度探讨[J].针刺研究,2002：27(2)：152-154
[16]彭万才,黄馥卿,孙明.针刺不当所致医疗事故的分析[J].中医杂志,1962；(8)：32
[17]李伯宁,成都中医学院学报,1978；(2)：66
[18]胡全轩,中级医刊,1983；(4)：36
[19]孙国杰.腧穴学[M].上海：上海科学技术出版社,1997
[20]包礼平.针刺风池穴、哑门穴引起蛛网膜下腔出血3例报告[J].吉林医学,1983：4(3)：45-53
[21]周健伟.针刺风池引起死亡1例报告[J].四川中医,1988；6(10)：52.
[22]刘生祥.针刺风池穴并发蛛网膜下腔出血[J].山西医药杂志,1980；9(6)：531
[23]杨甲三主编.腧穴学[M].上海：上海科技出版社,1984：44
[24]王英.关于人迎穴的研究概况[J].上海针灸杂志.1996,15(2)：36
[25]中国中医研究院.针灸学简编[M].第2版,北京：人民卫生出版社,1978：73
[26]天津中医学院第一附属医院针灸科.实用针灸学[J].天津：天津科学技术出版社,1981：138
[27]廖辉,焦茂.针刺的深浅[J].铁道医学.1998；26(6)：411
[28]孙永显,王启芳,张静.腧穴毫针针刺深度刍议[J].中国针灸2005；24(11)：769-772
[29]常晓娟,徐斌.针刺深度与疗效关系的研究进展[J].上海针灸杂志,2008；25(3)：203-206
[30]孟立强.深浅之宜针之要道[J].山西中医学院学报,2006；7(6)：6-8
[31]许银珊,徐晖,刘清国.《内经》刺禁初探[J].山西中医.2006；23(5)：379-382
[32]张建华,严振国等.针刺意外穴位的安全深度[J].针刺研究.2000；25(3)：233-235
[33]张建华,余安胜等.肩井穴的解剖结构与其针刺安全深度探讨[J].针刺研究,2002；27(2)：152
[34]严振国,白娟等.危险穴位针刺深度与角度的研究[J].中国针灸2004；24(11)：769-772
[35]陈跃,吴炳煌等.天突、气舍针刺安全的临床解剖研究[J].中国针灸,2007；27(2)：120-122
[36]姜俊,邵水金等.眼周危险穴位的安全进针解剖研究[J].中国中医眼科杂志,2008；18(6)：351-352
[37]方继良,王映辉等.CT定位下风池穴安全进针深度初步研究[J].中国针灸,2000：(9)：549-550
[38]啜振华,王子臣等.CT轴扫评价长针深刺中脘穴安全措施[J].河北医药,2002：24(8)：614-615
[39]李亚东,杨松堤等.应用CT测量大椎、肩中俞、悬枢、命门的针刺深度的研究[J].中国针灸,2005；25(12)：863-864
[40]王丰玲,程为平,李亚东.应用CT测量直刺肺俞穴位的安全深度的研究[J].河南中医学院学报,2006,(6)：43
[41]杨期东.神经病学[M].北京：人民卫生出版社,2002
[42]王毅刚.针灸度量标准的改革与建议[J].中国针灸2004；24(8)：591
[2]张志聪,黄帝内经集注[M].浙江：浙江古籍出版社.2002,48
[3]黄帝内经素问[M].北京：人民卫生出版社.1963
[4]唐·孙思邈.备急千金要方[M].北京：人民卫生出版社.1997,16
[5]晋·皇甫谧.针灸甲乙经[M].北京：人民卫生出版社.2006,29
[6]唐·孙思邈.备急千金要方[M].北京：人民卫生出版社.1982,24
[7]宋·王惟一.铜人腧穴针灸图经[M].北京：人民卫生出版社.1956,16
[8]宋·王执中.针灸资生经[M].上海：上海科学技术出版社.1959
[9]明·徐凤.针灸大全[M].上海：上海科学技术出版社.1967,22-43.
[10]明·高武.针灸聚英[M].北京：中国中医药出版社.1997,36-37
[11]明·汪机.针灸问对[M].北京：科学技术文献出版社.2002,32-33
[]2]明·陈言.杨敬斋针灸全集[M].北京：中医古籍出版社,1992,16
[13]明·吴谦刺法心法要诀[M].北京：人民卫生出版社.1993,33.
