針刺毫針針尖規格差異性之比較

THE DIFFERENCES OF ACUPUNCTURE NEEDLE TIP BETWEEN DIFFERENT MANUFACTURERS

理想的針刺毫針應考量操作的方便性並兼顧其安全性，即將其對組織的傷害性減至最低，而目前市面上的毫針品質參差不齊，對人體組織的潛在傷害頗令人擔憂。本實驗針對市售多種品牌針刺毫針共654 支，先以光學顯微鏡放大200 倍觀察，對各廠牌針之針尖輪廓、錐度、圓角、對稱性以及是否有重大瑕疵（鉤針、平頭、凹槽等）加以觀察記錄。結果顯示，在各種針尖輪廓特性中，以尖銳情形最為普遍（25.2%），其次為標準針（17.6%），而以大鉤（5.4%）與凹槽針（2.1%）最不常見。34.6%的毫針針尖有明顯瑕疵，部分廠牌不良率高達54.4%，其中鉤針比率佔15.6%；而且大陸與台製廠毫針的不良率與鉤針率皆大於日本廠。符合針尖曲線平滑的基本，沒有明顯瑕疵的毫針中（標準、尖銳、圓鈍針，佔65.4%），仔細測量其針尖細部規格（錐度及圓角），發現錐度及圓角的差異性也很大。坊間充斥這種高不良率、高變異性錐度及圓角的毫針，它們可能導致滯針、彎針、斷針、損傷肌肉、刺傷神經、穿破血管等針刺合併症。日後如何加強對國內各廠牌毫針品質之監督、改善，及對針尖細部規格（錐度及圓角）的適度規範，實有其迫切性與必要性。An ideal acupuncture needle should satisfy both practicing feasibility and safety；the later means causing lesser tissue injury as possible. However, quality of marketable acupuncture needles is quite variable. Therefore, the potential harms due to the defects of acupuncture needles should be cautious. In this study, 654 acupuncture needles purchased from different manufacturers were observed under light microscope (200 x). The contour shape, cone angle, arc of tip, symmetry and defects (such as hooked, flattened, grooved deformations) of needle tips were recorded. For the needle tip contour, the most commonly seen form is the sharp-tipped needle (25.2%), followed by the standard (modest sharp) needle (17.6%), the big-hooked (5.4%) and the grooved needle (2.1%). The needles with defects and the hooked needles were approximately 36% and 15.6% in all the observed samples, respectively. Most of the needles with defects were manufactured in main land China and Taiwan. Needles with better contour, symmetry and smooth surface were about 65.4% of all observed needles, which are considered to be satisfactory for clinical use. These needles were classified into three major categories as sharp-tipped, round blunted-tipped and intermediate (standard)-tipped needles. Cone angle and radius (arc) of the needle tips were observed on the photographs. Large variations were still seen for these needle tips purchased from different manufactures. Possible complications associated with the flawed needle tip include needle stagnation, needle curving, needle tip broken, muscular injury, nerve injury, blood vessel penetration…etc. Therefore, it is urgent and necessary to define more delicate criteria for the acupuncture needle tip. In addition, regular surveillance to improve the quality of acupuncture needle is important.