“左脸神经性疼痛，吃饭、刷牙、吞咽、大笑甚至说话都会诱发更严重的疼痛！我太痛苦了！”
2023年10月的一天，诊所来了一位D女士，她今年76岁，左侧面部神经性疼痛已经一年半了。
一年半之前，刚开始的时候，患者的左侧面部有时痛，有时不痛，疼痛呈往来反复。后来病情逐渐加重，近六个月，就开始呈现持续性疼痛的状态，而且疼痛的程度也越来越重。刷牙、吞咽、咀嚼、大笑甚至说话时又会使疼痛加重。我在进行问诊的时候，患者就极其痛苦，她一边诉说症状，一边会有突发的疼痛使正在进行的谈话停下来。整个的30分钟的问诊，被严重的疼痛干扰无数次，有时一句话说不完，就会疼痛2-3次。患者极其无耐，不得不小心的说话，不敢笑，怕某一个动作会更加痛苦。当更痛苦的时刻发生时，患者的手本能的抬起去保护面部，但也只是空掌虚放在疼痛的区域，并不敢用手去按揉或者抚摸，因为任何触碰都可能再诱发更严重的疼痛。患者的表情不停的切换，或微笑、或苦笑、或痛苦、或狰狞，看得出她在极力的掩饰痛苦，但痛苦就是这样禁不住掩饰。患者说只有睡觉的时候是不痛的，但是如果不小心触碰了左侧的面颊，也会在梦中疼醒......
D女士尽量保持她优雅的微笑，她说：“我经历了一年半的痛苦，寻求了许多的帮助，我吃了很多西药......这些西药不但对我没有帮助，而且还对我的身体有很多副作用，问题是，我还越来越严重！...... 我于是停掉了所有的西药，包括所有的止痛药，......我查了很多资料，我发现针灸可以帮忙我的情况......我不需要你对治疗结果的任何承诺，我就是愿意来尝试。”
患者非常诚恳，我当然愿意为她尽力去治疗。
结合患者的症状、体征及病史，我选择了双脚的太冲穴，为患者疏肝理气，解肝郁；又选择了右侧列缺穴（腕部），及董氏奇穴的灵谷穴（手虎口处），以疏导左侧的面部经络之气血。患者体虚脉弱，其有肝郁，所以我会如此选择穴位。
以上四个穴位，均用1寸针浅刺直刺。依次进针后，让患者活动左侧面部，患者随即感觉疼痛减轻。其实我运用的是中医的动气疗法--远端取穴，配合疼痛部位的活动，从而达到医治的作用。所以我鼓励D女士，尽可能的做各种诱发疼痛的动作。她于是很配合我的治疗，并且面露惊喜和诧异！她说“不痛了，真的不痛了！之前是7-8级的疼痛（0-10）!.....现在2-3级.....现在好像没有什么感觉了！太不可思议了！发生了什么？！” 她不解的看一看双脚和右手上的四根小小的针灸针，又是摇头，又是惊叹。
简直是奇迹！被称为“天下第一痛”的三叉神经痛，疼痛了一年半了，四根小针，不到一分钟，就这样减轻了痛楚！
我其实也被眼前的一幕震撼到了！我接下来在她的患侧面部取穴：上关穴、下关穴直刺，颊车、地仓、承浆穴平刺。这是我惯用的神经痛阻断法+平刺营养神经法。留针25分钟后，除去面部的毫针（保留远端针），对患者进行观察和评估，嘱患者说话，大笑、吞咽，疼痛虽然减轻，但还是会出现2-3级，甚或4-5级的小范围的诱发痛。我再用手持毫针对阿是穴（疼痛部位）进行手法刺络--这是我自创的毫针手法刺络：双手戴无菌手套，缓慢平刺进针，缓慢出针。右手持针进针后即可出针，虽缓慢但无停歇--如行云流水缓缓徐之。出针时，左手在针行处辅助轻压，心神合一，意念行针。每行完一次针，询问患者如何，都说针刺处附近疼痛消失。再找痛点--阿是穴，再行针，行针三次后，患者诉--面部无任何区域疼痛。遂止，除去远端针，本次治疗结束。
三叉神经痛，目前的药物治疗多为卡马西平（carbamazepine），苯妥英钠（sodium phenytoin）或者类似的药物。其目的主要是控制疼痛，很多患者终身服药。这两类药物的副作用大，长期服用后又会出现耐药性，药量也可能会逐渐加大，经常会导致患者吃的药越来越多，疼痛却越来越重。严重的患者也考虑手术治疗。由于西药的副作用，手术的风险性，中医针灸的治疗成为了许多患者的选择。
D女士说，“这是我接受的所有的治疗当中，唯一有用的治疗！而且这次的治疗体验也是最让我兴奋的！”
我为她制定的治疗方案是每周针灸2次。在接下来的治疗里，我会根据患者的病情，调整一些取穴的位置和方法，但通经活络，和疏解肝郁气滞的基本理念不变。患者疼痛的程度逐渐减轻、无痛期延长--明显好转！慢慢的可以有非常美丽的2-3天连续无电击样疼痛的日期，可以大笑，可以跟朋友说很多话，可以欢乐的参加聚会。最近半个月基本没有出现闪电样的疼痛，虽然有时可以感觉1-3级的钝痛，但患者说“完全不影响我的日常生活，任何的谈话和笑容都不必中断，我可以与它和平的共处！”
这个感恩节，由于家庭聚会的关系，D女士连续11天没有接受针灸治疗，她告诉我她很好,t她享受了一场场美丽的聚会，那个让她恐惧而痛楚的电击痛没有发生过一次！
哦，太棒了！我和D女士激动得相互拥抱庆祝！
感恩，美丽的感恩节！
感恩，世界上最美妙的礼物！
治疗还在继续，希望患者与痛苦远离，希望可以继续书写奇迹。
作者： 贺英华中医博士，整理此病例（ 病历号20230397）于2023年11月29日