[14]清·李学川.针灸逢源[M].上海：上海科学技术出版社.1987,120.
[15]清·廖润鸿.针灸集成[M].北京：学苑出版社.1959,29.
[16]明·朱梓.普济方[M].北京：学苑出版社.1997,37
[17]明·杨继洲.针灸大成[M].北京：人民卫生出版社.1957,28.
[18]明·张介宾.类经图翼[M].北京：人民卫生出版社.1993,103.
[19]晋·王叔和.脉经[M].北京：科学技术文献出版社.2005,25
[20]清·阎纯玺.胎产心法[M].北京：人民卫生出版社.1988,201.
[21]清·李守先.针灸易学[M].福建：福建科学技术出版社.1993,63.
[22]元·杜思敬.济生拔萃[M].北京：学苑出版社.1959,99.
[23]晋·陈寿.三国志[M].武汉：崇文书局2010,362
[24]明·江瓘.名医类案[M].北京：人民卫生出版社.2005,39
[1]陆寿康.刺法灸法学[M].中国中医药出版社(北京),2003,49
[2]刘玉书.浅谈针疗事故的严重性[J].内蒙古中医药,1986,(4)：30-32
[3]丛华.腹部针刺失误浅析[J].长春医学院学报,1990,6(4)：49-50
[4]李玲.对针灸意外病例的统计和分析[J].中医药图书情报,1991,4：8-11
[5]刘炎,张斌渊.针灸临床意外107例分析[J].针灸临床杂志,1997,13(3)：49-53
[6]王克非.关于针刺意外的几点思考[J].针灸临床杂志,1999,15(5)：57-58
[7]金平林.浅谈针灸意外及其防治[J].中华实用中西医杂志,2005,5(18)：765
[8]蔡用治,王礼清.深刺致大量血胸[J].中国医刊,1982,(6)：54
[9]彭玉格.电针过敏一例报告[J].江西中医药,1982,(3)：19
[10]张传英,郑淑梅,裴延辅.针刺不当导致内脏意外损伤5例报告[J].,黑龙江中医药,1992(1)：38
[11]马丽,张纯娟.针刺导致气胸的临床浅析[J].针灸临床杂志,1997,13(2)：40
[12]丁蔚英.针刺胸背部引起外伤性气胸10例[J].中原医刊,1986,(4)：39
[13]蒋水成,陈惜秋.针刺风池穴引起死亡1例[J].中国法医杂志,1987,2(2)：116-117
[14]朱望太,李新锁,张永涛,李玮娜.针灸致心脏破裂死亡1例[J].法医学杂志,2008,24(4)：312
[15]丁喜艳,刘顺益,朱江.临床针灸意外1例[J].中国针灸,2008,28(11)：817-818
[16]高清山,郑亚君.亳针过敏2例[J].中国针灸,2008,28(11)：818
[17]罗春燕,黄红云.针刺引发肌束震颤二例[J].中国针灸,2006,26(6)：460
[18]唐韬,李强.临床针灸意外一例[J].中国针灸,2006,26(6)：459460
[19]陈安.针灸意外4例医案分析[J].上海针灸杂志,2009,28(2)：112-113
[20]蒋作贤.针刺异常100例分析[J].陕西中医学院学报,1988,(01)：25-29
[21]宋南昌.晕针32例分析[J].江西中医药,1989,(3)：39
[22]戴萦萦.晕针之24例之分析[J].针灸临床杂志,1995,11(3)：46
[23]徐贵平,袁永梅.82例针刺晕针患者的急救与护理[J].中国医疗前沿,2007,2(13)：125
[24]Cassedy JH. Early uses of acupuncture in the United States, with an addendum (1826) by Franklin Bache, M. D. Bull N Y Acad Med 1974; 50(8): 892-906
[25]Wang H, Hong Q, Wang Bai-song, et al. Is acupuncture beneficial in depression? A meta-analysis of 8 randomized controlled trials. J Affect Disord 2008;111:1-10.
[26]NIH Consensus Conference. Acupuncture. JAMA 1998; 280(17):1518-1524
[27]Turner JS. The regulation of acupuncture needles by the United States Food and Drug Administration. J Altern Complement Med 1995; 1(1):15-16
[28]Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults:United States,2002. Adv Data 2004; 2004(343):1-19
[29]Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children:United States,2007. Natl Health Stat Report 2009; (12):1-23
[30]Rampes H, James R. Complications of acupuncture. Acupunct Med 1995;13:26-33.
