SUMMARY: 60 patients diagnosed with primary trigeminal neuralgia (PTN) were randomly divided into control group (30 subjects) and treatment group (30 subjects) by random number table method. All subjects met the diagnostic criteria of PTN according to the “Diagnostic Standards for Internal Diseases (內科疾病診斷標準)”. The treatment group and control group were statistically comparable as there was no significant difference in age, gender, and course of disease between the two groups (P>0.05).
In treatment group, subjects received acupuncture treatment with the following acupoint combination and methods: ST-44 (Neiting 内庭), LV-3 (Taichong 太衝), LI-4 (Hegu 合谷), SP-6 (Sanyinjiao 三陰交), GB-40 (Qiuxu 丘墟) on the unaffected side with 30 mm x 44 mm needles, perpendicular angle, releasing method, needle manipulation for 5 minutes, and treatment duration of 20 minutes. Additional points were applied on the unaffected side according to individual needs.
In control group, subjects received acupuncture treatment with the following acupoint combination and methods: ST-2 (Sibai 四白), ST-7 (Xiaguan 下關), ST-4 (Dicang 地倉), LI-4 (Hegu 合谷), ST-44 (Neiting 内庭), LV-3 (Taichong 太衝) on the affected side with 30 mm x 44 mm needles, perpendicular angle, even reinforcing-reducing method, and treatment duration of 30 minutes. Additional points were applied on the affected side according to individual needs. Total course of treatment was 4 weeks, with 6-acupuncture sessions every week for both groups.
To evaluate the efficacy of treatment, Short-Form McGill Pain Questionnaire (SF-MPQ) was to assess visual analog scale (VAS), pain rating index (PRI) and present pain index (PPI). Calcitonin gene-related peptide (CGRP) and 5-I tryptamine (5-HT) were also measured before and after treatment. The result was considered as:
- Cured: if pain and associated symptoms completely resolved.
- Markedly Effective: if pain and associated symptoms resolved, and interval between attacks significantly prolonged.
- Effective: if the level of pain and frequency of attacks significantly reduced, but pain was still easily induced with trigger points.
- No Response: no significant improvement in clinical symptoms after treatment.
Table 1. Comparison of Clinical Efficacy between Treatment Group and Control Group
|Group||n||Cured||Markedly Effective||Effective||No Response||Total Effective Rate (%)|
|Treatment||30||1||21||7||1||29 (96.67) Δ|
According to the result, VAS, PPI and PRI significantly reduced 2 days after the treatment, but the improvement was more significant in the treatment group (P<0.05). CGRP level reduced and 5-HT level increased in both groups after the treatment, but the treatment group showed a more significant improvement (P<0.05). The total effective rate was also significantly higher in the treatment group (96.67%) than the control group (90.00%) (P<0.05). This suggested that applying local-distal acupoint combination with opposing needling methods may effectively alleviate clinical signs and symptoms and improve quality of life for patients with PTN. Future study with larger sample size may be beneficial to further determine the effectiveness of such treatment methods.
Shuangyan Dai, et al. JETCM. 2021. 30 (7): 1189-1225