Headache






Prescription



Main formula



Chuan xiong cha tiao san


Ligusticum–Green Tea Regulating Powder. This formula is very good for treating headache due to invasion of Wind-Cold. Gui Zhi Ramulus Cinnamomi 6g and Ge Gen Radix Puerariae 10g, etc, should be added to relieve the External symptoms.


Alternative formulas



Jing fang bai du san


Schizonepeta and Ledebouriella Powder to Overcome Pathogenic Toxin. This formula is better than the above at dispelling External Wind and eliminating the Cold so as to relieve the External symptoms in general. However, its effect in treating headache is not sufficient, therefore, Bai Zhi Radix Angelicae Dahuricae 10g and Man Jing Zi Fructus Viticis 10g, etc. could be added to relieve the headache.


Ge gen tang


Pueraria Decoction.This formula has good properties which dispel Wind-Cold, harmonise the collaterals and relieve the neck pain, mainly indicated in headache in association with much neck pain. Qiang Huo Rhizoma seu Radix Notopterygii 10g, Du Huo Radix Angelicae Pubescentis 10g and Chuan Xiong Radix Ligustici Wallichii 10g could be added to the prescription to relieve the headache.


Gui zhi tang


Cinnamon Twig Decoction. This formula can dispel Wind-Cold and relieve the External symptoms. When it is used to treat headache, Qiang Huo Rhizoma seu Radix Notopterygii 10g, Chuan Xiong Radix Ligustici Wallichii 10g and Xi Xin Herba Asari 3g could be added to relieve the headache.


Modifications





1. If there is a strong aversion to cold, add Wu Zhu Yu Fructus Evodiae 5g to warm the channels and dispel the Wind-Cold


2. If there is fever, add Ma Huang Herba Ephedrae 10g to promote the sweating, regulate the Qi circulation and dispel the Cold to reduce the fever


3. If there is body pain, add Xi Xian Cao Herba Siegesbeckiae 10g to promote the Qi circulation and relieve the pain


4. If the nose is stuffed up, with a discharge, add Cang Er Zi Fructus Xanthii 10g and Xin Yi Flos Magnoliae 10g to dispel the Wind and clear the nasal passage.


Patent remedy


Chuan Xiong Cha Tiao Wan Ligusticum and Green Tea Regulating Pill







Main Points


LU-7 Lieque, LI-4 Hegu, TE-5 Waiguan, GB-20 Fengchi, GB-21 Jianjing, BL-10 Tianzhu and some Ah Shi points. All the points are needled with reducing method. Moxibustion is used on the first three points.


Explanations





▪ LU-7, the Connecting point of the Lung channel, dispels Wind-Cold, stops the cough and relieves the headache.


▪ LI-4, the Source point of the Large Intestine channel, promotes the sweating, regulates the Qi circulation and relieves the headache.


▪ TE-5, the Connecting point of the Triple Burner channel, dispels the Wind, harmonises the Less Yang channels, regulates Qi circulation and relieves the headache.


▪ GB-20 is the crossing point of the foot Lesser Yang channel and Yang Linking Vessel. It is one of the patent points to dispel Wind and regulate the Qi circulation. It is good at treating the headache caused by Wind-Cold.


▪ GB-21, the crossing point of the hand and foot Lesser Yang channel and Yang Linking Vessel, dispels Wind-Cold, regulates the circulation of Qi and relieves headache.


▪ BL-10, a local point, regulates the circulation of Qi and relieves the headache in the Bladder channel distribution area.


▪ The Ah Shi points promote the circulation of Qi on the head to relieve the headache.


▪ Moxibustion warms the channels and collaterals, dispels the Cold and relieve the pain.


Alternative points


Extra Taiyang, Extra Yintang, GB-8 Shuaigu, GB-14 Yangbai, BL-9 Yuzhen, BL-11 Dazhu, BL-60 Kunlun, BL64 Jinggu, BL-65 Shugu and BL-66 Zutonggu, etc.


Modifications





1. If there is an aversion to cold, add ST-36 with moxibustion to warm the channels and dispel the Cold


2. If there is a fever, add GV-14 to dispel the Wind and reduce the fever


3. If there is body pain, add LR-3 and BL-58 to promote the circulation of Qi, dispel the Wind and relieve the pain


4. If there is a stiff neck, add SI-3 and BL-62 to promote the circulation of Qi and relieve the stiff neck


5. If there is a stuffed-up nose with a discharge, add LI-20 and GV-23 to dispel the Wind and clear the nasal passage.





A 39-year-old man had suffered from occipital headache for 2 weeks. The pain developed after he had caught a cold. It was diagnosed as neurotic headache in a hospital and he was given some painkillers. He had no relief from this, so he asked for TCM treatment.