[31]Jeffreys DB, Smith S, Brennand-Roper DA, Curry PVL. Acupuncture needles as a cause of bacterial endocarditis. BMJ 1983:287:326-327.
[32]Lixing Lao, Gayle R Hamilton, Jianping Fu, Brian M Berman. Is acupuncture safe? A systematic review of case reports Alternative Therapies in Health and Medicine; Jan/Feb 2003; 9,1:72-83
[33]Adrian White.A cumulative review of the range and incidence of significant adverse events associated with acupuncture ACUPUNCTURE IN MEDICINE 2004:22(3):122-133.
[34]E. Ernst, Myeong Soo Lee, Tae-Young Choi E. Ernst et al. Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews /PAIN 2011; (152):755-764
[35]E. Ernst, Deaths after acupuncture:A systematic review International Journal of Risk& Safety in Medicine 2010;(22) 131-136
[36]HITOSHI YAMASHITA, HIROSHI TSUKAYAMA, YASUO TANNO, KAZUSHI NISHIJO. Adverse Events in Acupuncture and Moxibustion Treatment:A Six-year Survey at a National Clinic in Japan, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE 1999;3(5):229-236
[37]Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97,733 patients. Arch Intern Med 2004:164:104-105.
[38]E Eenet, Acupuncture Research-The First 10 years in Exeter. ACUPUNCTURE IN MEDICINE.2003;21(3):100-104.
[39]E Ernst, A White.Acupuncture:safety first Training programmes should include basic medical knowledge and experience BMJ 1997;314:1362
[40]Jorge Vas, Emilio Perea-Mill, Camila Me'ndez, Cayetana Sa'nchez Navarro, Jose'Mari, Leo'n Rubio, Mauricio Brioso, Inmaculada Garc i, Obrero, Efficacy and safety of acupuncture for chronic uncomplicated neck pain:A randomised controlled study Pain 2006; (126):245-255
[41]Wang H, Hong Q, Wang Bai-song, et al. Is acupuncture beneficial in depression? A meta-analysis of 8 randomized controlled trials. J Affect Disord 2008:111:1-10.
[42]Mona Potter, MDa, AlanaMoses, BAb, Janet Wozniak, MDa,* Alternative Treatments in Pediatric Bipolar Disorder Child Adolesc Psychiatric Clin N Am 2009; (18):499-500
[43]LIXING LAO, Ph.D., L.Ac. Safety Issues in Acupuncture. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE.1996;2(1):27-31
[44]Hitoshi Yamashita and Hiroshi Tsukayama, Safety of Acupuncture Practice in Japan:Patient Reactions, Therapist Negligence and Error Reduction Strategies. eCAM 2008;5(4):391-398
[45]Sabina Lim, Seunghun Lee,Seung-Ho Yi, Yang-Sun Son,Sung-min Choi and Young-Kon Kim. The Biological Safety of Stainless Steel Needles Used in Warm-needling. eCAM 2010;7(2):259-264
[46]Gerhard Litscher, Weibo Zhang, Seung-Ho Yi,Lu Wang, Tao Huang, Ingrid Gaischek, Yu Ying Tian and Guang Jun Wang. The Future of Acupuncture Moxibustion:A Transcontinental Three-Center Pilot Study Using High-Tech Methods. MEDICAL ACUPUNCTURE.2009; 21(2):115-121
[47]Pratt RJ, Hoffman PN, Robb FF. The need for skin preparation prior to injection:point-counterpoint. British Journal of Infection Control AUGUST 2005;6(4):18-20
[48]工晴霞.针刺意外损伤的原因及预防,咸宁学院学报,2007,6(21)：464
[49]Mike Cummings, Frankie Reid BMAS policy statements in some controversial areas of acupuncture practice ACUPUNCTURE IN MEDICINE 2004;22(3):134-136.
[50]Elisabet Stener-Victorn, Matts Wikland, Urban Waldenstrom and Thomas Lundeberg Alternative treatments in reproductive medicine:much ado about nothing. Acupuncture-a method of treatment in reproductive medicine:lack of evidence of an effect does not equal evidence of the lack of an effect Human Reproduction.2002;17(8):1945-1946
[51]Guidelines on basic training and safety in acupuncture. Geneva:World Health Organization; 1999:1-31.
