I. Analysis of the meaning of six meridians headache
1. Headache related to the circulation of meridians. The six meridians headache refers to the headache occurring in the area of the circulation of the meridians, such as sun headache, yangming headache, shaoyang headache and syncope headache.
2. Headache related to the pathology of the six meridians. Six meridians headache refers to the headache related to six meridians disease. For example, sun headache refers to typhoid sun disease headache, yangming headache refers to typhoid yangming disease headache, and so on. The headache related to the six meridians is the headache related to the six meridians. The Taiyin headache and Shaoyin headache, which are complemented by the “Headache Gate”, also belong to this category.
The six channels of headache not only include external headache, but also internal headache. Headache is an extremely complicated disease, not only in terms of etiology and pathogenesis, but also in terms of disease location, it can involve internal organs and their meridians. Obviously, the understanding of the six channels of headache from a single aspect is not comprehensive.
3.The pathogenesis of the six meridians of the three yin and three yang diseases is combined with the circulation parts of the meridians. If the above two understandings are combined, it is more suitable for clinical needs, and this is the definition of the scope and properties of six meridians headache in this paper. Lenglu Medical Talk? Headache”: “The headache belongs to the sun, from the back of the head up to the top of the pinnacle, its pain even Xiang; belongs to the Yangming, up to the eye pearl, pain in the forehead; belongs to the Shaoyang, up to the two horns, pain in the corner of the head. After the Sun meridian travels through the body, Yangming meridian travels through the side of the body, and the pulse of the Turk’s yin will be in the pinnacle, so the headache is in the pinnacle. Although Taiyin and Shaoyin meridians do not go up to the head, but the phlegm and gas rebellious congestion in the diaphragm, head gas can not be smooth and also pain. The method of identification is that each of the six meridians has its own symptoms.” Ming? Qin Jingming pointed out in his Treatise on the Causes of Headache. Headache Theory”, it is pointed out that “headache in the door of typhoid fever is a symptom of the surface of the three yang meridians, and now in the door of miscellaneous diseases, although it is divided into external sensation and internal injury, but the three yang and three yin, all have headache.”
In terms of its properties, any disease does not deviate from yin and yang deficiency and does not come from the five organs, six bowels and twelve meridians, and its disease is not external sensation that is internal injury. Therefore, the organic combination of the three yang and three yin, the internal organs and meridians and the etiology and pathogenesis of the external sensation and internal injury in the diagnosis and treatment of headache is both clinically and practically relevant.
There are three basic elements in the clinical diagnosis and treatment of headache: one is to be able to identify the location of the disease, the other is to be able to determine the nature of the disease, and the third is to be able to identify the nature of the evil energy causing the disease. The treatment of headache by the six meridians can fully satisfy the above conditions.
II. Clinical evidence of headache treated by the six meridians
(A) Sun headache
1.Part: Sun headache is mainly seen in the forehead, the top of the head, the occipital pain even with the neck and back, or from the neck even with the shoulder.
Usually the sun headache is mainly pain in the back of the head or even in the neck. Ling Shu? The meridians: “bladder foot sun veins …… is moving then the disease rushes headache, eyes like off, item like pulling, spine pain ……” “Lenglu medical words? Headache”: “headache belongs to the sun, from the back of the head up to the top of the pinnacle, its pain even the item …… item strong lumbar spine pain.” Because of the foot sun bladder meridian circulation to, can also occur head side headache, such as “Danxi Xinfa twelve sutra witness” foot sun bladder meridian witness “head bitter pain …… head two side pain …… item like pulling ……”
2, etiology and pathogenesis: wind-cold and wind-heat external sensations are common, and evil qi blocks the solar meridians; also see internal injuries as the disease.
3, properties: external sensation and internal injury can cause the disease, but the internal injury is the main; the majority of the real.