26年的医疗的生涯，我最开心的事情就是能够结识中医，并把中医元素越来越多的应用到我的临床实践当中。期间，有很多让人惊喜的医疗故事，这些故事的奇妙之处在于，你无法用现代医学去解释，它完全颠覆了我本身对西医体系的认知！我对这个打败疾病的过程与结果充满着喜悦，见证并崇拜着中医的神奇！于是，我怀着激动的心情，愿意来分享这些奇妙的治疗旅程。并希望可以帮助到更多的人。----贺英华
My Story at a Chinese Medicine Clinic in the United States
Article 1 Relieve Trigeminal Neuralgia in ne Minute
"Neuropathic pain on the left side of my face. Eating, brushing my teeth, swallowing, laughing and even talking can induce more severe pain! I am in so much pain!"
One day in October 2023, Ms. D. came to the clinic. She is 76 years old and has had neuropathic pain on the left side of her face for a year and a half.
A year and a half ago, at the beginning, the left side of the patient's face sometimes hurt, sometimes not, and the pain came and went. Later, the condition gradually worsened. In the past six months, she began to suffer from persistent pain, and the pain became increasingly severe. Brushing, swallowing, chewing, laughing, and even talking can make the pain worse. When I was conducting consultations with her, Ms.D. was in extreme pain. While she was describing her symptoms, she would experience sudden pain that would stop the ongoing conversation. The entire 30-minute consultation was interrupted countless times by severe pain. Sometimes she couldn't finish a sentence and would suffer from pain 2-3 times. She was extremely impatient and had to be careful about what he said and did not dare to laugh, for fear that a certain movement would make her face more painful. When a more painful moment occurs, she instinctively raises her hand to protect her face, but she only places her empty palm on the painful area and does not dare to massage or touch it with her hand, because any touch may cause more severe pain. Her expression kept switching between smiles, bitter smiles, pain, or ferociousness. It could be seen that she was trying her best to hide the pain, but the pain just couldn't be concealed. She said that it only does not hurt when sleeping, but if she accidentally touches her left cheek, she will wake up from the pain in his sleep.