[52]HUGH MacPHERSON. Fatal and Adverse Events from Acupuncture:Allegation, Evidence, and the Implications, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE 1999;5(1):47-56
[53]ADRIAN WHITE. The Safety of Acupuncture Techniques, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE,2007; 13(1):9-10
[54]MacPherson H, Thomas K, Walters S, Fitter M. The York acupuncture safety study:prospective survey of 34000 treatments by traditional acupuncturists. BMJ 2001;323:486-487.
[55]Claudia M. Witt, Daniel Pach, Thomas Reinhold, Katja Wruck, Benno Brinkhaus, Sigrid Mank, Stefan N. Willich. Treatment of the adverse effects from acupuncture and their economic impact:A prospective study in 73,406 patients with low back or neck pain. European Journal of Pain 2011;15:193-197
[56]Vanita Jindal, Adeline Ge, and Patrick J. Mansky. Safety and Efficacy of Acupuncture in Children A Review of the Evidence. J Pediatr Hematol Oncol 2008;30(6):431-442
[1]贺君,唐庆芬,庄礼兴.晕针疗效的分析及机制初探[J].中国针灸,2004,08：553-555
[2]宗维军,李志实.白发性气胸88例临床分析[J].中华实用中西医杂志,2003,(2)：203.
[3]P.M. Barnes, E. Powell-Triner, K. McFann and R. L. Nahin, Complementary and alternative medicine use among adults:United States,2002, Advance Data 2004:1-20.
[4]Susan Q. Wilburn, MPH, RN.针刺意外损伤的预防[J].护理实践与研究,2006,3(1)：1-3
[5]Ernst E. The risks of acupuncture[J]. Int J Risk Safety Med 1995,6:179-186.
[6]金平林.浅谈针灸意外及其防治,中华实用中西医杂志[J].2005,5(18)：765
[7]张传英,郑淑梅,裴延辅.针刺不当导致内脏意外损伤5例报告[J].黑龙江中医药,1992(1)：38
[8]马丽,张纯娟.针刺导致气胸的临床浅析,针灸临床杂志[J].1997,13(2)：40
[9]朱望太,李新锁,张永涛,李玮娜.针灸致心脏破裂死亡1例[J].法医学杂志,2008,24(4)：312
[10]Val Hopwood, Maureen Lovesey, Sara Mokone. Acupuncture& Related Techniques in Physical Therapy, [M]NEW YORK Edinburgh London Madrid Melbourne San Francisco and Tokyo,1997:62-74
[11]Norheim AJ. Adverse effects of acupuncture:a study of the literature for the years 1981-1994. J Altern Complement Med 1996; 2:291-7doi: 10.1089/acm.1996.2.291 pmid:9395661.
[12]Peuker ET, White A, Ernst E, Pera F, Filler TJ. Traumatic complications of acupuncture. Therapists need to know humananatomy. Arch Fam Med 1999; 8:553-8 doi:10.1001/archfami.8.6.553 pmid:10575398.
[13]Yamashita H, Tsukayama H, White AR, Tanno Y, Sugishita C, ErnstE. Systematic review of adverse events following acupuncture:the Japanese literature. Complement Ther Med 2001; 9:98-104 doi:10.1054/ctim.2001.0446 pmid:11444889.
[14]Ernst E, Sherman KJ. Is acupuncture a risk factor forhepatitis ystematic review of epidemiological studies. J Gastroenterol Hepatol 2003; 18:1231-6 doi:10.1046/j.1440-1746.2003.03135. xpmid:14535978.
