台灣現代針灸的適應性與原創性：以進針手法的演變為例

Innovation and adaptation in contemporary Taiwanese acupuncture: changes in needling insertion technique as an example

針灸的歷史悠久而它的使用方法經過許多演變。很多學者分析過最近中國大陸針灸使用的演變，而台灣的情況較未引起大家的注意。本研究的目的關注於台灣針灸使用的發展，分析針刺手法如何受到政治、經濟與社會文化的影響。首先提供簡略的歷史回顧，主要標出從民國38 年至今的針灸相關事件，以五本具有代表性的台灣針灸教科書與針灸指引，透過分析進針手法的描述指出拿針與進針如何變化。較完善的針灸制度化始於中國醫藥學院建立中醫系開始，但是針灸的研究發展與針灸地位的提升，是從「針灸熱」的推動而來。這個事件促進了醫院設立針灸科。最後，針灸治療步入台灣全民健保給付範圍。針灸進入以西醫體制為主的環境後，設立了拿針與進針的標準，而使用拋棄式針灸針。當時重視保持無菌環境，院校規定執針手指不能碰到針體，這些規定引起進針的變化。整體來看，台灣針灸使用的變化受到台灣特定歷史與環境全面的影響。

 

Acupuncture has a long history and has changed throughout centuries of practice. Many scholars have shown interest in the recent changes in acupuncture practice in China, but little is known about the Taiwanese case. Our aim is to analyze the development of Taiwanese acupuncture practice and to show how this technique was transformed in connection with political, economic and socio-cultural events. This paper starts with a historical review, covering 1949 until today, to highlight the most prominent events related to acupuncture. Then, through an analysis of the descriptions of needle insertion techniques in five representative acupuncture textbooks and guideline publications, we aim to illustrate the changes appearing in the way the needle is inserted and held.The institutionalization of acupuncture began with the creation of a Chinese medicine department at the China Medical College in 1966. However, it is the ""acupuncture fever"", in 1972, which pushed acupuncture to the front stage and triggered the development of acupuncture research. This event speeded up the creation of acupuncture departments in hospitals. Finally, in 1995, acupuncture treatments became covered by the National Health Insurance. The inclusion of acupuncture into institutions based on a biomedical healthcare system led to the establishment of standards for holding and inserting the needles and facilitated the adoption of disposable needles with tube. A strong focus was put onto maintaining a sterile environment and the physicians became required to avoid touching the needle body with bare hands to avoid contamination. This resulted in changes to the insertion techniques. These changes are due to the overall context that acupuncture practice is embedded in, and are linked to the specific history of Taiwan.