4.Cure: ① Headache is mainly in the occipital and cervical region, with pain even in the top of the head and forehead, or in the side of the head, or with tightness or soreness in the cervical and occipital region, even in the temporal forehead, or with discomfort in the shoulders and back, with light red tongue, thin white fur, and string or tight pulse. Treatment: Diversify the solar meridian, clear the channels and stop the pain. Remedy: Ge Gen Tang with Tianma, Chuanxiong, Jiang Huang, Tiannanxing and Angelica. Blood stasis: headache with strong neck, or pain even in the shoulder and back and arm, persisting for a long time, with pressure pain in the neck, dark or purple tongue, or dark red, thin white fur, thin or thin and astringent pulse. Treatment: Invigorate blood circulation and remove blood stasis, dredge the channels and channels. Remedy: Ge Gen Tang with Radix Angelicae Sinensis, Safflower, Salviae Miltiorrhiza, Qiang Wu, or Gui Zhi Fu Ling Wan with flavor. (3) Damp-heat evidence: headache with heavy head, neck discomfort, chest fullness and nausea, red tongue, yellowish greasy coating, smooth or moist pulse. Treatment: clear heat and dampness, dredge the channels and channels. Remedies: Ephedra lenghuang and red bean soup with raw coix seeds, earth poria, etc. Wind-cold disease: headache with acute onset, pain like breaking, even to the back of the neck, vicious wind and fear of cold, especially in case of wind, no thirst, thin white fur, floating and tight pulse. Treatment: Expel wind and disperse cold, promote circulation and relieve pain. Prescription: Ma Huang Tang, Gui Zhi Tang, Ge Gen Tang, Gui Zhi plus Ge Gen Tang with flavor. Wind-heat evidence: headache with swelling, or even headache like cracking, fever or vicious wind, thirst for drink, red face and eyes, constipation and yellow urine, red tongue with yellow fur and floating pulse. Treatment: Draining wind and clearing heat, promoting circulation and relieving pain. Prescription: remove ephedra and cinnamon sticks from Ge Gen Tang, add mulberry leaves, chrysanthemum, stiff silkworm, cicada molts or Shengma Ge Gen Tang and Sang Ju Drink. Or use selective Qi Tang, “typhoid fever Dabai? Headache” said “This is the formula for treating the headache of the sun wind-heat.” (6) Wind-dampness evidence: headache like wrapping, heavy limbs, stuffy chest, dullness, unfavorable urination, loose stools, white greasy coating, moist and slippery pulse. Treatment: Dredge wind and channels, resolve dampness and relieve pain. This formula is based on Ephedra almonds, Coix seeds, Glycyrrhiza glabra soup and Ephedra plus Art.
(II) Yangming headache
1. Location: Headache is common in the forehead, cheeks and eyebrow bones, or pain even in the gums, or pain in the face. Typhoid fever dabai? Headache”: “Yangming Jing forehead pain, pain even orbital, pulse flood and long ……”
2, etiology and pathogenesis: external sensations are more heat knots or for cold condensation; internal injuries are more accumulated heat, damp heat, stomach fire, heat poison, wine poison.
3.Properties: real evidence is the main.