When he arrived at the clinic, he had severe headache in the occipital region, a stiff neck, a slight aversion to cold, a poor appetite, and a stuffed-up nose with a clear discharge. His tongue was white, and his pulse was superficial and wiry.


Diagnosis


Headache due to invasion of Wind-Cold.


Principle of Treatment


Warm channels, eliminate External Cold and relieve the headache.


Herbal Treatment




Chuan xiong cha tiao san





Ligusticum and Green Tea Regulating Powder


Chuan Xiong Rhizoma Ligustici Chuanxiong 10g


Jing Jie Herba Schizonepetae 6g


Fang Feng Radix Ledebouriellae 6g


Bai Zhi Radix Angelicae Dahuricae 6g


Xi Xin Herba Asari 3g


Gan Cao Radix Glycyrrhizae 5g


Qiang Huo Rhizoma Seu Radix Notopterygii 10g


Cha Ye Folium Camelliae Sinensis 3g


Gui Zhi Ramulus Cinnamomi 10g


Ge Gen Radix Puerariae 10g


Explanations





▪ Chuan Xiong, Ge Gen and Qiang Huo dispel Wind-Cold and sedate headache


▪ Gui Zhi, Bai Zhi and Xi Xin work as assistants to warm the channels and relieve the headache


▪ Jing Jie and Fang Feng dispel Wind and release the external symptoms


▪ Cha Ye dispels Wind and calms the Mind


▪ Gan Cao harmonises the actions of the other herbs in the formula.

The patient received daily herbal treatment. He had recovered from headache after 1 week of treatment. Two years later, he was followed up and he stated that he completely recovered after the herbal treatment.





Invasion of Wind-Heat



Symptoms and signs


Distending headache with hot or burning feeling, fever, an aversion to wind, red face and eyes, thirst, nasal obstruction, a runny nose with a yellow discharge, a sore throat, constipation, a red tip of the tongue and a yellow coating, a superficial and rapid pulse are the symptoms and signs of Wind-Heat.


Principle of treatment


Dispel the Wind, clear the Heat and relieve the headache.





Prescription



Main formula



Ju hua cha tiao san


Chrysanthemum Powder to be Taken with Green Tea. This formula is based upon CHUAN XION GCHA TIAO SAN by adding Ju Hua Flos Chrysanthemi 10g and Jiang Can Bombys Batryticatus 10g. Sang Ye Folium Mori 10g, etc., could be added to relieve the headache.


Alternative formulas



Xiong zhi shi gao tang


Cnidium, Angelica and Gypsum Decoction. This formula has properties which dispel the Wind, clear the Heat and relieve the headache due to invasion of Wind-Heat with predominance of Heat. Sang Ye Folium Mori 10g, Jin Ying Hua Flos Lonicerae 10g and Sheng Di Huang Radix Rehmanniae 10g could be added to relieve the neck pain.


Chai ge jie ji tang


Bupleurum and Kudzu Decoction to Release the Muscle Layer. This formula has strong properties which dispel the Wind, clear the Heat and relieve the headache. Shi Gao Gypsum Fibrosum is very cold in nature, so if there is no high fever, this herb could be left out. If there is little or no cough, then Jie Geng Radix Platycodi could be left out.


Modifications





1. If there is a severe headache, add Man Jing Zi Fructus Viticis 10g to dispel the Wind-Heat and sedate the headache


2. If there is a stiff neck, add Ge Gen Radix Puerariae 15g to dispel the Wind and relieve the neck stiffness


3. If there is a high fever, add Shi Gao Gypsum 30g to clear the Heat and reduce the fever


4. If the throat is red and painful, add Zhe Bei Mu Bulbus Fritillariae Thunbergii 10g and Pu Gong Ying Herba Taraxaci 10g to disperse the Lung-Qi, clear the Heat and benefit the throat


5. If there is a severe cough, add Qian Hu Radix Peucedani 10g and Niu Bang Zi Fructus Arctii 10g to disperse the Lung-Qi and relieve the cough


6. If there is much thirst, add Zhu Ye Herba Lophatheri 10g to clear the Heat in the Upper Burner and relieve the thirst


7. If there is severe constipation, add Da Huang Radix et Rhizoma Rhei 6g to clear the Heat, promote the defecation and relieve the constipation.


