Articles

Migraine

Related Health Condition

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Introduction

Traditional Chinese medicine holds that migraine is caused by blockage of channels and collaterals, imbalance between yin and yang, and disorder of qi and blood in the head due to exopathic wind, cold, dampness, and heat or internal injury.

Primary Treatments with Chinese Medicinal Herbs

Chuan Xiong Cha Tiao San

Ingredients: Chuan Xiong (Cnidium), Jing Jie (Schizonepeta), Bai Zhi (Angelica), Qiang Huo (Notopterygium Root), Gan Cao (Licorice), Xi Xin (Wild Ginger), Fang Feng (Siler), and Bo He (Mentha)

Clinical Application:
Yang, et al. treated 57 cases of migraine a modification of this formula. The modified formula consisted of Chuan Xiong (Cnidium), Bai Zhi (Angelica), Qiang Huo (Notopterygium Root), Xi Xin (Wild Ginger) and Gan Cao (Licorice). One dose of the formula in decoction (300ml) was taken per day (equally divided into two portions to be taken in the morning and in the evening). The results: 24 cases resolved, 21 cases much improved, 5 cases improved, and the remaining 7 cases did not respond to the treatment, with a total effective rate of 87.7%. (1)

In another study, Chuan Xiong Cha Tiao San was used to treat 168 cases of migraine of the deficiency type, and it was reported that 72.2% of the patients significantly improved, another 23.21% improved. (2)

Hu, et al. treated 65 cases of migraine with this formula and modified Qing Zhen Tang. The herbs used were Chuan Xiong (Cnidium), Dan Shen (Salvia), Bai Zhi (Angelica), Fang Feng (Siler), Grassleaved Sweetflag Rhizome (Rhizoma Acori Graminei), Qiang Huo (Notopterygium Root), Atractylodes (Rhizoma Atractylodis), Xi Xin (Wild Ginger), Cimicifuga (Rhizoma Cimicifugae), and Gan Cao (Licorice). The decoction was taken one dose a day for 10 days. The results: 20 cases resolved, 25 cases much improved, 16 cases improved, and the remaining 4 cases did not respond to the treatment, with a total effective rate of 93.9%. (3)

Yang treated 80 cases of headache with a modification of this formula, and reported that 30 cases resolved, 31 cases much improved, 18 cases improved, and the remaining 1 case did not respond to the treatment. (4)

Wang treated 54 cases of nervous headache with a modification of this formula. The modified formula consisted of Chuan Xiong (Cnidium), Dan Shen (Salvia), Jing Jie (Schizonepeta), Fang Feng (Siler), Qiang Huo (Notopterygium Root), Yan Hu Suo (Corydalis Tuber), Bai Zhi (Angelica), Bo He (Mentha), and Xi Xin (Wild Ginger). One dose in decoction was taken daily (administered at half-dose portions twice a day), and 7 days comprised one course of treatment. The results: 16 cases resolved, 21 cases much improved, 14 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effective rate of 94.4%. (5)

Yao treated 19 cases of headache due to internal injury with Chuan Xiong Cha Tiao San plus Wu Gong (Centipede) or Quan Xie (Scorpion) and Jiang Can (Silkworm). The formula was modified to suit individual patients’ symptoms. One dose of the formula in decoction was equally divided into 3 portions for oral administration, a dose per day for 2-15 days resolved the headache in all of the patients. A 2-year follow-up found that one relapse occurred in 3 cases and two relapses occurred in 2 cases. The headaches again resolved after all the patients had taken the formula again. (6)

Liao treated 150 cases of headache with a modification of this formula featuring large-dose use of Chuan Xiong (Cnidium). After taking 3-30 doses, 142 cases resolved, 6 cases improved, and the remaining 2 cases did not respond to the treatment. (7)

Wang, et al. treated 56 cases of angioneurotic headache with modified Chuan Xioang Cha Tiao San. The decoction was taken one dose a day or 3 doses every two days for severe cases. The results: 38 cases resolved, 14 cases much improved, and the remaining 4 cases improved. (8)