4, treatment: ① Yangming damp-heat: headache and body weight, chest and epigastric stuffiness, urination red and closed, mouth sticky, tongue red, coating yellow, pulse slippery or moistened. Treatment: clear heat and dampness, harmonize the middle and relieve pain. Remedies: for those with epigastric gangrene, use Han Xia Di Xin Tang; for those with irregular bowel movements, use Ge Gen Scutellaria Tang with added flavor. For prolonged damp-heat stagnation, use Chencha Bud Decoction. Cold stagnation of Yang Ming meridian: headache mainly in the forehead and cheeks, or pain in the eyebrow bones, aggravated or induced by wind and cold, with a pale tongue, thin white fur, and a stringent or tight pulse. Treatment: Drain wind and disperse cold to clear the Yang Ming meridians. The formula is Shuang Qi Tang. Danxi Xinfa? The formula “Selecting Qi” is effective in treating unbearable pain in the eyebrow bone. Yangming heat: headache and distension, disturbed face, dry mouth or thirst, stomach discomfort, red tongue, yellow tongue coating, slippery pulse. Treatment: clear the stomach heat, pass the ligaments and relieve pain. The formula is Baihu plus dahurica dahurica soup (Health Treasure Book, Volume 9). Or Bai Hu Ge Gen Tang (Zhi Mu, gypsum, Ge Gen, Bai Zhi. (Typhoid Fever Da Bai). In the late stage of fever, heat injures qi-yin, residual heat is not yet exhausted, headache and thirst, shortness of breath and distress, red tongue, yellow tongue coating and deficient pulse, use Bamboo Leaf and Gypsum Tang. Stomach fire attack: severe pain on the face with unbearable pain, redness and burning of the face, dry mouth and bad breath, red urine and feces, or yellow and mucous nasal congestion, red tongue, yellow moss, and smooth pulse. Red tongue, yellow coating, slippery pulse. Treatment: Clearing the stomach and dipping fire, clearing the ligaments and relieving pain. Prescription: Clear the stomach, reusing Shengma, adding gypsum, Zhi Mu, Tian Ma, Ge Ge Gen, and Stiff Silkworm. For nasal congestion with yellow mucus, add dahurica dahurica, dandelion, sorrel, etc. ⑤ Yangming heat and congestion: headache and redness, dry mouth and thirst, heartburn and bad breath, closed stool, red tongue, yellow tongue coating or yellow dryness, slippery pulse. Treatment: Clearing heat from the stomach and lowering Qi to direct turbidity. The formula is based on Cheng Qi Tang formula or Fang Feng Tong Sheng Wan.
(C) Shaoyang headache
1. Location: The pain is mainly on the side of the head and can be connected to the ears and the outer canthus of the eyes. Typhoid fever Dabai? Headache”: “Shao Yang Jing head angle pain, pain leading to the ear before and after ……”
2.Etiology and pathogenesis: wind-heat is the main cause of external sensation, and wind-cold is also present; internal injury is mostly liver-biliary qi depression, fire or damp-heat congestion.
3.Properties: actual evidence, heat evidence is common.
4.Cure: ① Shaoyang heat (fire): headache mainly in the two solar plexus points, or even in the ears and eyes, swelling and pain, or dizziness, dry mouth, bitter mouth, red tongue, thin yellow fur, string pulse. Treatment: Diversion of Shao Yang and clearing away the depressed fire. Remedy: Xiao Chai Hu Tang with the addition of Radix et Rhizoma, Radix et Rhizoma, Radix et Rhizoma, Mulberry leaf, Chrysanthemum and Radix et Rhizoma. Shaoyang qi depression: headache and head swelling, pain in both temporal areas, stopping at times, or wandering, or pain even in the pillow and neck, light red tongue, thin white fur, string or thin string pulse. Treatment: Reconcile Shao Yang and dissipate stagnation. The formula is based on Chai Hu Gui Zhi Tang. (3) Heat and Qi congestion in Shaoyang: headache and distension, especially in the solar plexus, distress in the heart and mouth, irregular bowel movements, red tongue, yellow fur, string or number of strings in the pulse. Treatment: Relieve Shaoyang and unblock the Qi flow. The formula is based on Da Chai Hu Tang. Special headache–Thunderhead wind: Headache is severe, occurring on the ear, with nucleus in the painful area, not to be touched, aggravated at night, with red tongue, thin white or thin yellow fur, and strong string pulse. Treatment: Diversion of Shao Yang, clearing heat and dampness to detoxify. Prescription: [Zhen Tang with added flavor.
(D) Taiyin headache
1. Location: Headache with variable location, or full headache, or localized pain. Ling Shu? Meridians: “The vein of the spleen and foot Taiyin …… enters the abdomen belongs to the spleen and the stomach, goes up to the diaphragm, holds the throat, connects the tongue and disperses under the tongue ……”.