Patent remedy


Huang Lian Shang Qing Pian Coptis Tablet to Clear Heat of Upper Jia.






Main Points


ST-8 Touwei, Extra Taiyang, GV-23 Shangxing, GB-14 Yangbai, GB-20 Fengchi, LI-2 Erjian, LI-4 Hegu, LI-11 Quchi and TE-5 Waiguan. All the points needled with reducing method.


Explanations





▪ ST-8 is the crossing point of the Gallbladder channel of the foot Lesser Yang and Bright Yang. It is used to promote the Qi circulation and relieve the headache


▪ Extra Taiyang clears Heat, regulates the circulation of Qi and relieves the headache


▪ GV-23 is good at clearing Heat and regulating circulation of Qi in the head so as to relieve the headache


▪ GB-14 and GB-20 dispel the Wind, clear the Heat and relieve the headache.


▪ LI-4, the Source point of the Large Intestine channel, regulates the circulation of Qi, clears the Heat and relieves the headache


▪ LI-2 and LI-11, the Spring point and the Sea point of the Large Intestine channel respectively, reduces the Heat, reduce the fever and relieve the headache


▪ TE-5, the Connecting point, dispels Wind-Heat, promotes circulation of Qi and relieves the headache.


Alternative points


LU-7 Lieque, Extra Yintang, GB-8 Shuaigu, BL-10 Tianzhu, BL-12 Fengmen, BL-58 Feiyang, BL-60 Kunlun, BL63 Jinmen, BL-65 Shugu and BL-66 Zutonggu, etc.


Modifications





1. If there is a severe headache, add some Ah Shi point on the head to dispel the Wind-Heat and sedate the headache


2. If there is high fever, add GV-14 to clear the Heat and reduce the fever


3. If there is severe obstruction in the nose, add LI-20 to disperse the Lung-Qi and relieve the nasal obstruction


4. If there is a runny nose with much nasal yellow discharge, add BL-2 to clear the Heat, eliminate the phlegm and clear the nasal passage


5. If there is much thirst, add SP-6 to clear the Heat, promote the secretion of Body Fluid and relieve the thirst


6. If there is a severe sore throat with swelling, add LU-10 to clear the Heat, subside the swelling and relieve the throat pain


7. If there is severe constipation, add ST-25 to promote the defecation and so relieve the constipation.


Invasion of Wind-Damp



Symptoms and signs


Acute occurrence of headache with a heavy sensation, a feeling as though the head is wrapped in a piece of cloth, an aversion to cold, slight fever, lassitude, a sense of fullness in the chest, generalised body pain with a sensation of heaviness, a poor appetite, a sense of fullness in the stomach, a white and greasy tongue coating and a slippery and superficial pulse are the signs and symptoms of this condition.


Principle of treatment


Dispel the Wind, eliminate the Damp and relieve the headache.





Prescription



Main formula



Qiang huo sheng shi tang


Notopterygium Dispelling Dampness Decoction. This formula is very effective at treating headache due to invasion of Wind, Cold and Damp. Xi Xin Herba Asari 3g could be added into this formula to strengthen the effect of pain relieving.


Alternative formulas



Juan bi tang


Remove Painful Obstruction Decoction. This formula has a good function for dispelling External Wind, eliminating Damp, promoting the Qi and Blood circulation and relieving the pain. Chuan Xiong Radix Ligustici Wallichii 10g, Xi Xin Herba Asari 5g and Man Jing Zi Fructus Viticis 10g should be added to relieve the headache.


Ma huang fu zi xi xin tang


Ephedra, Prepared Aconite, and Asarum Decoction. Although this formula is mainly used to treat External symptoms due to invasion of Wind-Cold with deficiency of Yang, it has also string function to relieve the body pain and headache due to invasion of Wind, Cold and Damp.

Chuan Xiong Radix Ligustici Wallichii 10g, Qiang Huo Rhizoma seu Radix Notopterygii 10g and Du Huo Radix Angelicae Pubescentis 10g should be added into the prescription to relieve the headache.


Modifications





1. If there is a heavy sensation in the body, add Cang Zhu Rhizoma Atractylodis 10g to dry the Damp and relieve the pain


2. If there is lassitude, add Xiang Ru Herba Elsholtziae seu Moslae 10g and Hou Po Cortex Magnoliae Officinalis 10g to promote the Qi circulation in the body and dry the Damp


3. If there is a sense of fullness in the chest, add Bai Kou Ren Semen Amomi 5g to promote the Qi circulation in the chest and relieve the fullness in the chest.