Ms. D tried her best to keep her elegant smile. She said: "I have experienced pain for a year and a half and tried to find any treatment that can help me, then I took a lot of western medicine... However, not only did these western medicines not help me, but that had many side effects in my body. And the problem was getting worse!... So I stopped taking all medicines, including all pain pills... Recently, I did a lot of research, checked a lot of information. I found that acupuncture could help with my situation...I don’t need any promise from you, I’m just willing to give it a try.”
Ms.D. is very sincere and I am of course willing to try my best to treat her.
Based on the patient's symptoms, signs and medical history, I selected the Taichong point on both feet to soothe the liver stress, regulate qi and relieve liver stagnation; I also selected the right Lieque point (wrist) and Dong's strange point Linggu acupoint (at the hand) to channelize the qi and blood of the facial meridians on the left side. The patient's body is weak and her pulse is weak. She also has liver stagnation and anxiety, so I choose these acupoints for her.
The above four acupoints are all pricked shallowly and straight with 1-inch needles. After inserting the needles in sequence,I asked her to move the left side of her face, and she immediately felt pain relief. In fact, I use Qi-moving therapy of traditional Chinese medicine acupuncture skills, selecting distal acupoints and cooperating with the movement of the painful area to achieve the therapeutic effect. So I encouraged Ms. D. to do all kinds of pain-inducing movements as much as possible. She cooperated very well with my treatment and showed a surprised smile! She said, "It doesn't hurt anymore, it really doesn't hurt anymore! It used to be a pain level of 7-8 (0-10)!... Now it's level 2-3... I don't seem to feel anything now! Fantastic！Unbelievable! What happened?!" She looked at the four small acupuncture needles on her feet and right hand in confusion, shaking her head and marveling at the same time.
What a miracle! Trigeminal neuralgia, known as "The most painful pain in the world！"She has been in pain for a year and a half. Four small needles relieved the pain in less than a minute!
I was actually shocked by the scene in front of me! In the next step, I selected acupoints on her affected side of the face: Shangguan and Xiaguan acupoints were stabbed straight, and Jiache, Dicang, and Chengjiang acupoints were stabbed with horizontal acupuncture under the skin. This is my usual nerve pain blocking method + horizontal acupuncture to nourish the nerves. After leaving the needles in place for 25 minutes, remove the facial needles (keep the distal needles), observe and evaluate the patient, and instruct her to talk, laugh, and swallow. Although the pain is relieved, grade 2-3 or even grade 4-5 will still occur. A small range of pain. I then used a hand-held acupuncture method to pick the Ashi point (the painful area) - this is my own acupuncture method: wear sterile gloves on both hands, insert the needle slowly and horizontally, and slowly move out the needle. Hold the needle with my right hand and then take it out, slowly but without stopping - like flowing water slowly. When taking out the needle, use my left hand to assist with gentle pressure where the needle goes. Unite my mind and the pain area to move the needles. After each acupuncture, the patient was asked how she was doing, and she all said that the pain near the acupuncture site disappeared. Then the pain point - another Ashi point was found, and acupuncture was performed again. After three acupunctures, Ms.D. told me that there was no pain in any area of the face. Then all stopped, the distal needle was removed, and the first time treatment ended.
The current drug treatments for trigeminal neuralgia are mostly carbamazepine, sodium phenytoin or similar drugs. The purpose is primarily to control pain, and many patients take medication for life. These two types of drugs have serious side effects, and drug resistance may develop after long-term use. The dosage of the drugs may also gradually increase, often resulting in patients taking more and more drugs, and the pain becomes more and more severe. Surgery may also be considered in severe cases. Due to the side effects of medicine and the risks of surgery, traditional Chinese medicine and acupuncture have become the treatment of choice for many patients.
Ms. D. said“ Among all the treatments I received, this was the only one treatment that worked! And this treatment experience is also the only exciting one for me!”