Tan treated 52 cases of angioneurotic headache with a modification of this formula. The modified formula consisted of Chuan Xiong (Cnidium), Jing Jie (Schizonepeta), Bo He (Mentha), Ku Ding (Herba Lactucae Taiwanianae), Bai Zhi (Angelica), Qiang Huo (Notopterygium Root), Fang Feng (Siler), Gan Cao (Licorice), and Xi Xin (Wild Ginger). For patients with blood stasis, the formula Xu Fu Zhu Yu Tang was also prescribed; for patients with damp-heat in the liver channel, the formula Dan Zhi Xiao Yao San was also prescribed; and for patients with phlegm-dampness, the formula Bai Xia Bai Zhu Tian Ma Tang was also prescribed. The decoction was equally divided into 2 portions for taking, one dose a day. A 30-day course of treatment resulted in headache resolution in 16 cases, significant improvement in 19 cases, improvement in 12 cases, no effect in 5 cases, with a total effective rate of 90.4%. (9)

Zhang, et al. treated 88 cases of angioneurotic headache with a modification of this formula. The modified formula consisted of Chuan Xiong (Cnidium), Jing Jie (Schizonepeta), Fang Feng (Siler), Bai Zhi (Angelica), Ge Gen (Pueraria Root), Xi Xin (Wild Ginger), Ju Hua (Chrysanthemum), Dan Shen (Salvia), Bai Shao (White Peony Root), and Gan Cao (Licorice). The decoction was taken one dose per day. The results: 70 cases recovered, 12 cases improved, and the remaining 6 cases did not respond to the treatment. (10)

Xue treated 58 cases of angioneurotic headache with this formula, and reported that 27 cases recovered, 14 cases much improved, another 14 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effective rate of 94.8%. (11)

Other Treatments with Chinese Medicinal Herbs

Chuan Xiong, Bai Shao, Di Long, Man Jing Zi, Bai Zhi, Gan Cao, Chai Hu, and Xi Xin

In treating 76 cases of migraine, Zhao adopted the differentiation treatment principle. The patients were divided into 5 categories: of retention of blood stasis, stagnation of phlegm, deficiency of both qi and blood, wind and fire in the liver and gallbladder, and deficiency of lower pylorus. The basic formula consisted of Chuan Xiong (Cnidium), Bai Shao (White Peony Root), Di Long (Earthworm), Man Jing Zi (Vitex Fruit), Bai Zhi (Dahurian Angelica Root), Gan Cao (Licorice Root), Chai Hu (Bupleurum Root), and Xi Xin (Asarum Herb), and modifications were made to suit individual patients’ symptoms. The results: 50 cases recovered, 24 cases improved, and the remaining 2 cases did not respond to the treatment, with a total effective rate of 97.4%. (12)

Pian Tong Fang

Lin treated 40 cases of migraine with Pian Tong Fang. The formula consisted of Chuan Xiong (Cnidium), Dang Gui (Chinese Angelica Root), Wu Zhu Yu (Evodia Fruit), Bai Zhi (Dahurian Angelica Root), Xi Xin (Asarum Herb), and Qiang Huo (Notopterygium Root). A comparison group of 30 cases was treated with Nimodipine 20mg, 3 times a day, for 3 months. The results: of the treatment group, 10 cases had the symptoms brought under control, 20 cases significantly improved, 8 cases improved, and the remaining 2 cases did not respond to the treatment, with a total effective rate of 95%; of the comparison group, the corresponding numbers were 2, 7, 14, 7, and 76.67%. (13)

Chai Hu Shu Gan San modification

Liang treated 66 cases of migraine with modified Chai Hu Shu Gan San. The formula consisted of Chai Hu (Bupleurum Root), Zhi Qiao (Bitter Orange), Chuan Xiong (Cnidium), Bai Shao (White Peony Root), Xiang Fu (Cyperus Tuber), and Gan Cao (Licorice Root). The formula was modified to suit individual patients’ symptoms. The results: 40 cases recovered, 15 cases significantly improved, 8 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effective rate of 95.5%. (14)

Tong Qiao Huo Xue Tang

Ou used Tong Qiao Huo Xue Tang to treat 50 cases of migraine due to blood stasis in the brain. A comparison group of 40 cases was treated with Nimodipine tablets, etc. The results: of the treatment group, 36 cases recovered, 10 significantly improved, and the remaining 4 cases did not respond to the treatment, with a total effective rate of 92%; of the comparison group, the corresponding numbers were 17, 10, 13, and 67.5% (P

