Trigeminal Neuralgia - Liver-Fire Blazing Pattern
TCM differentiation and treatment for trigeminal neuralgia
Trigeminal Neuralgia · Liver-Fire Blazing Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Head
Pattern Overview
Liver-Fire Blazing is a common pattern in trigeminal neuralgia,
characterized by **sympathetic excitation decreasing pain threshold,
severe facial pain triggered by stress, irritability, red eyes, and
bitter taste. The core pathogenesis is emotional stress causing
Liver depression transforming into Fire**, leading to sympathetic
excitation, lowered pain threshold, and severe pain.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
stress, irritability |
| Associated Symptoms |
|---|
insomnia |
| Tongue and Pulse |
|---|
pulse |
| Pathogenesis | Liver depression transforming into Fire |
|---|
| Etiology |
|---|
deprivation |
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| Taichong (LR3) |
|---|
metatarsals | Source point of Liver meridian; clears Liver Fire |
| Xingjian (LR2) |
|---|
metatarsals, proximal to the web margin | Spring point of Liver
meridian; drains Liver Fire |
| Fengchi (GB20) |
|---|
sternocleidomastoid and trapezius | Disperses Wind and clears Heat |
| Hegu (LI4) |
|---|
metacarpals | Disperses Wind and unblocks collaterals |
| Xiaguan (ST7) |
|---|
zygomatic arch, below the temporal process of the zygomatic bone | Key
point for trigeminal neuralgia |
Clinical Recommendation: Filament needle, reducing method; may
combine with pricking at Xingjian to enhance Liver Fire drainage.
Herbal Formula
Base Formula: Long Dan Xie Gan Tang (龙胆泻肝汤)
Composition:
Gentian Root (Long Dan Cao), Scutellaria (Huang Qin), Gardenia (Zhi Zi),
Bupleurum (Chai Hu), Alisma (Ze Xie), Akebia (Mu Tong), Angelica (Dang
Gui), Rehmannia (Sheng Di), Licorice (Gan Cao)
Action: Clears Liver-Fire, calms the meridians, and relieves pain.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Severe pain | Add Quan Xie, Wu Gong to search out Wind and stop pain |
|---|
| Irritability |
|---|
depression |
| Headache | Add Ju Hua, Xia Ku Cao to clear Liver Fire |
|---|
| Insomnia | Add Suan Zao Ren, Long Gu to calm the spirit |
|---|
| Constipation | Add Da Huang to drain heat |
|---|
Western Mechanism Reference
Sympathetic excitation decreasing pain threshold, with
sympathetic-adrenal system excitation and substance P release.
Liver-Fire Blazing corresponds to trigeminal neuralgia associated with
stress, where sympathetic excitation and substance P release contribute
to lowered pain threshold and severe pain.
References
1. Internal Medicine of TCM - Facial Pain with Liver Fire.
2. Zang-Fu Pattern Differentiation: Liver-Fire Blazing → Clearing
Pathway.
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.
- Deepen your knowledge at TcmCIO.com – Full
research papers and clinical case studies on TCM neurology.
Related TCM Patterns for Trigeminal Neuralgia
Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly
Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.