OBJECTIVETo observe the clinical efficacy on primary trigeminal neuralgia treated with joint needling method at the trigger point.

METHODSOne hundred and three cases of primary trigeminal neuralgia were divided into a joint needling group (53 cases) and a conventional needling group (50 cases) according to the visit sequence. In the joint needling group, the joint needling method was used at the trigger point in the mandibular joint [the positive point near to Xiaguan (ST 7)]; the conventional needling was used at Hegu (LI 4), Waiguan (TE 5), Taichong (LR 3) and Neiting (ST 44). In the conventional needling group, Xiaguan (ST 7) and Fengchi (GB 20) were used and the supplementary acupoints were selected according to the involved branches of trigeminal nerve. The conventional needling method was used. The Visual Analogue Scale (VAS) and the score of trigeminal neuralgia were adopted to assess the pain severity and the comprehensive symptoms before treatment and after the 1st and 2nd sessions of treatment separately. The efficacy was assessed.

RESULTSAfter the 1st and 2nd sessions of treatment, VAS score and the comprehensive symptom score were reduced obviously as compared with those before treatment in either group (P < 0.05, P < 0.01). The score reducing in the joint needling group was much superior to that in the conventional needling group (both P < 0.05). The total effective rate was 90.6% (48/53) and 72. 0% (36/50) in the joint needling group and the conventional needling group respectively. The effect in the joint needling group was better than that in the conventional needling group (P < 0.05).

CONCLUSIONThe joint needling method at the trigger point achieves the significant efficacy on primary trigeminal neuralgia, which is superior to that with the conventional needling method.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neuralgia ; physiopathology ; therapy ; Trigeminal Nerve ; physiopathology ; Trigeminal Neuralgia ; physiopathology ; therapy ; Trigger Points ; physiopathology ; Young Adult

OBJECTIVETo observe the differences of therapeutic effect in primary trigeminal neuralgia (PTN) of hyperactive of liver yang type treated by deep and shallow puncturing at Xiaguan (ST 7).

METHODSSixty-three cases of PTN of hyperactive of liver yang type were randomly divided into a deep puncturing group (32 cases) and a shallow puncturing group (31 cases). Xiaguan (ST 7) of affected region, Hegu (LI 4) and Taichong (LV 3) of bilateral sides, Cuanzhu (BL 2), Sibai (ST 2) and Jiachengjiang (Extra) relevant to the affected branch of nerve stem were selected in both groups. In deep puncturing group, Xiaguan (ST 7) was punctured to the depth of spheno-palatine ganglion (SPG); Cuanzhu (BL 2), Sibai (ST 2) and Jiachengjiang (Extra) were respectively punctured to the depth of supraorbital foramen, infraorbital foramen and mental foramen. In shallow group, routine puncturing was applied; the needles were connected with G6805 electric acupuncture apparatus, and switched on for 30 min every time; the treatment was applied every other day. Pain index, traditional Chinese medicine symptoms index and clinical therapeutic effect were observed after 2 courses of treatment.

RESULTSIn deep puncturing group, the VAS scores and the traditional Chinese medicine symptoms scores (pain degree, pain frequency, upsetting, conjunctival congestion, bitter mouth and hypochondriac pain) after treatment were much more lower than those before treatment (all P < 0.01); in shallow puncturing group, except hypochondriac pain (P > 0.05), other indices above after treatment were obviously lower than those before treatment (P < 0.01, P < 0.05). Compared with the indices in both groups after treatment, the VAS scores, the pain degree, conjunctival congestion and total scores of traditional Chinese medicine symptoms in deep puncturing group were more significant (all P < 0.05). The total effective rate was 93.8% (30/32) in deep puncturing group, superior to that of 87.1% (27/31) in shallow puncturing group (P < 0.05). No any adverse reaction was observed in both groups.

CONCLUSIONThe therapeutic effect of trigeminal neuralgia of hyperactive of liver yang type treated with electroacupuncture is remarkable, and deep puncturing at Xiaguan(ST 7) to SPG is more effective than routine puncturing.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Liver ; physiopathology ; Male ; Middle Aged ; Trigeminal Neuralgia ; diagnosis ; physiopathology ; therapy

Peripheral nerve injury often results in abnormal neuropathic pain such as allodynia or hyperalgesia. Acupuncture, a traditional Oriental medicine, has been used to relieve pain and related symptoms. However, the efficiency of acupuncture in relieving neuropathic pain is not clear. The aim of this study was to investigate the anti-allodynic effects of acupuncture through behavioral and electrophysiological examinations. Male Sprague-Dawley rats were subjected to neuropathic surgery consisting of a tight ligation and transection of the left tibial and sural nerves, under pentobarbital anesthesia. The acupuncture experiment consisted of four different groups, one treated at each of three different acupoints (Zusanli (ST36), Yinlingquan (SP9), and a sham-acupoint) and a control group. Behavioral tests for mechanical allodynia and cold allodynia were performed for up to two weeks postoperatively. Extracellular electrophysiological recordings were made from the dorsal roots using platinum wire electrodes. Mechanical and cold allodynia were significantly reduced after acupuncture treatment at the Zusanli and Yinlingquan acupoints, respectively. Electrophysiological neural responses to von Frey and acetone tests were also reduced after acupuncture at the same two acupoints. These results suggest that acupuncture may be beneficial in relieving neuropathic pain.
Spinal Nerve Roots/*physiology ; Rats, Sprague-Dawley ; Rats ; Neuralgia/physiopathology/*therapy ; Male ; Electrophysiology ; Animals ; *Acupuncture Analgesia

