The paper introduces Professor LIU Xing's clinical experience and characteristics of integrative acupuncture and medication in treatment of primary trigeminal neuralgia (PTN). It is believed that the essential pathogenesis of PTN is pathogenic wind, and qi and blood obstruction results from invasion of pathogenic wind. Hence, dispelling wind is the key principle of treatment. Palpation is done at first in the neck, face and buccal mucosal region to detect the masses in treatment. Acupotomy is operated at the masses distributed at Shangguan (GB3), Xiaguan (ST7) and the white line of buccal mucosa, so as to release masses. Additionally, five-wind points (Fengfu [GV16], bilateral Fengchi [GB20], Yifeng [TE17], Bingfeng [SI12] and Fengmen [BL12]), three-nape points (bilateral Naokong [GB19], Tianzhu [BL10] and Jianjing [GB21]) and three-governor-vessel points (Baihui [GV20], Zhiyang [GV9] and Yintang [GV24⁺]) are selected to dispel wind and stop pain. Besides, herbal decoction (wu feng tang) and blood-letting at ear apex are administered in combination. The integration of acupuncture and medication obtains a holistic effect on PTN by dispelling wind pathogen, and promoting qi and blood circulation.
Humans ; Trigeminal Neuralgia/drug therapy* ; Acupuncture Therapy ; Acupuncture Points ; Female ; Male ; Middle Aged ; Drugs, Chinese Herbal/administration & dosage* ; Combined Modality Therapy ; Adult ; Aged

OBJECTIVE: To observe the clinical effect of chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling on negative emotion in primary trigeminal neuralgia (PTN) of phlegm obstruction and blood stasis. METHODS: Sixty cases of patients with PTN of phlegm obstruction and blood stasis were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling (acupoints Sibai [ST 2], Yuyao [EX-HN 4], Hegu [LI 4], Taichong [LR 3] and auricular points Xin [CO₁₅], Shenmen [TF₄], Pizhixia [AT₄], etc.), once a day, 6 d as a course of treatment, rest 1 d between courses, a total of 2 courses of treatment; and the control group was given oral carbamazepine tablets for 13 days. Before and after treatment, the pain visual analogue scale (VAS), TCM syndromes, self-rating anxiety scale (SAS) scores and the contents of serum neurotransmitter (β-endorphin [β-EP], substance P [SP] and 5-hydroxytryptamine [5-HT]) were compared, and the clinical efficacy was evaluated. RESULTS: After treatment, the VAS, SAS, TCM syndrome scores and the contents of serum SP in the two groups were lower than those before treatment (P<0.05), and the above indexes in the observation group was lower than those in the control group (P<0.05). The contents of serum β-EP and 5-HT in the two groups were higher than those before treatment (P<0.05), and the above indexes in the observation group were higher than those in the control group (P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was higher than 83.3% (25/30) in the control group (P<0.05). CONCLUSION Chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling can relieve pain symptoms and negative emotions in patients with primary trigeminal neuralgia of phlegm obstruction and blood stasis, which may be related to the regulation of serum neurotransmitter levels.
Acupuncture Points ; Acupuncture Therapy ; Emotions ; Humans ; Pain ; Serotonin ; Syndrome ; Treatment Outcome ; Trigeminal Neuralgia/therapy*

OBJECTIVE: To compare the clinical therapeutic effect between deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle and conventional acupuncture in patients with trigeminal neuralgia (TN) of wind and heat, and explore its mechanism. METHODS: A total of 60 patients with TN of wind and heat were randomized into an observation group (30 cases) and a control group (30 cases). In the observation group, deep needling with round sharp needle was applied at Xiaguan (ST 7), and tapping with plum-blossom needle was applied at Yangbai (GB 14), Quanliao (SI 18), Dicang (ST 4), Sibai (ST 2), etc. of affected side. In the control group, conventional acupuncture was applied at the same acupoints selected in the observation group. The treatment was given once a day, 5 times a week for 4 weeks in the both groups. Before and after treatment, the scores of short-form McGill pain questionnaire (SF-MPQ), TCM syndrome, patient global impression of change (PGIC) and comprehensive symptom were observed, the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vasoactive intestinal peptide (VIP) and β-endorphin (β-EP) were detected, and the adverse reaction was observed in the both groups. RESULTS: After treatment, the scores of PRI, PPI, VAS, TCM syndrome, PGIC and comprehensive symptom and the serum levels of IL-6, TNF-α and VIP were decreased compared before treatment in the both groups ( CONCLUSION Deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle can effectively treat the trigeminal neuralgia of wind and heat and relieve pain, its therapeutic effect is superior to conventional acupuncture. The mechanism may be related to the regulation of serum IL-6, TNF-α, VIP and β-EP.
Flowers ; Hot Temperature ; Humans ; Prunus domestica ; Trigeminal Neuralgia/therapy* ; Wind

