Why do you get migraines?

  Migraine is a common chronic neurovascular disorder with intermittent recurrent headaches mainly on one side, lasting about 2 to 72 hours at a time, and may be accompanied by visual, sensory, motor, emotional disturbances and gastrointestinal and other vegetative symptoms. Migraine is often divided into typical migraine with aura and common migraine. The pathogenesis of migraine is still unclear and may be related to genetic, endocrine, vascular factors, neurotransmitters, and immune factors.  Migraine is a primary headache with recurrent attacks. Its attacks are characterized by persistent throbbing head pain and lead to nausea and vomiting. Without preventive treatment, migraine increases the risk of complications, increasing the risk of ischemic stroke by 2.16 times and the risk of white matter abnormalities in the brain by 3.9 times, in addition to triggering major depression and phobic disorders. As a result, the World Health Organization has designated severe migraine as one of the most disabling chronic diseases, comparable to dementia, tetraplegia and severe mental illness.  In recent years, the global incidence of migraine is 8.4%-28%, with a higher incidence in women than in men. Epidemiological surveys show that the incidence of migraine is higher in Western countries, ranging from 10% to 15% in Europe and the United States, and 11% in the United States. The incidence of migraine is higher in women than in men, with the ratio of male to female patients being 1:2 to 3 in foreign countries and 1:4 in China, and the incidence of migraine is highest in whites, followed by African Americans and lowest in Asians (20.4%, 16.2% and 9.2% in women and similar ratios in men). Migraine attacks occur on average 1.5 times per month, with each attack lasting approximately 24 hours, and at least 10% of patients have weekly attacks. A survey in the United States in 2001 showed that 90% of people experienced at least 1 migraine; the incidence of migraine in Japan was 8.4%-12%, with an average attack frequency of 2.1±3.1 attacks/month and a duration of 9.3±7.6 hours/attack. There is a lack of relevant epidemiological data in China. It is reported that the incidence of migraine in China is 65.8/100,000 population (0.07%) and the incidence rate is 732.1/100,000 population (0.73%) after standardization of world population, and the ratio of men to women is 1:4. The incidence rate is the lowest under 10 years old, the highest from 25 to 29 years old, and gradually decreases with age after 30 to 50 years old. This survey indicates that China is a low-prevalence country for migraine. Of course, the above results are not comparable with foreign statistics because the current international diagnostic criteria for migraine are not used.  Despite the high incidence of migraine, even in the United States more than 50% of patients are not properly diagnosed and effectively treated because these patients believe that there is nothing doctors can do for migraine at this time. As medicine advances, more and more patients will likely be treated with medications that will eventually cure their migraines. Western medical treatment options for migraine include acute headache management, lifestyle modification, and preventive medication. Migraine is a common disease and its physiological etiology needs to be further investigated. It may be related to genetic, endocrine, vascular, neurotransmitter, immune, dietary and psychological factors. For acute migraine, aspirin, ibuprofen and naproxen are the most effective non-steroidal anti-inflammatory drugs. Ergotamines, selective 5-HT agonists, and adrenocorticosteroids have also been affirmed in the clinical treatment of migraine. The main drugs used for prophylactic migraine treatment are beta-blockers, antidepressants, calcium channel antagonists, and anticonvulsants. Although these oral medications are relatively easy to use, as chemical drugs they all bring some clinical toxicities. For example, repeated use of antipyretic and anti-inflammatory drugs may result in gastrointestinal symptoms such as nausea, vomiting, gastric mucosal bleeding, gastric ulcers, and bleeding tendencies and symptoms due to anti-platelet effects. The use of analgesic drugs is prone to tolerance and dependence, and drug-dependent headache may occur. Oral ergotamines have many adverse effects, including nausea, vomiting, increased headache, paresthesia, dizziness, and dry mouth. The efficacy of Western medicine in treating this disease is uncertain, with more toxic side effects and a high recurrence rate, while Chinese medicine is guided by a holistic concept, with abundant treatment means, precise efficacy and low recurrence rate, and has achieved a series of results in clinical aspects, and acupuncture, as a non-drug natural therapy, is getting more and more attention from the world. The history of acupuncture for migraine is very long, and it not only has positive clinical efficacy and safety, reduces the toxic side effects brought by some chemicals, but also has good social and economic benefits.  Migraine belongs to the category of headache and migraine head wind in Chinese medicine. In the Yellow Emperor’s Classic of Internal Medicine, there are records of “cerebral wind” and “first wind”, which call the acute and critical headache with clinical manifestation of severe headache radiating to the head and neck “true headache”; and the headache from the occipital region (back of the head) to the head. The headache that occurs from the occiput (back of the head) to the top of the skull (top of the head) and between the eyebrows is called “punch headache”, and at the same time, the types of headache are named according to the characteristics of the meridians in the head and their distribution, which pioneered the classification of headache diseases by meridians. In Zhang Zhongjing’s “Treatise on Typhoid”, there are records of headache in the six meridians of Sun disease, Yangming disease, Shaoyang disease and Jueyin disease. The causes of migraine are external sensation and internal injury, but internal injury is the main factor. The head is the meeting of clear yang, and the house of clear air, and the essence of the five organs and six bowels are all injected up here, so it is easy to be attacked by external evil. Taiyin Yangming Theory” cloud: “in the wind, on the first to suffer. Wind is “the longest of all diseases”, “the first of the six perversions”, and its feeling of external evil is mainly wind, mostly with cold, heat, moisture. Ling Shu? The “meridians” cloud: “the liver and feet of the fructus yin veins, starting from the hair of the big finger, …… hosts the stomach belongs to the liver and bile, on the diaphragm, cloth, after following the throat, into the fly down, even the eye system, out of the forehead, and the Governor’s vein will be at the top; its branches, from the eye system under the cheek, the ring lip inside… …”. The Liver meridian starts from the big toe of the foot, belongs to the liver, contacting the gall bladder, going up to connect the eye system, out of the forehead, and up to meet with the Governor’s vein at the top; the gall bladder is attached to the liver, the meridians are connected, and the gall bladder meridian is spread on both sides of the head. The liver and gallbladder meridians occupy the main position of the head. According to clinical observation: when the head wind attacks, the pain area is mainly on the lateral side of the head or the frontal corner, and its aura symptoms are also consistent with the circulation line of the liver meridian. According to the theory of Chinese medicine, diseases in the area where the meridians pass through are most related to the internal organs, thus it is clear that migraine is related to the liver. In recent years, with the inclusion of migraine in the recommended spectrum of diseases treated by acupuncture by the World Health Organization, acupuncture practitioners and researchers at home and abroad have done a lot of research on the effectiveness and safety of acupuncture in the treatment of migraine, and acupuncture methods have developed towards diversification and synthesis.