Trigeminal Neuralgia · Blood Stasis Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Head


Pattern Overview

Blood Stasis is a common pattern in trigeminal neuralgia, characterized by nerve demyelination with vascular compression, fixed stabbing pain, worse at night, and dull complexion. The core pathogenesis is Blood stasis in the facial collaterals, causing nerve ischemia, hypoxia, and persistent pain.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsFixed stabbing pain, worse at night, stabbing quality
Associated SymptomsDark complexion, purple-dark lips, fixed location, poor response to treatment
Tongue and PulsePurple-dark tongue with petechiae, hesitant pulse
PathogenesisBlood stasis in the facial collaterals
EtiologyChronic trigeminal neuralgia, inadequate treatment, vascular compression, microcirculatory disturbance

Acupuncture Point Prescription

PointLocationFunction
Hegu (LI4)Dorsum of the hand, between the 1st and 2nd metacarpalsRegulates Qi and invigorates blood
Taichong (LR3)Dorsum of the foot, between the 1st and 2nd metatarsalsSoothes Liver-Qi and invigorates blood
Xuehai (SP10)On the medial thigh, 2 cun above the patellaInvigorates blood and resolves stasis
Xiaguan (ST7)In the depression on the lower border of the zygomatic arch, below the temporal process of the zygomatic boneKey point for trigeminal neuralgia
Ashi pointsTender spots on the faceLocal blood invigoration and pain relief

Clinical Recommendation: Filament needle, reducing method; may combine with cupping on the local area to enhance blood stasis resolution.


Herbal Formula

Base Formula: Xue Fu Zhu Yu Tang (血府逐瘀汤) or Tong Qiao Huo Xue Tang (通窍活血汤)

Composition:
Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Rehmannia (Sheng Di), Bupleurum (Chai Hu), Immature Bitter Orange (Zhi Ke), Musk (She Xiang), Licorice (Gan Cao)

Action: Invigorates blood, resolves stasis, unblocks collaterals, and relieves pain.

Modifications

Associated SymptomsAdditions/Subtractions
Severe painAdd Quan Xie, Wu Gong to search out Wind and stop pain
Vascular compressionAdd Dan Shen, San Qi to enhance blood invigoration
Chronic conditionAdd Huang Qi, Dang Shen to supplement Qi and invigorate blood
Night aggravationAdd Ru Xiang, Mo Yao to relieve pain

Western Mechanism Reference

Nerve demyelination with vascular compression, nerve ischemia and hypoxia, and microvascular compression. Blood Stasis corresponds to trigeminal neuralgia with vascular compression, where microvascular compression and nerve ischemia contribute to demyelination and pain.


References

  1. Internal Medicine of TCM - Facial Pain with Blood Stasis.
  2. Xiong Jibai: Blood Stasis uses Xue Fu Zhu Yu Tang.
  3. WHO. (2023). Neurological health. World Health Organization.

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