Peripheral nerve injury often results in abnormal neuropathic pain such as allodynia or hyperalgesia. Acupuncture, a traditional Oriental medicine, has been used to relieve pain and related symptoms. However, the efficiency of acupuncture in relieving neuropathic pain is not clear. The aim of this study was to investigate the anti-allodynic effects of acupuncture through behavioral and electrophysiological examinations. Male Sprague-Dawley rats were subjected to neuropathic surgery consisting of a tight ligation and transection of the left tibial and sural nerves, under pentobarbital anesthesia. The acupuncture experiment consisted of four different groups, one treated at each of three different acupoints (Zusanli (ST36), Yinlingquan (SP9), and a sham-acupoint) and a control group. Behavioral tests for mechanical allodynia and cold allodynia were performed for up to two weeks postoperatively. Extracellular electrophysiological recordings were made from the dorsal roots using platinum wire electrodes. Mechanical and cold allodynia were significantly reduced after acupuncture treatment at the Zusanli and Yinlingquan acupoints, respectively. Electrophysiological neural responses to von Frey and acetone tests were also reduced after acupuncture at the same two acupoints. These results suggest that acupuncture may be beneficial in relieving neuropathic pain.
Spinal Nerve Roots/*physiology ; Rats, Sprague-Dawley ; Rats ; Neuralgia/physiopathology/*therapy ; Male ; Electrophysiology ; Animals ; *Acupuncture Analgesia

Activation of microglia plays a vital role in the initiation and maintenance of specific neuropathic pain states. By activating microglia in central nervous system, Toll-like receptor 4 (TLR4) can promote the release of proinflammatory cytokines and neuroactive compounds, participate in the initiation and maintenance of neuropathic pain, and trigger the opiate side effects. Therefore, TLR4 may be a potential therapeutic target for neuropathic pain. Inhibition of TLR4 has shown some biological effects in neuropathic pain models and ibudilast (the TLR4 pathway-inhibiting agent) has been approved for for phase 2 clinical trials. This article briefly reviews the structure, function, and mechanism of TLR4 as well as the development of TLR4-targeted drugs.
Humans ; Neuralgia ; drug therapy ; physiopathology ; Toll-Like Receptor 4 ; antagonists & inhibitors ; physiology

OBJECTIVETo provide a set of the self-help and mutual-aid treatment with moxibustion to deal with myofasicial pain syndrome (MPS) of the back for the military soldiers.

METHODSFifty-eight cases were randomly devided into a moxibustion group (30 cases) and a plaster application group (28 cases). In the moxibustion group, the suspended moxibustion was applied to Yanglingquan (GB 34) for 15 min. The moxibustion massage device was used to massage the pain area. Under the physician's guides, the self-help or mutual-aid treatment was adopted. In the plaster application group, Goupi Gao (a black plaster used in TCM) was used on the local pain area. The treatment was given once every day in either group, lasting for 5 days. The clinical symptom scale, clinical physical sign scale, functional disturbance scale, functional disturbance index, comprehensive economic benefit and the others were adopted to analyze and compare the clinical efficacies between the two groups.

RESULTSBoth moxibustion and the plaster application achieved a certain efficacy on MPS of the back in the soldiers and either of them received the obvious improvements in the clinical symptoms, physical signs and functional disturbance (P < 0.01, P < 0.05). The results in the moxibustion group were superior to those in the plaster application group (P < 0.01, P < 0.05). In terms of the comprehensive economic benefit index, the result in the moxibustion group was better than that in the plaster application group. The total effective rate was 96.7% (29/30) in the moxibustion group and was 35.7% (10/28) in the plaster application group. The efficacy in the moxibustion group was superior to that in the plaster application group (P < 0.01).

CONCLUSIONThe self-help or mutual-aid treatment with moxibustion achieves the satisfactory clinical efficacy on MPS of the back in the military soldiers. It reduces the conventional medical cost and the military medical expenditure. This therapeutic approach is suitable to be promoted in the military.

Adult ; Facial Neuralgia ; physiopathology ; therapy ; Humans ; Military Personnel ; Moxibustion ; methods ; Young Adult

BACKGROUNDPain physicians pay close attention to neuropathic pain (NP), since there is currently no ideal treatment. Radial shock wave therapy (RSWT) is a noninvasive treatment to chronic pain of soft tissue disorders. So far, there is no information on the use of RSWT for the treatment of NP. Therefore we observe the effects of RSWT on a NP model induced by chronic constriction injury (CCI) in rats.

METHODSFour different energy densities (1.0, 1.5, 2.0 and 2.5 bar) RSWT administered as a single session or repeated sessions in rats with NP induced by CCI of the sciatic nerve. The analgesic effect was assessed by measuring mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL). The safety was assessed through calculating sciatic functional index (SFI).