2, etiology and pathogenesis: internal injury is the main cause: common injuries caused by diet, excessive labor, loss of blood due to prolonged illness, etc.; or due to internal injury of emotions, liver wood multiplied by spleen, loss of transport and transformation, dampness gathering to produce phlegm.
3. Attributes: both deficiency and reality are seen, with deficiency being the main cause. Deficiency is mostly seen in deficiency of qi and blood or clear yang not rising; actual evidence is mainly phlegm-damp, damp-heat, phlegm-heat, phlegm turbidity.
4.Cure: ①Phlegm syncope headache: faint headache, fullness in the chest and epigastrium, vomiting and vomiting of phlegm, fat tongue with teeth marks, white greasy moss, sunken string or sunken slippery pulse. Treatment: Strengthen the spleen and the middle, resolve phlegm and lower turbidity. Remedies: Radix Bupleurum and Rhizoma Atractylodis Macrocephalae Tang (The Secret Collection of the Orchid Room), or Rhizoma Ligusticum and Rhizoma Xiongxian Guiding Phlegm Tang (The Miracle Formula). For headache caused by phlegm stagnation turning into heat and phlegm-heat overwhelming the head, Er Chen Tang with added flavor (“Medical Formulas”) is used. Er Chen Tang is the basic formula for treating phlegm syndrome headache, as stated in “Typhoid Fever Dabai? Headache” says: “For stubborn phlegm headache with chest fullness and nausea, Er Chen Tang with Nan Xing and Hai Shi”. That is, Er Chen Tang plus gall bladder star and sea floating stone, named Xing Shi Er Chen Tang. Also Er Chen Tang plus Gardenia, Lian, Bile Star, named Er Chen Gardenia Lian Bile Star Tang, to treat the headache of “phlegm and fire upstream”. ②Qi deficiency headache: headache and dizziness, palpitations, heavy in case of labor, spontaneous sweating, shortness of breath, fear of wind, fatigue, white face, thin white tongue, thin white fur, sunken and weak pulse. Treatment: Benefit Qi, strengthen the spleen, and promote clearing of Yang. Remedy: Shun qi and zhong tang (“Health Treasure”, Huang Qi, Ginseng, Licorice, Atractylodes Macrocephala, Chen Pi, Angelica Sinensis, Sheng Ma, Chai Hu, Radix et Rhizoma Sinensis, Radix et Rhizoma Cranberry, Rhizoma Chuanxiong). Qi deficiency and blood stasis: pain in the occipital region, persisting for a long time, recurrent attacks, sometimes light and sometimes heavy, pain even in the back of the neck, fixed and immovable, with a light and dark tongue, thin white fur and weak pulse. Treatment: Benefit Qi, promote clearing, activate blood circulation and resolve blood stasis. Remedies: Qing Yang Tang (Treatise on the Spleen and Stomach). Qi deficiency and complex paralysis: Recurrent headache attacks that do not heal over a long period of time, sometimes stopping, accompanied by dizziness of the head and eyes, mental fatigue, lack of facial color, pale tongue, thin white fur, weak pulse. Treatment: Benefit Qi and strengthen the spleen, tonify deficiency and promote circulation. Radix Astragali, Cinnamomum Bureaux, Radix Paeoniae, Ginger, Jujube, Radix Angelicae Sinensis, Radix Puerariae Sinensis, Radix Codonopsis Pilosulae, Radix et Rhizoma Glycyrrhizae.
(E) Shaoyin headache
1. Location: variable, with full headache being the most common. Although the Yin meridians of the foot do not work in the head, they all follow the face, and “hold the tongue”. For example, “Ling Shu? The meridians say: “The veins of the kidney foot Shaoyin …… its straight, from the kidney on through the liver and diaphragm, into the lungs, following the throat, holding the tongue ……”.
