基于“不通则痛”理论浅析原发性三叉神经痛病因病机

Exploring the Etiology and Pathogenesis of Primary Trigeminal Neuralgia Based on the Theory of “No Pain without Obstruction”

摘要: 原发性三叉神经痛(Primary Trigeminal Neuralgia, PTN)是发生于颜面部的一种常见神经疼痛性疾病，严重影响人们的精神健康和生活质量，甚至会导致患者出现焦虑抑郁情绪，其病因病机尚不明确，中医认为其病因多与外因常感风寒、风热之邪，内因情志失调、痰瘀互结，以及不内外因如饮食失宜、久坐伤筋等因素相关。“不通则痛”是中医理论中的一个重要概念，它揭示了疼痛产生的基本病理机制，是中医解释和治疗疼痛性疾病的核心理论之一。本文将以“不通则痛”理论为指导，从外因、内因及不内外因等角度浅析原发性三叉神经痛的病因病机，以期为该病的临床研究及诊疗提供新思路。

Abstract: Primary Trigeminal Neuralgia (PTN) is a common neuropathic pain disorder that occurs in the facial region, severely affecting people’s mental health and quality of life, and may even lead to anxiety and depression in patients. The etiology and pathogenesis of PTN are still not fully understood. In traditional Chinese medicine, the etiology is believed to be related to several factors. Externally, it is often associated with the invasion of pathogenic factors such as wind-cold and wind-heat. Internally, it can be due to the disharmony of emotions, the interconnection of phlegm and blood stasis. Additionally, other factors that are neither purely external nor internal, such as improper diet and prolonged sitting that injures the tendons, are also considered relevant. The concept of “no pain without obstruction” is an important notion in Traditional Chinese Medicine (TCM), revealing the fundamental pathological mechanism of pain generation and serving as one of the core theories for TCM to interpret and treat painful diseases. This paper will explore the etiology and pathogenesis of primary trigeminal neuralgia from perspectives such as exogenous pathogenic factors, endogenous injuries, and neither exogenous nor endogenous factors guided by the theory of “no pain without obstruction”, in the hope of providing new ideas for the clinical research and treatment of this condition.