Objective To observe the changes of brain function in patients with trigeminal neuralgia after administration of flurbiprofen axetil by using the resting-state functional magnetic resonance imaging(fMRI)and based on the amplitude of low-frequency fluctuation(ALFF). Methods Resting fMRI data of 20 patients with trigeminal neuralgia before and after treatment with flurbiprofen axetil were collected by 1.5T magnetic resonance imaging system.The resting fMRI data were pretreated by Statistical Parametric Mapping and DPABI(a toolbox for Data Processing and Analysis for Brain Imaging)software,and the difference of low-frequency oscillation amplitude of brain spontaneous activity before and after treatment with flurbiprofen axetil was analyzed by ALFF. Results The Visual Analogue Scale of pain intensity after flurbiprofen axetil injection was significantly lower than that before administration,and the pain relieved significantly(P=0.000).The ALFF values of right dorsolateral prefrontal lobe,bilateral medial prefrontal lobe,and right middle cingulate gyrus in patients treated with flurbiprofen axetil at rest were significantly lower than those before administration(P=0.000). Conclusions The analgesic effect of flurbiprofen axetil is exerted on the central system.This agent can inhibit the abnormal brain function caused by chronic pain stimulation and thus reduce pain.However,the specific mechanism needs further investigations.
Brain ; drug effects ; Brain Mapping ; Flurbiprofen ; analogs & derivatives ; pharmacology ; Humans ; Magnetic Resonance Imaging ; Trigeminal Neuralgia ; drug therapy

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

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Pain, Intractable ; therapy ; Trigeminal Neuralgia ; therapy

The characteristics and rules of acupoint selection of acupuncture for trigeminal neuralgia were analyzed. By searching CNKI, VIP, WF, literature regarding acupuncture for trigeminal neuralgia from 1980 to 2013 was collected to establish an acupuncture prescription database. The data mining technology was applied to analyze the characteristics and rules of the acupoint selection. As a result, a total of 180 papers were included, involving 148 acupoints. It was found that the acupoints that had high frequency of selection included Hegu (LI 4), Xiaguan (ST 7), Fengchi (GB 20) and trigger points. The acupoints selected were distributed in 14 meridians, in which yangming meridian of hand-foot had a frequency of 41. 58%. The special acupoints including crossing points, yuan-primary points and five-shu points were widely used, accounting for 65. 9%. As for the branch of trigeminal nerve, the top-3 selected acupoints were Yangbai (GB 14), Yuyao (EX-HN 4), Cuanzhu (BL 2) in the first branch, Sibai (ST 2), Quanlian (SI 18), Yingxiang (LI 20) in the second branch, Jiache (ST 6), Xiaguan (ST 7), Dicang (ST 4) in the third branch. In conclusion, it is believed that the clinical treatment of trigeminal neural gia focuses on local acupoints in combination with nerve distribution-based acupoints and distal acupoints, also the special acupoints are emphasized.
Acupuncture Points ; Acupuncture Therapy ; Data Mining ; Humans ; Medicine in Literature ; Meridians ; Trigeminal Neuralgia ; therapy

Trigerninal neuralgia is a common refractory disease in clinic. Professor FANG Jianqiao has rich experience through diagnosing and treating the disease for many years. In the first diagnosis, professor FANG underlines the position of damaged neuron and syndrome differentiation. He considers acupuncture should be implemented by stages,namely according to whether the patients are in the period of pain attack, different acupuocture prescriptions are made. Acupuncture manipulation and needle-retention time should be adjusted according to the condition of disease. And the appropriate application of electroacupuncture and transcutaneous electrical acupoint stimulation can strengthen the effect.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, 20th Century ; History, 21st Century ; Humans ; Trigeminal Neuralgia ; diagnosis ; therapy

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Trigeminal Neuralgia ; therapy

Acupuncture Therapy ; Adult ; Female ; Humans ; Trigeminal Neuralgia ; therapy