[15]徐贵平,袁永梅.82例针刺晕针患者的急救与护理[J].中国医疗前沿,2007,2(13)：125
[16]肖炜,黄泳,卓鹰,陈俊琦,廖韧赞,夏冒李.慎刺穴位的局部解剖及安全操作[J].中国医学研究与临床,2008,6(5)：47-50
[17]李鼎.针灸学释难[M].上海：上海中医药大学出版社,1998,1-26
[18]罗玉芬.腧穴学[M].上海：上海科学技术出版社,1996,1-168
[19]严振国.中医应用腧穴解剖学[M].上海：上海中医药大学出版社,2001,1-37
[20]郑魁山.郑氏针灸全集[M].北京：人民卫生出版社,2000,1-29
[21]刘信基.4例针刺治疗精神分裂症的意外事故[J].神经精神病杂志,1981,5(317)：92
[22]王启才,李映平.针刺断针一例报告[J].江苏中医,1988,9(29)：355
[23]朱汲.针刺天突窒息死亡一例[J].江苏中医,1986,2(28)：138
[24]朱秋娇,指针在晕针中的运用[J].福建中医药,1992,6(31)：321
[25]伦新等.针灸意外案例选析[M].北京：人民卫生出版社,1997,96
[1]刘潜.一个发展中的交叉科学领域——安全科学[J].中国安全科学学报,1991(2)：59-67
[2]Hales BM, Pronovost PJ. The checklist-a tool for error management and performance improvement [J].J Crit Care,2006,21 (3):231-235
[3]辞海第六版彩图本[M].上海：上海辞书出版社,2009：35
[4]西汉·焦延寿,民国·尚秉和.焦氏易林注[M].北京：光明日报出版社,2005：94
[5]唐·房玄龄.晋书[M].上海：中华书局,2011：2082
[6]新牛津英汉双解大词典[M].上海：上海外语教育出版社,2007：1872
[7]新牛津英汉双解大词典[M].上海：上海外语教育出版社,2007：1924
[8]苏长和.从国家安全到世界安全——现实主义及其后[J].欧洲,1997(1)：43-48
[9]周法超,余宏明.试论安全观[J].中国公共安全·学术版,2010,4(21)：9-12
[10]林伯泉.安全学原理[M].北京：煤碳工业出版社,2002
[11]张景林.构思“安全学”[J].中国安全科学学报,2004,14(10)：7-12
[12]陆忠伟.非传统安全论[M].北京：时事出版社,2003
[13]张弘.加拿大职业健康与安全体系特点浅析[J].重庆科技学院学报(社会科学版),2011(10)：63-66
[14]范六一,曹金福,王宏,张明,薛良辉.发展中国家食品安全体系的构建[J].中国公共卫生管理,2007,23(5)：470-471
[15]张建耕.构建临床输血安全体系的设想[J].中国医学伦理学,2005,18(3)：4-6
[16]卢礼,宋锦,邓锋,戴红卫,高翔.基于医院信息系统和Oracle9i数据库的网络化口腔电子病历安全体系的研究[J].口腔医学,2008,28(12)：634-636
[17]龚翔.加快分类管理进程完善安全评价体系——我国药物政策中药品安全体系现状浅析[J].中国医药报,2004：1-4
[18]胡一芳.建立“以病人为中心”护理服务安全体系的探讨[J].全科护理,20097(5)：1388-1389
[19]何俊华,韩德军.论构建农村食品安全体系[J].医学动物防治,2006,22(3)：200-201
[20]冯尚坤.论建立农村食品安全体系的必要性[J].四川省卫生管理干部学院学报,2004,23(2)：126-127
[21]林俭.浅谈职业健康安全体系的持续改进要求[J].中国航天报,2010,3：1-2
[22]田磊.危害分析关键控制点是食品安全体系建设的重要环节[J].淮海医药,2005,23(2)：162-163
[23]陈晓勐,张建国.医疗信息安全体系架构设计[J].红外与毫米波学报,2005,24(1)：71-75
[24]时洪洋,刘仁民.中外食品安全监管比较及中国食品安全体系建构思考[J].中国卫生事业管理,2006,(3)：186-188
[25]林伯泉.安全学原理[M].北京：煤炭工业出版社,2002
[26]张景林,崔国璋.安全系统工程[M].北京：煤炭工业出版社,2002
