Trigeminal Neuralgia - Yin Deficiency with Yang Hyperactivity Pattern

Dr. Li Wei, DACM

Trigeminal Neuralgia · Yin Deficiency with Yang Hyperactivity Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Yin Deficiency with Yang Hyperactivity is a chronic pattern in trigeminal neuralgia, characterized by increased nerve excitability, burning pain, worse at night, dry mouth, and irritability. The core pathogenesis is Yin deficiency failing to control Yang, leading to Yang hyperactivity, nerve hyperexcitability, and central sensitization.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Burning pain, worse at night, dry mouth, irritability |

| Associated Symptoms | Heat in palms and soles, night sweats, dizziness, tinnitus |

| Tongue and Pulse | Red tongue with little coating, thready and rapid pulse |

| Pathogenesis | Yin deficiency with Yang hyperactivity causing nerve hyperexcitability |

| Etiology | Chronic trigeminal neuralgia, aging, constitutional Yin deficiency, prolonged illness |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Taixi (KI3) | Depression between medial malleolus and Achilles tendon | Source point of Kidney meridian; nourishes Kidney-Yin |

| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Calms Liver-Yang and extinguishes Wind |

| Fengchi (GB20) | Depression below the occipital bone, between the sternocleidomastoid and trapezius | Disperses Wind and calms Yang |

| Sanyinjiao (SP6) | 3 cun above the medial malleolus | Nourishes Blood and Yin; regulates the Spleen and Kidney |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Regulates Qi and unblocks collaterals |

Clinical Recommendation: Filament needle, reinforcing method for Yin-nourishing points, reducing method for Yang-calming points.

Herbal Formula

Base Formula: Zhen Gan Xi Feng Tang (镇肝熄风汤)

Composition:

Achyranthes (Huai Niu Xi), Hematite (Dai Zhe Shi), Dragon Bone (Long Gu), Oyster Shell (Mu Li), Tortoise Shell (Gui Ban), White Peony (Bai Shao), Scrophularia (Xuan Shen), Asparagus (Tian Dong), Melia (Chuan Lian Zi), Licorice (Gan Cao)

Action: Nourishes Yin, calms Yang, extinguishes Wind, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe burning pain | Add Zhi Mu, Huang Bai to clear deficiency heat |

| Night sweats | Add Mu Li, Fu Xiao Mai to stabilize the exterior |

| Dizziness | Add Tian Ma, Gou Teng to extinguish Wind |

| Insomnia | Add Suan Zao Ren, Yuan Zhi to calm the spirit |

Western Mechanism Reference

Increased nerve excitability with Na+ channel abnormal expression, nerve hyperexcitability, and central sensitization. Yin Deficiency with Yang Hyperactivity corresponds to chronic trigeminal neuralgia with nerve hyperexcitability, where Na+ channel abnormal expression and central sensitization contribute to persistent burning pain.

References

  1. Internal Medicine of TCM - Yin Deficiency with Yang Hyperactivity.

  2. Zang-Fu Pattern Differentiation: Liver-Yang Hyperactivity → Cross-layer.

  3. WHO. (2023). Neurological health. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for nerve pain relief.

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