2, etiology pathogenesis: Shao Yin essence and blood deficiency, can not produce marrow to fill the brain, the brain marrow is empty; Yang deficiency, both easy to feel the cold, and can not warm the clear orifices.
3. Attributes: deficiency of essence and blood and deficiency of yang qi are the basic pathological changes.
4. Treatment: ① Kidney Yin deficiency: headache and dizziness, soreness and weakness of the waist and knees, tinnitus, insomnia, dry mouth and throat, flushed face, heat in the hands and feet, red tongue with little coating, thin pulse. Treatment: Nourishing Yin and tonifying the kidney. Remedies: Qiju Dihuang Wan with flavor, asparagus, mulberry leaf, black sesame. ② deficiency of kidney essence: headache and empty, or with dizziness, lumbar pain and soreness, fatigue, forgetfulness and dizziness, tinnitus and less sleep, light red tongue, less moss, sunken and weak pulse. Treatment: Tonifying the kidney and filling in the essence, producing marrow and glorying the brain. Remedy: Adding flavor Zuo Gui Drink (《医学從众錄》), based on Zuo Gui Drink, reusing Cistanches, with less adjuvant Chuanxiong and Hsiang Xin). Kidney Qi deficiency: headache with empty space, dizziness, lumbar pain and weakness, fatigue and forgetfulness, impotence and spermatorrhea, menorrhagia and dysmenorrhea, tinnitus and hypersomnia, pale red tongue with little coating, sunken and weak pulse. Treatment: Tonify kidney energy, fill in essence and generate marrow. This formula is based on the formula of Tai Teng Yuan Decoction with added flavor. Kidney Yang deficiency: head emptying and pain, lack of warmth in hands and feet, soreness and weakness of waist and knees, mental fatigue, or dizziness, pale tongue, thin white fur, sunken and feeble pulse. Treatment: Warming kidney yang, benefiting qi and generating essence. Remedy: Right Return Pill. ⑤ Yang deficiency with cold: headache persists for a long time, stopping at times, vicious wind and fear of cold, white face and cold limbs, pale fat tongue, thin white moist moss, sunken and thin pulse. Treatment: Warming Yang and replenishing deficiency, dispersing cold and relieving pain. Remedies: Ephedra, pungent and ephedra soup with Chuanxiong and ginger.
(F) Syncope headache
1. Location: Pain on the top of the head and face is common, or full headache, or headache with variable location. Ling Shu? The meridians said: “The pulse of the liver and foot fermin, starting from the time of the hair of the big finger, …… on the diaphragm, cloth, after following the throat, up into the forehead, even the eye system, up out of the forehead, and the Governor’s pulse will be at the top; its branches, from the eye system under the cheek, ring the lips inside… …”. The “Danxi Xinfa Twelve Sutra Witnesses” has “headache”.
2. Etiology and pathogenesis: Emotions and emotions injure the liver, resulting in qi depression, fire, qi stagnation and blood stasis, hyperactivity of yang and wind; or deficiency of cold in prolonged illness.
3.Properties: both deficiency and reality.