4. If there is nausea or vomiting, add Huo Xiang Herba Agastachis 10g to hamonise the Stomach, descend the Stomach-qi and relieve the vomiting


5. If there is a poor appetite, add Ji Nei Jin Endothelium Corneum Gigeriae Galli 15g and Mai Ya Fructus Hordei Germinatus 30g to improve the appetite and promote the digestion


6. If there are loose stools, add Cang Zhu Rhizoma Atractylodis 10g and Hou Po Cortex Magnoliae Officinalis 10g to activate the Spleen and dry the Damp.


Patent remedy


Qiang Huo Sheng Shi Pian Notopterygium Dispelling Dampness Tablet.






Main Points


LU-7 Lieque, TE-4 Yangchi, TE-6 Zhigou, LI-4 Hegu, GB-20 Fengchi, SP-9 Yinlingquan, SP-6 Sanyinjiao and Ah Shi points on the head. All the points are needled with even method.


Explanations





▪ LU-7, the Connecting point of the Lung channel, promotes the circulation of Qi, eliminates Damp in the Upper Burner and relieves the headache


▪ TE-4, the Source point of the Triple Burner channel, together with TE-6, dispels Wind-Damp, promotes urination and relieves the headache


▪ LI-4, the Source point of the Large Intestine channel, dispels Wind-Damp, regulates the circulation of Qi and relieves the headache


▪ GB-20, the crossing point of the foot Lesser Yang channel and Yang Linking Vessel, dispels External pathogenic factors, promotes the circulation of Qi and relieves the headache


▪ SP-6, the crossing point of three Yin channels of the foot, and SP-9, the Sea point of the Spleen channel, promote the circulation of Qi and eliminate the Damp in the body and in the head


▪ The Ah Shi points regulate the Qi circulation, harmonise the local collateral and relieve the headache.


Alternative points


Extra Yintang, BL-2 Zanzhu, BL-10 Tianzhu, BL-12 Fengmen, BL-58 Feiyang, BL-60 Kunlun, BL63 Jinmen, GB-8 Shuaigu, ST-40 Fenglong, CV-12 Zhongwan and GB-34 Yanglingquan, etc.


Modifications





1. If there is a sense of heaviness in the body, add SP-3 to activate the Spleen and eliminate the Damp


2. If there is severe lassitude, add ST-36 to activate the Spleen and Stomach, eliminate the Damp and relieve the lassitude


3. If there is a sense of fullness in the chest, add PC-6 and CV-17 to regulate the Qi circulation in the chest and relieve the sense of fullness


4. If there is a poor appetite, add ST-42 to regulate the Qi circulation in the Stomach and improve the appetite


5. If there is severe diarrhoea, add ST-25 to eliminate the Damp, regulate the Large Intestine and relieve the diarrhoea.


Invasion of Toxic Fire



Symptoms and signs


Severe headache that is sharp or with a sense of distension and hot or burning, a red face or even swollen face and eyes, high fever, thirst, irritability or even coma, a stiff neck, convulsion, delirium, constipation, deep yellow urine, a dark reddish purple tongue and a rapid pulse are the signs and symptoms of Toxic-Fire invasion.


Principle of treatment


Clear the Heat, reduce the fever, remove the Toxin, cool the Blood and relieve the headache.





Prescription



Main formula



Pu ji xiao du yin


Universal Benefit Decoction to Eliminate Toxin. This formula has strong functions which clear the Heat, remove the Toxin and reduce the swelling. When it is used to treat headache, some other herbs could be added, such as Jin Yin Hua Flos Lonicerae Japonicae 10g, Pu Gong Ying Herba Taraxaci Mongolici cum Radice 10g, Ye Ju Hua Flos Chrysanthemi Indici 10g and Man Jing Zi Fructus Viticis 10g to clear the Heat, remove the Toxin and relieve the headache.


Alternative formulas



Wu wei xiao du yin


Five-Ingredient Decoction to Eliminate Toxin. This formula has good properties for eliminating the Toxin and reducing the swelling. Man Jing Zi Fructus Viticis 10g and Qing Xiang Zi Semen Celosiae Argenteae 10g, etc., could be added to relieve the headache.


Huang lian jie du tang


Coptis Decoction to Relieve Toxicity. This formula is good for clearing the Toxin, reducing the Fire and subsiding the swelling. This kind of Toxic Fire is formed internally, usually not from External invasion. Jin Yin Hua Flos Lonicerae Japonicae 10g, Man Jing Zi Fructus Viticis 10g and Qing Xiang Zi Semen Celosiae Argenteae 10g, etc., could be added to relieve the headache.


