ACUPUNCTURE TREATMENT OF TRIGEMINAL NEURALGIA FACIAL PAIN

Xia Shouren, Xu Chunyang, Kong Xianfen

(Department of Acupuncture, Beijing Hospital of TCM)

Trigeminal neuralgia is characterized by an outbreak of acute, paroxysmal and flash like pain. According to clinical observation, the symptoms described in "Standards for Diagnosis and Treatments" (Ming dynasty) are quite consistent to the signs of trigeminal neuralgia.

Etiology and Pathogenesis

Records in "Standards for Diagnosis and Treatments" showed that "Facial pain attributes to fire, .... Acute pains are usually excessive, whereas persistent pains are usually deficient." According to the clinical observation on 165 cases, we analyzed the etiology and pathogenesis of this disease as follows: To be affected by wind is the exogenous pathogenic factor; thinking deeply, worry and anger induce the stagnation of qi (Vital energy) which transforms into fire with the result of wind. This is one of the endogenous pathogenic factors. Wind induced by the deficiency of Yin leads to flaming up of fire and deficiency of Yin brings up hyperactivity of Yang. These are the other endogenous pathogenic factors. The wind and fire rise up to make an intrusion of Yangming with the result of painful symptom. Paroxysmal, flash like, brief and violent pains are Just the manifestation of the instigation of wind and fire,

Treatment according to differentiation

Analysis on 165 cases of trigeminal neuralgia showed that the syndromes of this disease can be divided into 7 types which are differentiated and treated as follows:

1. Wind and cold. Symptoms manifest as an aversion of cold and to be fond of warmth. This type should be treated by dispelling the wind and cold. Points were prescribed:

Lieque (right) and Hegu (left). Waiguan and Zu Linqi of the affected side.

2. Wind and heat. Symptoms manifest as the exacerbation of pain in a hot condition. This should be treated by expelling the wind and heat. Points: Dazhui, Renzhong, Lieque (right) and Hegu (left).

3. Stagnation of the qi of liver. Symptoms manifest as a stiffness sensation in the-chest and deep breath with prolonged expiration. This can be treated by the removal of the stagnated qi of liver. Points; Neiguan, Zhangmen and Shangjuxu.

4. Stagnated qi transformed into fire. Symptoms manifest as bitter taste and deep breath with prolonged expiration. It is treated by clearing up the liver and expelling the fire. Points: Qiuxu, Ligou, Yanglingquan.

5. Deficiency of Yin leads to flaming up of fire. Symptoms: insomnia and fever during night. Treatment: to nourish Yin and suppress fire. Points: Shenmen, Sanyinjiao, Hegu (left) and Taichong (right),

6. Deficiency of Yin brings of hyperactivity of Yang. Symptoms: insomnia, dizziness. and heaviness. Treatment: to nourish Yin and to suppress Yang. Points: Lieque, Zhaohai, Hegu and Taichong.

7. Predominance of dryness leads to impairment of Yin. Symptoms: constipation and dryness of the throat. Treatment: to nourish Yin and eliminate dryness. Points: Zhigou,. Zhaohai and Shangjuxu.

Typical cases

Tan: a female worker, aged 22, unmarried. She was suffered from trigeminal neuralgia on the left side. She was diagnosed as stagnation of Qi. It was transformed into fire and reserved the dampness and heat. She was treated according to the principle of removing the Qi of liver and to clear up the heat and to resolve the dampness. Summary of points adopted: a, Yinlingquan, Gongsun, Shangjuxu. b, Lieque, Qihai, Fenglong. c, Lieque, Zhaohai, Xiangu.

This patient was cured after 70 treatments in 20 months. The curative effect was stable in 9 years.