[27]吴穹,许开立.安全管理学[M].北京：煤炭工业出版社,2002
[28]洪寿海,王然芸,郭义,李桂兰,郭永明,陈泽林,蔡青.针灸标准化的研究现状及思考[J].湖南中医杂志,2011,27(3)：123-124
[29]何玉长,倪稼民,曹士海.知识就是力量：走向前沿的知识经济学[M].湛江：广东旅游出版社,1999
[30]胡一芳.建立”以病人为中心”护理服务安全体系的探讨[J].全科护理,20097(5)：1388-1389
[31]杨庆.浅议中医针刺针的消毒及针刺无菌操作[J].云南中医中药杂志,2007,28(7)：59
[32]Susan Q. Wilburn, MPH, RN.针刺意外损伤的预防[J].护理实践与研究,2006,3(1)：1-3
[33]刘辉,刘晓辉.针灸操作中血肿的预防及处理[J].中国误诊学杂志.2007,7(29)：59
[34]姚玉红,席玉红,邓耀辉.意外针刺伤临床预防与处理[J].医药论坛杂志.2006,27(4)：91-92
[35]杨荣坤.医务工作者发生针刺伤原因及安全防护措施[J].基层医学论坛.2008,(12)：1128-1129
[36]徐军,蒋鹏程,王鑫扬,余飞鹏.医疗不良事件报告体系研究[J].中国卫生质量管理,2009,16(1)：23-25
[37]马铁明.试析针刺操作基本流程[J].福建中医学院学报,2004,14(2)：22-23
[38]朱林贞.学习《内经》“刺禁”理论的体会[J].四川中医,1997,15(6)：14-15
[39]徐晖,许银珊,刘清国.《内经》刺禁初探[J].山西中医.2007,23(1)：42-45
[40]孙国杰.腧穴学[M].上海：上海科学技术出版社,1997
[41]中国中医研究院.针灸学简编[M].北京：人民卫生出版社,1978
[42]天津中医学院第一附属医院针灸科.实用针灸学[M].天津：天津科学技术出版社,1981
[43]杨甲三.腧穴学[M].上海：上海科学技术出版社,1984
[44]邱茂良.针灸学[M].上海：上海科学技术出版社,1985
[45]赖新生,陈兴华.简明针灸学[M].北京：中国中医药出版社,2008
[46]孙国杰.针灸学[M].北京：人民卫生出版社,2011
[47]陆寿康.刺法灸法学[M].北京：中国中医药出版社,2004
[48]冯淑兰.刺法灸法学技能实训[M].北京：中国中医药出版社,2011
[49]方剑乔.刺法灸法学[M].北京：科学出版社,2004
[50]王富春.刺法灸法学[M].上海：上海科学技术出版社,2009
[51]张仁.针刺意外事故防治[M].上海：上海科学技术出版社,2004
[52]李珊.临床常用腧穴针灸意外预防手册[M].北京：人民军医出版社,2003
[53]杨占林,马贵宝,杨学智,牛欣.临床针刺事故防范[M].北京：人民卫生出版社,2010
[54]赵华,米勇,马忠.针灸操作记录规范化探索[J].新疆中医药,2007,25(4)：58-59
[55]刘伍立,朱文锋.针灸方法、手法规范化研究[J].针灸临床杂志,1999,15(11)：2-3
[56]张英.浅谈针灸临床亟待解决的几个问题[J].湖北中医学院学报,2000,2(4)：43-44
[57]Hsiao-Neng Chen, Jaung-Geng Lin, Albert D. Yang, Shu-Kuei Chang. Safe depth of abdominal acupoints in pediatric patients[J]. Complementary Therapies in Medicine,2008(16):331-335
[58]ADRIAN WHITE. The Safety of Acupuncture Techniques, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE,2007;13(1):9-10
[59]Vincent C. The safety of acupuncture [J]. BMJ 2001:323:467-468.
[60]British Medical Association Board of Science and Education. Acupuncture: efficacy, safety and practice[M]. London:Harwood Academic Publishers,2000.