Other Treatments

Massage
Zhuang, et al. treated 32 cases of migraine with massage on the underside of the foot. Reflection areas for nerve plexus in the abdominal cavity, kidney, bladder, ureter, and lymphatic glands were massaged for 20-30 minutes daily. A comparison group of 30 cases were treated with Western medicine. Two weeks comprised one course of treatment for both groups. After 2 courses of treatment, of the treatment group, 6 cases recovered, 22 improved, and the remaining 4 did not respond to the treatment, with a total effective rate of 88.75%; of the comparison group, the corresponding numbers were 2, 18, 10, and 66.67% (P

Acupunture & Acupressure

Acupuncture
Wang treated 60 cases of migraine with acupuncture. The acupoints selected for treatment were Bai Hui (Du 20), Shang Xing (Du 23), Feng Chi (GB 20), Tai Yang (Extra 2), Tai Zhong (Sp 3), and Lie Que (Lu 7). Gentle and slow twirling manipulation was used and the needles were retained for 20 minutes. The procedure was performed once a day, and 10 sessions constituted one course of treatment. After 1-3 courses of treatment, 32 cases recovered, 17 cases improved, and the remaining 11 cases did not respond to the treatment, with a total effective rate of 95% (the effective rate was 94.1% for those with a less-than-3-year illness history, 86.7% for those with an illness history between 4 and 10 years, and 71.4% for those with an illness history longer than 11 years). (15)

Zhan et al. treated 35 cases of migraine with acupuncture on the bilateral acupoint Lie Que (Lu 7). The needles were inserted obliquely 0.5-1 cun (1.65-3.3cm) deep. The reducing method was used to provide strong stimulation, and the needles were retained for 30 minutes. The results: 18 cases recovered, 9 cases significantly improved, 5 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effective rate of 91.4%. (16)

Blood-pricking therapy
Ye treated 50 cases of migraine with blood-pricking therapy. The acupoints treated were Tai Yang (Extra 2), Tou Wei (St 8), Han Yan (GB 4), Xuan Lu (GB 5), Xuan Li (GB 6), Qu Bin (GB 7), etc. 1-2 points on the affected side were treated in each session. Gentle patting was applied to cause local hyperemia. Subcutaneous vein was rapidly pricked with a prismatic needle to bleed about 1-2ml. The procedure was conducted once every 2-3 days, and seven sessions constituted one course of treatment. The results: 40 cases recovered, 5 cases significantly improved, 3 cases improved, and the remaining 2 cases did not respond to the treatment, with a total effective rate of 96%. (17)

Acupuncture combined with acupoint injection therapy
Weng treated 130 cases of migraine with acupuncture and liquid-acupuncture on Jen Ying (St 9), Feng Chi (GB 20), Tai Yang (Extra 2), Tou Wei (St 8), Wai Guan (SJ 5), and Di Wu Hui (GB 42). The uniform reinforcing-reduction method was used, and the needles were retained for 30 minutes. After the needles had been withdrawn, Vitamin B12 was injected at both sides of Jen Ying (St 9) (0.25mg each side). The treatment was repeated once a day or every other day, and 10 days constituted one course of treatment. The study reported a total effective rate of 93.8%. (18)

Mild Moxibustion therapy
Zhu et al. treated 62 cases of senile obstinate migraine with mild moxibustion on Zu San Li (St 36), Chi Hai (Ren 6), San Yin Jiao (Sp 6), Tai Xi (K 3), and Shen Shu (UB 23). During remission, 2-4 of the above-mentioned points were selected each time for moxibustion (3 cones for each acupoint), and when a migraine attack is under way, acupuncture treated was applied on Ah Shi point, Feng Chi (GB 20), Tou Wei (St 8), and Shuai Gu (GB 8). The acupuncture treated was repeated daily, and 10 sessions constituted one course of treatment. After 4-6 courses of treatment, 7 cases recovered, 28 cases significantly improved, 17 cases improved, and the remaining 10 cases did not respond to the treatment, with a total effective rate of 83.9%. (19)

