三叉神经痛的中医治疗

Trigeminal Neuralgia

本病是一种原因尚未完全明了的神经科常见疾病，多发生于40岁以上妇女，特征为面部三叉神经分布区内有反复发作的阵发性剧痛，如刀割、钻刺样疼痛，不伴有器质性改变，感觉检查很少有障碍。疼痛性质独特，是一种突然急骤发作、突然停止的闪电样剧痛。持续数秒至数十秒，可引起同侧面肌抽搐、眼结膜充血、流泪或流涎等。

Trigeminal Neuralgia is a common neurologic disease. The cause for it is still unknown. It is more seen in female over 40. It shows as a frequent onset of sharp pain in the area of face that the trigeminal nerves distributes. The pain can feel as cut, burning, a drilling, It usually comes quickly and stops quickly and lasts for several seconds or tens of seconds. It can be triggered out by cold, hot, drink, eat, stress or tired, but many times there is no any triggering factors.

西医治疗，多采用镇痛剂、酒精封闭等法，无效时则考虑开颅行三叉神经根切手术。这样虽能解除剧痛之苦，但术后面部易出现后遗症，且不易为患者所接受。

Western medicine basically gives patients pain killer. It may work in the beginning, but the dose has be to higher and higher along with the history of the disease. The pain killer works pretty much for the symptom, not for cure. If the pain killer does not work, doctor may suggest a surgical operation by cutting the nerves. The surgical operation may release the pain but may also create side effect on the face by loss of feeling and others.

中医治疗三叉神经痛具有很好的疗效。主要疗法为草药和针灸。

Traditional Chinese medicine works well for the trigeminal neuralgia. The main therapy is herbal therapy and acupuncture, especially the herbal therapy for cure.

草药疗法需要辩证用药。

It is needed to have a Chinese medicine diagnosis to choose the herbal formula. Different people need different herbal formula, though all of them have the trigeminal neuralgia as diagnosed according to the western medicine.

如果病人常常恶寒，很少出汗，体质较为健壮，脉浮紧，用麻黄汤。如果恶寒，可发热也可不发热，但乏力嗜睡喜欢暖怕冷，精神疲惫，脉沉细弱，用麻黄附子细辛汤加芍药甘草汤加止痉散；如果怕冷，胃中嘈杂，泛酸，喜欢热饮，时时有气上冲眩晕感，脉洪紧而沉，用吴茱萸汤；手脚常冰，喜欢冷饮，脉有力或数，用四逆散；手脚常冰而无内热者，用当归四逆散；面部常冷，可试用麻黄附子细辛汤或乌头汤。

Cold syndromes

If the person usually strong in body constitution, feels cold or chilly, no sweat, and the pulse is floating and tight, we use herbal formula Ma Huang Tang. If the person feels cold and chilly, with or without hot, feels tired and has desire to lie down for a nap, likes to stay in warm room and drink warm water, and the pulse feels deep, thin and weak, use Ma Huang Fu Zi Xi Xing Tang (plus Shao Yao Gan Cao Tang and Zhi Jing San). If the person feels cold in stomach, likes to drink warm water, feels a kind of “gas” rushing up to the head or face from time to time, and pulse feels tight, big and deep, use Wu Zhu Yu Tang. If the hands and feet feel cold, likes to drink cold water, and the pulse feels strong and faster, use Si Ni San. If the person only feels cold in hands and feet, but no inner hot, use Dang Gui Si Ni Tang. If the face always feels cold, use Ma Huang Fu Zi Xi Xing Tang or even Wu Tou Tang.

如果病人怕热，喜欢冷饮冷处，用白虎汤或风引汤；如果伴有后项后背僵紧，用葛根汤。如果病人腹满，上腹部紧而不适，压之不适，用大柴胡汤。腹满便秘者，用小承气汤。面红目赤、失眠多梦、口干口苦、便秘溲赤、舌红苔黄、脉弦或脉弦数等症者，用龙胆泻肝汤。

Fire syndrome

If the person dislikes hot, likes stay in cold room, drink cold or ice water, use herbal formula Bai Hu Tang, or Bai Hu Jia Ren Shen Tang, or Feng Yin Tang. If the person feels tightness on the neck and on the upper back, use Ge Gen Tang. If there is bloating feeling in the belly and the belly feels tight upon touch and press, use Da Chai Hu Tang. If there is constipation and bloating, use Xiao Cheng Qi Tang. If the person is red in eyes, dry and bitter taste in mouth, constipation and has strong yellow color in urine, and the tongue is red and tongue covering is yellow and thick, and the pulse feels as a string, or string-faster, use Long Dang Xie Gan Tang.