4. Evidence and treatment: ① Liver qi stagnation: headache and head swelling, pain without a fixed location, emotional restlessness, or see chest fullness and stuffiness, dullness and pain in the ribs, cachexia and belching, not thinking about eating and drinking, irregular bowel movements, light red tongue, thin and greasy moss, string pulse. Treatment: De-stressing the liver and relieving depression, relieving qi and pain. Prescription: Sichangjiao San combined with Xiangming San (forbidden formula of Lufu), Xiangfenzi, Chuanxiong, fine tea. (Decocted in water and served warm) with tianma, tiannanxing and tribulus terrestris. ② liver depression and fire: headache, impatience and irritability, chest fullness, bitter and dry mouth, or headache, red eyes, tinnitus, or noisy and swallowing acid, constipation, red tongue, yellow fur, string pulse. Treatment: De-stressing the liver and clearing heat and fire. Remedies: Bai Tou Weng Tang combined with Gardenia Black Bean Soup plus Tian Ma, Chuan Xiong, Siberian Rhizoma, Tribulus terrestris, Sheng Bai Shao; for Yin injury, Bai Tou Weng plus Licorice Agaricus Soup plus Wolfberry and Chrysanthemum. Qi stagnation and blood stasis: headache that does not heal for a long time, fixed pain, impatient temperament, insomnia and forgetfulness, or pain in the chest and hypochondrium, purple and dark tongue, or petechiae, petechiae, string or astringent pulse. Treatment: Diversifying the liver and Qi, activating blood circulation and relieving pain. Remedy: Tong qi and blood circulation soup with tian mao, chrysanthemum, spineflower and turmeric. Hyperactivity of Liver-Yang: head swelling, pain and dizziness, red face, irritability, pain in the dorsum, restless sleep at night, bitter mouth, red tongue with thin yellow coating and strong string pulse. Treatment: Calming the liver and submerging Yang, subduing rebellion and relieving pain. The formula uses Tianma Hooked Vine Drink or Zhi Sheng Qing Yang Tang. 5. Wind and fire in the liver meridian: pain in the face, burning sensation in the cheeks, pain even in the teeth, sudden onset and sudden cessation, no time for cessation, irritability, tinnitus and bitterness in the mouth, red tongue, yellow moss and string pulse. Treatment: Clearing the fire from the liver, draining wind and relieving pain. The formula is Antelope’s horn soup (Antelope’s horn powder, cicada molasses, Xia Ku Cao, peppermint, raw earth, chrysanthemum, stone cassia, asparagus, whitehead). Treatment: Nourishing Blood, softening the Liver, relieving urgency and pain. Prescription: Combining Si Shen San with Si Wu Tang (Dan Xi Xin Fa? The treatment of blood and wind in women, dizziness and headache”, using Si Shen San. (Chrysanthemum, Angelica, Radix et Rhizoma and Rhizoma Polygonatum), with the addition of asparagus and stiffness. For blood deficiency with cold, use Angelica Sinensis Si-wei Tang; for severe cold, use Angelica Sinensis Si-wei Tang plus Wu Zhu Yu Sheng Jiang Tang. (7) Liver cold: headache at the top, dry vomiting, vomiting saliva, or even cold extremities, light red tongue, white fur, string pulse. Treatment: Warming the liver and dispersing cold, warming menstruation and relieving pain. Wu Ju Ju Tang is preferred.
(G) Miscellaneous headache
The testimony of the twelve meridians of the Danxi Xinfa (Witnesses of the Twelve Meridians of the Hand and Foot Yin and Yang Meridians): “Headache at the top of the head, foot sun, hand shao yin.
1. Total headache: treatment from the six meridians combined with disease.
2.Wandering pain: focus on the liver and gallbladder and Shao Yang, and start from wind and qi.
3.Headache resting sometimes: Seeking from Shaoyang and Conjunctive Yin.
4. Treatment: ① Loss of harmony between Qi and Blood: Headache and dizziness, aggravated by emotional discomfort, accompanied by symptoms such as distension in the chest, palpitation and nausea, with red tongue, thin white fur and thin string pulse. Treatment is to de-regulate qi and blood and harmonize qi flow: Chai Hu Gui Zhi Tang (Chai Hu, Gui Zhi, Bai Shao, Dang Shen, roasted licorice, jujube, ginger) with Xiang Shen, Radix et Rhizoma Polygoni, Tian Ma, etc. (2) Damp-heat of liver and gall bladder: headache and head distension, bitter and dry mouth, irritability, yellow urine, red tongue, yellow greasy coating, and string pulse. Treatment is to clear damp-heat in the liver and gallbladder: gentian and liver diarrhea soup with flavour.