RESULTSMWT and TWL increased after a single session of RSWT from day 1 to day 5 but returned to baseline levels by day 10. Following repeated sessions of RSWT, both the MWT and TWL were significantly higher than NP group (P < 0.01) for at least 4 weeks. In addition, no significant changes of SFI were observed in any groups after repeated sessions of RSWT and no increased pain or other side effects in any animals.

CONCLUSIONSA single session of RSWT is rapidly effective in the treatment of CCI, but the efficacy maintained in a short period. However, repeated sessions of RSWT have prolonged efficacy.

Animals ; Chronic Pain ; therapy ; High-Energy Shock Waves ; Male ; Neuralgia ; therapy ; Rats, Sprague-Dawley ; Sciatic Nerve ; physiopathology

OBJECTIVETo observe the analgesic effect of ankle-three-needle on nerve root pain of prolapse of lumbar intervertebral disc.

METHODSThree hundred and eighty cases were randomly divided into an ankle-three-needle group, a routine acupuncture group and a medication group. The ankle-three-needle group were treated with ankle-three-needle therapy, i. e. according to different prolapse segments, points Gentong No. 1, 2 and 3 were selected with lifting-kneading needle insertion method used and the needle was inserted along the skin; the routine acupuncture group were treated with acupuncture at Shenshu (BL 23), Qihaishu (BL 24) and Jiaji (EX-B 2) of the prolapse corresponding segment, and Ciliao (BL 32), etc. with uniform reinforcing-reducing manipulation; the medication group were treated with routine buttock intramuscular injection of aspirin-DL-lysine plus saline.

RESULTSThe time inducing analgesia was 6 min in the ankle-three-needle group, 27 min in the routine acupuncture group and 18 min in the medication group. The effect-lasting time was 24.48 h in the ankle-three-needle group, 8.93 h in the routine acupuncture group and 6.36 h in the medication group, with a significant difference as the ankle-three-needle group compared with both the routine acupuncture group and the medication group, but with no significant difference between the routine acupuncture group and the medication group. After treatment, there were very significant differences in change tendency of the analgesic score among the three groups at all the time points (P < 0.01). And there was very significant differences in the changing tendency of straight-leg raising test among the three groups at 0.5 h, 1 h, 24 h and 48 h (P < 0.001).

CONCLUSIONAnkle-three-needle has obvious therapeutic effect on nerve root pain induced by prolapse of lumbar intervertebral disc.

Acupuncture Analgesia ; methods ; Adult ; Aged ; Ankle ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Neuralgia ; therapy ; Spinal Nerve Roots ; physiopathology

Excellent outcomes were achieved with spinal cord stimulation (SCS) for 7 to 10 days on 2 patients who developed postherpetic neuralgia. Both patients were within 2 to 3 months of the onset of the condition, and nerve blocks provided only temporary pain relief and drug therapies had poor efficacy. The authors believe that limited-duration SCS for subacute postherpetic neuralgia is a useful treatment approach that may prevent the pain from progressing to chronic postherpetic neuralgia.
Aged ; Electric Stimulation Therapy ; methods ; Female ; Herpes Zoster ; complications ; Humans ; Neuralgia, Postherpetic ; etiology ; physiopathology ; therapy ; Outcome Assessment (Health Care) ; Pain, Intractable ; therapy ; Spinal Cord ; physiology

Trigeminal neuralgia (TN) is a kind of recurrent transient and severe pain that is limited to the trigeminal nerve in one or more branches. The clinical incidence of TN is high, which seriously affects the quality of life of the patients and is difficult to cure. The present study investigated the effects of tetramethylpyrazine (TMP) on TN induced by chronic constriction injury of the infraorbital nerve (ION-CCI) in rats. Adult male Sprague-Dawley rats were randomly assigned to four groups: sham, sham treated with TMP (Sham+TMP), TN model (TN), and TN treated with TMP (TN+TMP). The rat TN model was established by ION-CCI and TMP (50 mg/kg) was injected intraperitoneally once a day for 2 weeks after operation. The mechanical response threshold was tested by the electronic von Frey filaments. The expression of CGRP in the trigeminal ganglia (TGs) of rats on the operative side was detected by RT-PCR, immunohistochemical staining and Western blot. In 15 days after operation, TN group showed a robust decrease in mechanical response threshold as compared with sham group. From day 9 to day 15 after operation, TMP treatment significantly suppressed the TN-induced mechanical hyperalgesia (P < 0.05). On day 15 after operation, RT-PCR, immunohistochemical staining and Western blot analysis showed an obvious increase in expression level of CGRP in TGs of TN group compared with sham group, which was downregulated by TMP treatment (P < 0.05). These results suggested that TMP might have a therapeutic potential for the treatment of TN through regulating CGRP expression in the TGs.
Animals ; Constriction ; Hyperalgesia ; drug therapy ; Male ; Pyrazines ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Trigeminal Ganglion ; physiopathology ; Trigeminal Neuralgia ; drug therapy