Otopoint plaster therapy
Want treated 13 cases of menstrual migraine with otopoint plaster therapy. Points of the liver, gallbladder, forehead, and Tai Yang (Extra 2) were selected for Shao Yang headache. Points of the liver, spleen, stomach, and eye were selected for Yang Ming headache. And Shen Men (H 7), and point related to the subcortical system, sympathetic nerve, endocrine, and the kidney were treated for both types of headaches. 3-5 days before menstruation, Wang Bu Liu Xing (Vaccaria) seed was plastered onto the above points every other day till the end of the menstrual cycle. One menstrual period comprised one course of treatment. The study reported satisfactory therapeutic effect in all 13 cases. (20)

References

  1. Yang Quan Ci, et al. Treating 57 cases of migraine with modified Chuan Xiong Cha Tiao San. Journal of Anhui College of TCM. 1999;18(1):31.
  2. Zhang Bing Hou, et al. Treating 168 cases of migraine of the deficiency type with Chuan Xiong Cha Tiao San. Journal of Beijing TCM University. 1994;17(4): 252-255.
  3. Hu Jian Qiu, et al. Treating 65 cases of migraine with modified Chuan Xiong Cha Tiao San and Qing Zhen Tang. Yunnan Journal of TCM and Chinese Drug. 1999;20(1):27.
  4. Mei Qing Wen. Treating 80 cases of headache with modified Chuang Xiong Cha Tiao San. Fuzhou Journal of Medicine and Drugs. 1997;27(1):17-18.
  5. Wang Li Zhao. Treating nervous headache with modified Chuan Xiong Cha Tiao San. Shandong Journal of TCM. 1989;8(5): 51.
  6. Yao Xiu Qin. Treating 19 cases of headache due to internal injury with Chuan Xiong Cha Tiao San. Shandong Journal of TCM. 1989;8(2):23-24.
  7. Liao Xiu Ying. Treating 150 cases of headache with Chuan Xiong Cha Tiao San. Jiangxi Journal of TCM. 1992;23(6):367.
  8. Wang Dao Xuan, et al. Treating 56 cases of angioneurotic headache with Chuan Xiong Cha Tiao San. Henan Journal of TCM Pharmacy. 1994;(5):21-22.
  9. Tan Xian Xian. Treating 52 cases of angioneurotic headache with Chuan Xiong Cha Tiao San. Zhejiang Journal of Traditional Chinese Medicine. 1998;33(2):61.
  10. Zhang Yu Hua, et al. Treating 88 cases of angioneurotic headache with Chuan Xiong Cha Tiao San. Journal of Shizhen Medicine. 1999;10(8):607.
  11. Xue Tang Yu. Treating 58 cases of angioneurotic headache with Chuan Xiong Cha Tiao San. Shanxi Journal of TCM. 1999;15(6):16-17.
  12. Zhao Guo Xiu. Treatment of migraine: The differentiation theory-guided approach. Beijing Journal of TCM. 2000;(2):41-42.
  13. Lin Bai Rong. Clinical observation on Bian Tong Fang (migraine formula’s) treatment for migraine. Shanghai Journal of Traditional Chinese Medicine. 2000;34(8):18-20.
  14. Liang Guang Yi. Treating 66 cases of migraine with modified Chai Hu Shu Gan San. Beijing Journal of TCM. 1998;17(1):48.
  15. Wang Zhan Hua. Therapeutic observation on acupuncture treatment for 60 cases of migraine. Hebei Journal of TCM. 1999;21(2):108.
  16. Zhan Jin Shan, et al. Treating 35 cases of migraine with acupuncture of Lie Que. Journal of Acupuncture Clinical Application. 1999;15(5):44.
  17. Ye Qing Qing. Observation on treating 50 cases of migraine blood-pricking method. Journal of Applied TCM. 1999;15(7):31.
  18. Weng Xi Ya. Clinical observation on treating migraine with acupuncture plus point-injection therapy. China Journal of Village Medicine. 1998;5(2):14-15.
  19. Zhu Guo Xiag, et al. Treating 62 cases of senile obstinate migraine with mild moxibustion. Zhejiang Journal of Traditional Chinese Medicine. 1999;34(5):212.
  20. Wang Chuan Dao. Treating 13 cases of migraine during menstruation with Auricular plaster therapy. Journal of Acupuncture Clinical Application. 1998;14(7):24.