Modifications





1. If there is coma, add An Gong Niu Huang Wan Calm the Palace Pill with Cattle Gallstone (patent pill, 1 pill a day) to the recipe to open the Heart orifice and revive the patient


2. If there is high fever, add Zi Xue Dan Purple Snow Special Pill (patent pill, 1 pill a day) to the recipe to clear the Heat and reduce the fever


3. If there is convulsion, add Gou Teng Ramulus Uncariae cum Uncis 10g and Jiang Can Bombyx Batryticatus 10g to subdue the Liver-Wind and relieve the convulsion


4. If there is a severe thirst, add Mai Dong Radix Ophiopogonis 10g and Xuan Shen Radix Scrophulariae 10g to nourish the Body Fluids and relieve the thirst


5. If the face is swollen, add Jin Yin Hua Flos Lonicerae 10g and Tian Hua Fen Radix Trichosanthis 15g to eliminate the Toxin and reduce the swelling.


Patent remedy


Niu Huang Jie Du Pian Cattle Gallstone Tablet to Resolve Toxin.






Main Points


GV-20 Baihui, GB-8 Shuaigu, GB-20 Fengchi, GB-21 Jianjing, GB-43 Xiaxi, LI-4 Hegu, LI-11 Quchi, TE-6 Zhigou, SP-6 Sanyinjiao, HT-3 Shaohai, BL-17 and LR-2 Xingjian. All the points are needled with reducing method.


Explanations





▪ GV-20, the crossing point of the foot Greater Yang channel and Governing Vessel Channel, and GB-20, the crossing point of the foot Lesser Yang channel and Yang Linking Vessel, clear Heat in the head, and calm the headache.


▪ GB-8 and GB-21 clear the Heat in the head and relieve the headache.


▪ LI-4, the Source point, and LI-11, the Sea point, of the Large Intestine channel, together with TE-6, clear the Heat, eliminate Toxin, reduce fever and relieve the headache.


▪ SP-6, the crossing point of the three Yin channels of the foot, and SP-10 clear Heat in the Blood, eliminate toxin and relieve the headache.


▪ LR-2 and GB-43, the Spring points, together with HT-3 and BL-17 clear the Heat in the Liver, suppress the Liver-Yang and relieve the headache.


Alternative points


Extra Yintang, TE-4 Yangchi, TE-22 Erheliao, TE-23 Sizhulong, GB-3 Shangguan, GB-5 Xuanlu, GB-16 Muchuang and HT-8 Shaofu, etc.


Modifications





1. If there is a high fever, add GV-14 to clear the Heat and reduce the fever


2. If there is a severe stiff neck, add SI-3 to regulate the Qi and Blood circulation and relieve the neck stiffness


3. If there is restlessness, add PC-8 to clear the Heat in the Heart and calm the Mind


4. If there is coma, add GV-26 and KI-1 to clear the Heat and revive the patient


5. If there is a severe thirst, add KI-6 to clear the Fire and nourish the Yin so as to relieve the thirst


6. If there is a severe constipation, add ST-25 to clear the Fire and promote the defecation.


Stagnation of Liver-Qi



Symptoms and signs


Gradual occurrence of headache, sensation of pressure and tension in the head, which starts or gets worse under stress or emotional disturbance, depression, distension and pain in the hypochondriac region, dizziness, irregular menstruation, a poor appetite or excessive eating, a thin and white tongue coating and a wiry pulse.


Principle of treatment


Smooth the Liver, promote Liver-Qi circulation and relieve the headache.





Prescription



Main formula



Xiao yao san


Free and Relaxed Powder. This formula harmonises the Liver, smoothes the emotions and relieves the headache. Chuan Xiong Radix Ligustici Wallichii 10g and Man Jing Zi Fructus Viticis 10g should be added to relieve the headache.


Alternative formulas



Chai hu shu gan san


Bupleurum Soothing the Liver Powder. This formula has properties which promote the Qi circulation and relieve the pain; however, its main function is to relieve the pain in the Interior Zang-Fu organs. When this formula should be used to treat headache, Chuan Xiong Radix Ligustici Wallichii 10g and Man Jing Zi Fructus Viticis 10g should be added.

Jun 19, 2016 | Posted by in PAIN MEDICINE | Comments Off on Headache

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