头昏头沉、胸中憋闷、舌质紫暗或有瘀点瘀斑、舌苔厚腻、脉沉涩或滑等症者用半夏天麻白术汤，或导痰汤。

Phlegm syndromes

If the person feels dizziness and cloudy in mind, pressure feeling in chest; the tongue is with purple and dark dots; and the tongue covering is thick and greasy, and the pulse feels deep-unsmooth, or deep-slippery, use Ban Xia Tian Ma Bai Zhu Tang or Dao Tang Tang.

以上这些基本方剂中都需要加川芎，白芍，白芷，白附子，白僵蚕，全蝎，地龙。

To all of the basic formula above, it is needed to add herb Chuang Xiong, Bai Shao, Bai Zhi, Bai Fu Zi, Bai Jiang Cang，Quan Xie, and Di Long.

如果很难判断寒热，可直接用通天笑痛方，方用生白附子12克，僵蚕6克，全蝎4.5克，川芎18克，白芍30克，炙甘草10克，大枣8枚。

If it is hard to make a clear diagnosis, some herbal formula can be tried first, such as Tong Tian Xiao Tong Fang, Shi Gao Huang Qin Tang, or Jia Wei Wu Bai Tang.

或石膏黄芩汤，方用生石膏24克，葛根18克，黄芩9克，赤芍12克，荆芥穗9克，钩藤12克，薄荷9克，甘草9克，苍耳子l 2克，全蝎6克，蜈蚣3克，柴胡12克，蔓荆子12克。

或加味五白汤，方用白芷、白蒺藜、白附子、白僵蚕各9克，地龙15克，全蝎、蜈蚣各5 克，白芍、川芎各30克，肉桂1.5克。

草药需要每天服用，连续一到两个月。如此，治愈率多在70%以上，好转率可达90%以上。

The herb decoction should be drunk three times a day for one to two months. By this way, the cure rate for the trigeminal neuralgia can be as high as more than 70% and the improvement rate is higher than 90%, under the condition that the Chinese medicine diagnosis is correct.

草药是治疗三叉神经痛的主要方法，但是我们也用针灸以快速止痛和加强加速草药疗效。

针灸的主穴是风池、翳风、下关、手三里、合谷。配穴：第1支疼痛者加太阳，阳白，捞竹，头维。第2、3支疼痛者 加太阳、四白、下关、听会、地仓、承浆、迎香。行重刺激法，并留针三十分钟。每天一次最好，至少每两到三天一次，需要至少十到二十次。与草药草药疗法结合时，需要的次数要少很多。

Though the herbal therapy is the major therapy in the Chinese medicine for cure of the Trigeminal neuralgia, acupuncture is also frequently used, at least for quick cease of the pain. According to the branch of the trigeminal nerve affected, the acupuncture points chosen are also different. For the first branch, use point Tai Yang, Yang Bei, Zan Zhu, and Tou Wei; for the second and the third branches, use Tai Yang, Si Bai, Xia Guan, Ting Hui, Di Cang, Cheng Jiang, and Yin Xiang, beside the main spots of Feng Chi, Yi Feng, Xia Guan, Shou San Li, and He Gu.

The acupuncture should be done once every day, at least once every two to three days. It takes about one hour for each time and cost $87. It needs more than 10 times to tell if the acupuncture works or not. The efficiency of the acupuncture, as well as for the herbal therapy, is to see if the intensity of the pain is reduced, and if the frequency of the episodes is also reduced.

针灸治疗的效果并不仅仅取决于每次针灸医生每次的技术能力和治疗的总次数，也和针灸的频率有密切关系。比如说我们治疗戒烟，我们要求每天针灸一次，一共七天到十天。如此，可以使得每天吸烟二十支以上减少到每天零到一支。但是，如果选择每周针灸一次，那么十周之后，每天还是吸二十支。

The healing effects of the acupuncture does not only depend on the personal skill of the acupuncture practitioner or the total numbers of the acupuncture, but also on the frequency of the acupuncture. Acupuncture needs to be done once every day for ten days (one healing circle). The important of the acupuncture frequency can be seen in the quit smoke program, in which we need acupuncture once every day for 7 to 10 days. By this way, the number of cigarette smoked can be reduced from more than 20 per day to 0 to 1 per day. If we perform the acupuncture once every week for ten weeks, the person will still smoke 20 cigarettes after the 10 weeks!  

如果您对于中医治疗三叉神经痛感兴趣，务必记住，草药疗法是最有治愈希望的疗法，和针灸合用则更好。如果单用针灸，需要的针灸次数会很多。

If you are really interested to get rid of trigeminal neuralgia by the Chinese medicine, you need to remember: the herbal therapy is the most powerful therapy, though the acupuncture can also be helpful. If we use acupuncture alone, more times of acupuncture sessions would be needed.