GB/T 21709.6-2026Standardized manipulations of acupuncture and moxibustion - Part 6: Point injection (English PDF)

4.1 Preoperative preparation

4.1.1 Needles Different types of disposable non-irritating medications should be selected based on the patient's condition, the site of application, and the dosage, viscosity, and irritant strength of the drug. Sterile syringes and disposable sterile injection needles. Disposable sterile syringes and disposable sterile injection needles should respectively comply with... Requirements of GB 15810-2019 and GB 15811-2025.

4.1.2 Drugs

4.1.2.1 Types of Drugs Commonly used medications for acupoint injection therapy include traditional Chinese medicine and Western medicine subcutaneous or intramuscular injections. These injections should comply with the Pharmacopoeia of the People's Republic of China. According to the regulations.

4.1.2.2 Drug Dosage The total amount of medication used in a single acupoint injection should be less than the amount specified in the drug's instructions for a single routine subcutaneous or intramuscular injection. The dosage varies depending on the injection site and the type of drug. Larger doses can be used in areas with abundant muscle, while smaller doses are preferable for areas such as joint cavities and nerve roots. Drugs with lower irritant activity can be used in larger doses, while drugs with higher irritant activity and specific drugs should be used in smaller doses. In a single acupoint injection for adults, the injection volume per acupoint should be controlled as follows: 0.1mL~0.2mL for ear acupoints, and 0.1mL~ for acupoints on the head and face. 1mL, 1mL~2mL for acupoints on the abdomen, back and limbs, and 2mL~5mL for acupoints on the waist and buttocks. In a single acupoint injection for children, the injection volume per acupoint should be controlled as follows: no more than

0.1 mL for ear acupoints, and not suitable for children under 7 years old. Auricular acupoint injection; 0.1mL~1mL for head and face acupoints, no more than 0.2mL per acupoint for infants 6 months and under; abdominal, back and four... For acupoints on the limbs, use 0.5mL to 1mL; for acupoints on the waist and buttocks, use 0.1mL to 1.5mL. For infants under 3 years old, the amount per acupoint should not exceed 0.5mL.

4.1.2.3 Drug Concentration The concentration of the drug for acupoint injection should be the same as the conventional concentration for subcutaneous or intramuscular injection. The drug concentration should comply with the Pharmacopoeia of the People's Republic of China. According to regulations, doctors may dilute medications as needed for treatment.

4.1.2.4 Drug Quality The medication should be within its expiration date. The packaging should be undamaged, the ampoules should be free of cracks, and the liquid should be clear, discolored, and free of mold. The quality should comply with the provisions of the Pharmacopoeia of the People's Republic of China.

4.1.3 Body Position Choose a treatment position that is comfortable for the patient and easy for the surgeon to operate in.

4.1.4 Selection and Location of Acupoints The appropriate acupoints should be selected according to the symptoms. The location of acupoints should comply with the provisions of GB/T 12346-2021, GB/T 40997-2021 and GB/T 13734-2008.

4.1.5 Environment The environment should meet the requirements for Class III environments in Chapter 4 of GB 15982-2012.Throughout the operation, attention should be paid to environmental cleanliness and hygiene to avoid... pollute.

4.1.6 Disinfection

4.1.6.1 Disinfection of the operator Operators should complete handwashing and hygienic hand disinfection in accordance with the requirements of Chapter 6 of WS/T 313-2019.

4.1.6.2 Disinfection of the affected area The application site should be disinfected using a qualified skin disinfectant, in accordance with the requirements of Chapter 12 of WS/T 367-2012.Attention should be paid to... The selected disinfectant is compatible with the properties of the drug.

4.2 Procedure

4.2.1 Medication collection and needle insertion Carefully check the bed number, patient's name, medication name, concentration, dosage, method of administration, time, and expiration date according to the injection card or doctor's order book. Remove from the packaging. Use a syringe to align the needle bevel with the syringe graduations and tighten it. Check the syringe for leaks. Dispense medication as prescribed and aspirate the solution. Double-check the syringe. Explain the characteristics of the treatment and the normal reactions that may occur during treatment to the patient. Expel all air from the syringe and apply the medication according to the acupoints. Different needle holding methods, insertion methods, and insertion angles should be selected based on factors such as the location of the needle insertion point and the size of the syringe. All insertion methods should be performed quickly. The technique of stabbing requires skill. The method of holding the needle, the method of inserting the needle, and the angle of insertion should be in accordance with Appendix A. The practitioner uses their forearm to leverage the wrist, quickly inserting the needle into the patient's acupoint. After insertion, various acupuncture points are obtained through the needle. By sensing the needle's movement through the fingers holding the syringe and observing the patient's reactions, one can carefully discern the needle's progress in different tissues and adjust the insertion accordingly. The direction and angle. For various sensations and procedures under the needle, please refer to Appendix B. If the patient experiences numbness, electric shock-like sensations, or radiating sensations, it indicates that a nerve has been punctured, and the practitioner should withdraw the needle slightly.

4.2.2 Adjusting the Qi After inserting the needle into the acupoint, carefully observe whether the sensation of Qi (deqi) is felt. If the sensation of Qi is not obvious after the needle tip reaches the predetermined depth, the needle can be withdrawn to a shallower depth. Then, adjust the direction of the needle and insert it deeper until the patient experiences a sensation of soreness and distension, indicating the arrival of Qi. The definition and judgment method of obtaining Qi can be found in GB/T 21709.20-2009.

4.2.3 Injecting the drug After the patient experiences a gas response, aspirate the needle. If no blood or fluid returns, the medication can be injected. Observe the patient's reaction continuously during the injection process. If a patient experiences discomfort during medication injection, the injection should be stopped immediately and the patient's reaction observed. Different injection methods should be selected according to the needs of treatment, and the injection methods should be specified in Appendix C.

4.2.4 Needle withdrawal Different needle withdrawal methods are selected based on the depth of acupuncture insertion. When withdrawing needles from shallowly inserted acupoints, use your left hand to hold a sterile cotton swab or sterile cotton ball and press it against the acupoint. Beside him, the right hand quickly withdrew the needle. When withdrawing needles from deeply inserted acupoints, first withdraw the needle to a shallow layer, wait a moment, and then slowly withdraw it. If the needle sinks deep or becomes stuck, do not... When applying force, it is advisable to press or pat the acupoints along the meridian to disperse qi and blood. The needle can be removed only after the needle feels light and smooth. The intervals between injections and the course of treatment should be in accordance with the provisions of Appendix D.

4.3 Postoperative care If oozing or bleeding is observed at the needle puncture site after needle removal, apply pressure with a sterile cotton swab or cotton ball for

0.5 to 2 minutes. Finally, tidy up the equipment and instruct... The patient should rest in a comfortable position for 5 to 10 minutes to observe for any adverse reactions.

4.4 Handling of Abnormal Situations During the Procedure

4.4.1 If blood or fluid is seen when aspirating the needle core after insertion, the needle should be withdrawn immediately, and the puncture site should be compressed with a sterile cotton swab or cotton ball for

0.5 to 2 minutes. Acupoints should not be injected again on the same day.

4.4.2 If a patient experiences an allergic reaction, the procedure should be stopped immediately. Anti-allergic treatment should be administered depending on the severity of the allergic reaction. Emergency measures should be taken for patients with severe allergies. For further information, please refer to the "2020 WAO Guidelines. Severe Allergic Reactions".

4.4.3 If a patient experiences an adverse drug reaction, the procedure should be stopped immediately and the patient's reaction observed. Appropriate treatment should be given according to the specific situation.

4.4.4 The handling of other common acupuncture abnormalities shall be in accorda...