原發性三叉神經痛的中醫治療

Trigeminal Neuralgia Treated by Traditional Chinese Medicine

方建喨(Chien-Liang Fang)

《臺灣中醫科學雜誌》 4卷1期 (2009/08) Pp. 7-13

https://doi.org/10.29810/SJTTCM.200908.0002

摘要

三叉神經痛是一種嚴格限制於三叉神經一支或多支的反復發作疼痛，疼痛可自發産生，也可由洗臉、刮臉、抽煙、說話、呵欠、吹風、刷牙等觸發某一“扳機點”，如口角、舌側緣、牙齒、牙槽骨等而引起發作，發作典型症狀爲突然的陣發性劇烈疼痛，有如電擊、刀割、鑽刺、燒灼、撕裂等各類感覺；西醫病理以神經壓迫理論較多被提及；此病在中醫診斷上屬於”面痛”範圍，病理狀態以邪實居多，或是本虛標實狀況，誘發之外因多係因風，受風、寒、濕、熱等外邪侵襲，內因則主要與肝、膽、脾、胃有關，經絡上則多以手足三陽經為治療方向，藥物使用除辨證遣方外，另需思及辛溫通絡藥，及動物纇搜剔通絡止痙藥的斟酌使用。

關鍵字

三叉神經痛 ； 面痛

並列摘要

Trigeminal neuralgia (TN) is a neuropathic disorder of one or both of the facial trigeminal nerves. It causes intensive pain from just a finger's glance of the cheek or spontaneously without any stimulation by the patient. To describe the pain sensation, patients may describe a trigger area on the face, and it can be triggered by common activities in one's daily life, such as facewashing, shaving, smoking, talking, yawning, toothbrushing and even air currents. The attacks are said to feel like stabbing electric shocks, burning, pressing, crushing or shooting pain that becomes intractable. Western Medicine tends to explain the cause of the pain syndrome of TN is a blood vessel compressing the microvasculature of the trigeminal nerve. In Chinese Medicine, TN is diagnosed as ”face pain” which belongs to evil repletion (邪實) or right qi vacuity and evil repletion (本虛標實). The external induced factors are mostly caused by wind, cold, dampness and fire; the internal ones are mainly related to abnormal liver, gallbladder, spleen, and stomach. The treatment to TN through the channel theory should be considered taking the three Hand Yang Channels and the three Foot Yang Channels. As to medication, besides the formula should be in accordance with identification, Chinese herbs of warming drugs, acrid drugs and the animal drugs which may cease spasm should be adopted.

並列關鍵字

Trigeminal neuralgia ； face pain