[Clinical study on improving the curative effect of acupuncture on primary trigeminal neuralgia by syndrome differentiation and treatment]

Objective: To evaluate the therapeutic efficacy of syndrome differentiation-based treatment in acupuncture for patients with primary trigeminal neuralgia (PTN). Methods: A total of 104 patients diagnosed with PTN at School of Stomatology, The Fourth Military Medical University from January 1, 2022, to August 31, 2023, were prospectively enrolled. Using a dynamic randomization method via a central randomization system, they were randomly assigned to the control group (n=52) and the experimental group (n=52). The control group received acupuncture treatment with acupoint selection based on the affected pain branches, while the experimental group received additional acupoint selection based on syndrome differentiation in addition to the branch-based selection. A comparative analysis was conducted between the two groups regarding changes in pain intensity, pain attack frequency, short-term clinical efficacy, as well as adverse reactions and emergencies during the treatment period. Results: 104 patients were enrolled in the clinical study, including 52 patients in the control group and 52 patients in the experimental group. During the treatment, the degree and frequency of pain attack in the experimental group were relieved with great intensity and fast speed. The pain changes of patients with branch Ⅱ and Ⅲ after treatment were relatively large and the effect was obvious. The short-term treatment effective rate [94.2%(49/52),96.2%(50/52)] in the experimental group was higher than that in the control group [88.5%(46/52),88.5%(46/52)] with statistical difference(P=0.026,P=0.034). The short-term curative effect of branch Ⅲ in the experimental group was better and more stable than that of other branches(P=0.013). In addition, the adverse drug reactions of both groups decreased after acupuncture treatment, but there were still more emergencies during treatment. Conclusions: According to the treatment of pain branches and syndrome differentiation, selecting the local acupoints of head and face and the distal acupoints of hands and feet can improve the effect of acupuncture on primary trigeminal neuralgia.