The clinical effect of acupuncture medicine in the treatment of trigeminal neuralgia, the method is through the observation and treatment of 86 cases of trigeminal neuralgia, it is believed that its mechanism primary may be due to the soft tissue around the trigeminal nerve innervation area after injury and adhesion to the trigeminal nerve, and its secondary may be due to tooth decay or alveolar ossification stimulation or compression of the trigeminal nerve endings excited the neurons in the semilunar ganglion. Closed painful point release treatment was performed in the trigger area using a small needle.
Results:The miraculous effect of simple method, quick effect, low cost, safe and reliable and no toxic side effects was achieved. Conclusion: It is significantly better than other treatments and is worthy of clinical application.
Trigeminal neuralgia refers to recurrent episodes of transient and severe pain within the innervation zone of the trigeminal nerve of the face, and it is the most common and most painful disease among neuralgia and not easily curable. It belongs to the category of headache and migraine in Chinese medicine. It has two kinds of symptoms, primary and secondary, and is most common in middle-aged and elderly women over 40 years old. Modern medicine mostly uses phenytoin sodium, carbamazepine and other drugs or trigeminal nerve block therapy to relieve pain or reduce the number of attacks.
Many patients have developed dependence. If drug therapy is ineffective, surgical treatment is used to cut off the trigeminal nerve branches. Since 2013, the author has treated 86 cases of this disease with minimally invasive acupuncture, and achieved the miraculous effect of simple, rapid, inexpensive, safe, reliable and non-toxic side effects. The results are reported as follows:
1.Clinical data
Among the 86 cases, 39 were male and 47 were female, male:female=1:1.21; the minimum age was 35 years old, the maximum age was 72 years old, the average age was 53 years old, and the duration of the disease was 1-8 years; 58 cases were primary and 2 cases were secondary; among them, 9 cases were ophthalmic branch (the first branch), 17 cases were maxillary branch (the second branch), 35 cases were mandibular branch (the third branch), and 25 cases were trigeminal nerve ganglion.
2. Clinical manifestations and signs
2.1 Pain site: limited to the trigeminal nerve innervation area, mostly on one side, with the 2nd and 3rd branches being the most common, while the first branch was rarely involved. Therefore, the pain is more obvious and most intense at the points of the sun, Shangguan, Xiaguan and Buccal car in the cheek and upper and lower jaw. It is not difficult to diagnose this disease according to the anatomical parts.
2.2 The nature and characteristics of pain: the onset is rapid, with typical paroxysmal sharp pain, stabbing pain or cutting or burning pain, each attack lasts for several seconds or 1-10 minutes.
2.3 Trigger zone or trigger zone: A certain area in the trigeminal innervation area is particularly sensitive and can be triggered by a slight touch, these areas are called trigger zone or trigger zone. Even in the interval, patients are afraid to eat or speak loudly or wash their faces for fear of triggering.
2.4 The disease generally has a long duration, with a remission period without seizures, usually occurring after several weeks or months. Once the onset of the disease, many consecutive seizures are quite frequent, and the interictal period is gradually shortened, and in severe cases, there may be several or dozens of seizures in a day.
2.5 The neurological examination is often unremarkable.
2.6 Exclude other diseases causing severe facial pain, such as dental pain, paranasal sinusitis, migraine, vascular tension headache, glossopharyngeal neuralgia, mandibular arthritis and trigeminal hemimelia neuroma.
3.Treatment method
Check the pain point that is the needle knife treatment point, fix the point with purple potion, lay sterile towel for local routine disinfection, wear sterile gloves, fix the pain point with the left thumb, hold the needle knife with the right hand, the incision line is generally in line with the local muscle and nerve, then suddenly force into the needle knife, wait for the local soreness and soreness to appear, then you can perform incision and release 3 to 5 knives or longitudinal sparing and stripping several times to get out the needle, after the operation, compress the needle hole for a moment, and fix with band-aid. For those with more severe clinical symptoms or more frequent attacks, 2% lidocaine 2ml and VitB12 500μg can be used for local injection after surgery.
4.Treatment results
The local tingling and throbbing symptoms disappeared immediately or were significantly reduced after one treatment, or there was only a local numbness and soreness, but not the numbness and electric sensation of nerve injury. 66 cases were cured at one time, and 13 cases had another attack after 24 hours, but they were not cured by the original pain treatment point and the method of treatment.
In two cases, after three treatments, the symptoms of throbbing pain in the trigeminal ganglion and the buccal region of the mandibular branch disappeared, but only the dull pain in the right lower second molar remained, which was secondary, and they were advised to extract the right lower second molar and were treated with Chinese and Western medicines. 5 cases were not cured, although the pain symptoms were relieved after treatment, but could not be stopped and the pain recurred. The cure rate was 91.86%.
5.Typical cases
Li Moumou, female, 63 years old, Guiping, farmer, suffered from trigeminal neuralgia for more than 5 years, which could be triggered by eating and talking, and had more than 10 episodes per day, which was not effective with multiple treatments, and relied on oral medications such as Daphne to prevent episodes and relieve pain.
After the treatment, he only felt localized mucositis and soreness. After 48 hours of follow-up, he reported that the number of attacks per day was significantly reduced to 3, and the pain level of each attack was significantly less than before.
6.Experience
The diagnosis of trigeminal neuralgia is not difficult according to its clinical symptoms and signs and anatomical location. Most scholars believe that there is no obvious pathological or organic changes, and acupuncture medicine believes that the underlying cause is chronic soft tissue injury in the distribution area of trigeminal nerve, cervical spine displacement and local electrophysiological circuit disorder.
Through clinical observation and treatment, the author believes that the primary cause may be due to soft tissue injury around the trigeminal nerve innervation area and trigeminal nerve adhesion or local muscle spasm squeezing and pulling to stimulate the trigeminal nerve [1], and the secondary cause may be due to dental caries or alveolar ossification stimulating or compressing the trigeminal nerve endings to stimulate the neurons in the hemimelia.
Drug resistance may develop with continued use of the drug, and the drug may be ineffective in further relapses, or the drug may be used in larger amounts with more toxic side effects. Although anhydrous alcohol injection into the trigeminal nerve branches is simple and can provide long-lasting pain relief, there is still a risk of hemorrhagic keratitis and blindness. Although surgical treatment is more effective, but the postoperative facial sensory loss, and there is a certain risk and recurrence rate, in addition to the normal tissue is also a kind of damage.
The author’s experience: small needle knife closed pain point release has a miraculous pain relief effect, but also does not damage the healthy soft tissue. The treatment mechanism may be that this method has the effect of loosening adhesions and relieving muscle spasm on soft tissue injury around the trigeminal nerve, while stimulating local chemoreceptors or nerve trunks to regulate central nerves and restore electrophysiological functions, thus achieving the purpose of loosening adhesions, relieving spasm, unblocking meridians, harmonizing qi and blood, calming and relieving pain, and restoring functions. This method can be treated at any time when the attack occurs, and it is not necessary to stick to the treatment after 5 to 7 days. It also has the advantages of simple operation, safety and reliability, unique therapeutic effect and no toxic side effects, which is worthy of clinical promotion and application.