[61]刘信基.4例针刺治疗精神分裂症的意外事故[J].神经精神病杂志,1981,5(317)：92
[62]王启才,李映平.针刺断针一例报告[J].江苏中医,1988,9(29)：355
[63]朱汲.针刺天突窒息死亡一例[J].江苏中医,1986,2(28)：138
[64]朱秋娇,指针在晕针中的运用[J].福建中医药,1992,6(31)：321页
[65]伦新等.针灸意外案例选析[M].北京：人民卫生出版社,1997,96
[1]黄帝内经灵枢[M].北京：人民卫生出版社,1963
[2]黄帝内经素问[M].北京：人民卫生出版社,1963
[3]明·马莳.黄帝内经素问注证法微[M].北京：科技文献出版社,1999
[4]清·张志聪.黄帝内经集注[M].浙江：浙江古籍出版社,2002
[5]唐·王冰.重广补注黄帝内经素问[M].人民卫生出版社,1963
[1]张仁.针刺意外事故防治[M].上海：上海科学技术出版社,2004：17
[2]宋·王惟一.铜人腧穴针灸图经[M].北京：人民卫生出版社,1956
[3]宋·琼瑶真人.针灸神书[M].北京：中医古籍出版社,2007
[4]晋·皇甫谧.针灸甲乙经[M].北京：人民卫生出版社,2006
[5]针灸学[M].南京：江苏人民出版社,1957
[6]针灸学[M].长沙：湖南科技出版社,1987
[7]针灸学[M].贵阳：贵州科技出版社,1993
[8]针灸学[M].北京：人民卫生出版社,1999
[9]针灸学[M].北京：人民卫生出版社,2002
[10]针灸学[M].北京：北京中医药出版社,2004
[11]国际针灸学教程[M].北京：华夏出版社,2004
[12]宋·王怀隐.太平圣惠方[M].北京：人民卫生出版社,1982
[13]宋·赵佶.圣济总录[M].北京：人民卫生出版社,2004
[14]清·廖润鸿.针灸集成[M].北京：学苑出版社.1956
[15]张建华,余安胜等.肩井穴的解剖结构与其针刺安全深度探讨[J].针刺研究,2002：27(2)：152-154
[16]彭万才,黄馥卿,孙明.针刺不当所致医疗事故的分析[J].中医杂志,1962；(8)：32
[17]李伯宁,成都中医学院学报,1978；(2)：66
[18]胡全轩,中级医刊,1983；(4)：36
[19]孙国杰.腧穴学[M].上海：上海科学技术出版社,1997
[20]包礼平.针刺风池穴、哑门穴引起蛛网膜下腔出血3例报告[J].吉林医学,1983：4(3)：45-53
[21]周健伟.针刺风池引起死亡1例报告[J].四川中医,1988；6(10)：52.
[22]刘生祥.针刺风池穴并发蛛网膜下腔出血[J].山西医药杂志,1980；9(6)：531
[23]杨甲三主编.腧穴学[M].上海：上海科技出版社,1984：44
[24]王英.关于人迎穴的研究概况[J].上海针灸杂志.1996,15(2)：36
[25]中国中医研究院.针灸学简编[M].第2版,北京：人民卫生出版社,1978：73
[26]天津中医学院第一附属医院针灸科.实用针灸学[J].天津：天津科学技术出版社,1981：138
[27]廖辉,焦茂.针刺的深浅[J].铁道医学.1998；26(6)：411
[28]孙永显,王启芳,张静.腧穴毫针针刺深度刍议[J].中国针灸2005；24(11)：769-772
[29]常晓娟,徐斌.针刺深度与疗效关系的研究进展[J].上海针灸杂志,2008；25(3)：203-206
[30]孟立强.深浅之宜针之要道[J].山西中医学院学报,2006；7(6)：6-8
[31]许银珊,徐晖,刘清国.《内经》刺禁初探[J].山西中医.2006；23(5)：379-382
[32]张建华,严振国等.针刺意外穴位的安全深度[J].针刺研究.2000；25(3)：233-235
[33]张建华,余安胜等.肩井穴的解剖结构与其针刺安全深度探讨[J].针刺研究,2002；27(2)：152
[34]严振国,白娟等.危险穴位针刺深度与角度的研究[J].中国针灸2004；24(11)：769-772
[35]陈跃,吴炳煌等.天突、气舍针刺安全的临床解剖研究[J].中国针灸,2007；27(2)：120-122
[36]姜俊,邵水金等.眼周危险穴位的安全进针解剖研究[J].中国中医眼科杂志,2008；18(6)：351-352
[37]方继良,王映辉等.CT定位下风池穴安全进针深度初步研究[J].中国针灸,2000：(9)：549-550
[38]啜振华,王子臣等.CT轴扫评价长针深刺中脘穴安全措施[J].河北医药,2002：24(8)：614-615
[39]李亚东,杨松堤等.应用CT测量大椎、肩中俞、悬枢、命门的针刺深度的研究[J].中国针灸,2005；25(12)：863-864
[40]王丰玲,程为平,李亚东.应用CT测量直刺肺俞穴位的安全深度的研究[J].河南中医学院学报,2006,(6)：43
[41]杨期东.神经病学[M].北京：人民卫生出版社,2002
[42]王毅刚.针灸度量标准的改革与建议[J].中国针灸2004；24(8)：591