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 DimensionManifestations
Primary SymptomsBurning pain, worse at night, dry mouth, irritability
Associated SymptomsHeat in palms and soles, night sweats, dizziness, tinnitus
Tongue and PulseRed tongue with little coating, thready and rapid pulse
PathogenesisYin deficiency with Yang hyperactivity causing nerve hyperexcitability
EtiologyChronic trigeminal neuralgia, aging, constitutional Yin deficiency, prolonged illness

Acupuncture Point Prescription

PointLocationFunction
Taixi (KI3)Depression between medial malleolus and Achilles tendonSource point of Kidney meridian; nourishes Kidney-Yin
Taichong (LR3)Dorsum of the foot, between the 1st and 2nd metatarsalsCalms Liver-Yang and extinguishes Wind
Fengchi (GB20)Depression below the occipital bone, between the sternocleidomastoid and trapeziusDisperses Wind and calms Yang
Sanyinjiao (SP6)3 cun above the medial malleolusNourishes Blood and Yin; regulates the Spleen and Kidney
Hegu (LI4)Dorsum of the hand, between the 1st and 2nd metacarpalsRegulates 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 SymptomsAdditions/Subtractions
Severe burning painAdd Zhi Mu, Huang Bai to clear deficiency heat
Night sweatsAdd Mu Li, Fu Xiao Mai to stabilize the exterior
DizzinessAdd Tian Ma, Gou Teng to extinguish Wind
InsomniaAdd 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.

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