J. Acupunct. Tuina. Sci. 2010, 8 (1): 50-51 DOI: 10.

1007/s11726-010-0050-7

Case Report

Acupuncture Combined with Chinese Herbs for Refractory Headache: One Case Report
SUN Ji-shan () Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, P. R. China

Key WordsAcupuncture Medication CombinedHeadache; Medical Records CLC NumberR246.1 Document CodeB A 44-year-old female patient came for the first medical visit on May 23, 2007. Chief complaint: Headache lasting more than 20 years. History of present illness: The patient presented with a headache 20 years ago, especially in the left side. The headache is aggravated at the end of the menstrual period, along with pain of the eyes. The menstrual disorder and headache occurred frequently afterwards, especially after fatigue or contracting wind. The headache was aggravated after a hysterectomy operation; the headache was more severe in the afternoon than in the morning which was accompanied by dizziness, tinnitus, sore and limp loins and knees, anorexia, dry stools with 2-3 d interval and the normal urination. Physical examination: The patient had a lean body constitution with lusterless observation; Pale tongue with a white thin coating and teeth-marks, thready weak pulse. Diagnosis in Western medicine: Vascular headache. Diagnosis in traditional Chinese medicine: Headache. Analysis of syndrome differentiation: The headache occurred during the menstrual period, which coincided with the menstrual period. It is thus evident that the etiology of the headache is in the uterus. The uterus is the origin of menstruation and the source of the Thoroughfare, Conception and Governor Vessels. The Thoroughfare and Conception Vessels govern menstruation. The menstruation is regular when the qi and blood is rich in the two vessels, while irregular
Author: SUN Ji-shan (1936- ), male, chief physician

menstruation will occur when qi and blood are deficiency. The Governor Vessel governs the yang qi of the whole body, thus these three meridians are of great importance in regulating the qi and blood of the twelve regular meridians. Blood is the primary substance for women and the liver plays a major role in the physical function of women. Blood deficiency could cause hyper-function of yang which can easily ascend to the upper region causing the headache to occur after menstruation. Blood deficiency also causes the loss of nutrients to the eyes which may lead to eye pain. Qi is the commander of blood and blood circulation depends on qi flow. Over-strain consumes essence and qi deficiency occurs, thus leading to blood stasis which may bring about pain, therefore the headache happened after over-strain. Yin im- pairment involves yang, blood deficiency may cause insufficiency of kidney yang, which is the reason the headache always occurs after the wind-cold attacks. Blood belongs to yin, so blood deficiency may cause yin deficiency which leads to hyperactive yang, the liver yang ascends to the upper region with wind causing dizziness and vertigo as well as tinnitus. The waist is the house of the kidney, and the knees are the house of the liver, if deficiency of kidney and liver occurs, sore and limp loins and knees will follow. Qi and blood deficiency may cause a lusterless complexion and a pale tongue as well as dry stools. The syndrome was qi-blood deficiency and liver-kidney insufficiency. Therapeutic principle: Tonifying qi and blood; Reinforcing liver and kidney. Therapeutic method: Filiform needle of 0.30 mm in diameter and 40 mm in length were selected. Baihui

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J. Acupunct. Tuina. Sci. 2010, 8 (1): 50-51

(GV 20), Fengchi (GB 20), Fengfu (GV 16), Touwei (ST 8) and Ashi points were punctured with even reinforcing-reducing method; Taichong (LR 3), Taixi (KI 3), Zusanli (ST 36) and Qihai (CV 6) were punctured in the reinforcing method by twirling and rotating the needle. The needles were retained for 30 min. The Chinese herbs prescription included Ren Shen (Radix Ginseng) 3 g Huang Qi (Radix Astragali) 50 g, Bai Zhu (Rhizoma Atractylodis Macrocephalae) 15 g, Chen Pi (Pericarpium Citri Reticulatae) 6 g, Chai Hu (Radix Bupleuri) 3 g, Sheng Ma (Rhizoma Cimicifugae) 3 g, Gan Cao (Radix Glycyrrhizae) 15 g, Dang Gui (Radix Angelicae Sinensis) 15 g, Man Jing Zi (Fructus Viticis Simplicifoliae) 10 g, Xi Xin (Herba Asari) 3 g, Bai Shao (Radix Paeoniae Alba) 15 g, Chuan Xiong (Rhizoma Chuanxiong) 15 g, Bai Zhi (Radix Angelicae Dahuricae) 10 g, E Jiao (Colla Corii Asini) 10 g (melt), Lu Jiao Jiao (Colla Cornus Cervi) 10 g (melt). The acupuncture and Chinese herbs were given once daily, and the headache almost disappeared after 10-day continuous treatment. The patient recovered after a course of Chinese herb treatment.

Note: Baihui (GV 20), Fengchi (GB 20), Fengfu (GV 16), Touwei (ST 8) and Ashi points activate qi and resolve blood circulation, expelling wind and removing cold, unblocking the meridians and collaterals. Taichong (LR 3), Taixi (KI 3) are the Yuan-Primary points of the liver meridian and kidney meridian respectively. The reinforcing manipulation of twirling and rotating the needle can tonify the liver and kidney; Reinforcing Zusanli (ST 36) has the function of invigorating spleen and stomach. Reinforcing Qihai (CV 6) can support healthy qi and strengthen bodys resistance. Chinese herbs have the function of tonifying the spleen and stomach, warming Ying-Nutritive qi and Wei-Defensive qi which is the correct formula for a headache caused by qi deficiency. The herbs plus E Jiao (Colla Corii Asini), Lu Jiao Jiao (Colla Cornus Cervi) and Bai Zhi (Radix Angelicae Dahuricae) have the function of warming yang to alleviate pain. Acupuncture combined with Chinese herbs had a significant therapeutic effect in treating this disease.
Translator: YANG Ling () Received Date: October 1, 2009

Related Link

Effectiveness of Acupuncture for Chronic Daily Headache: An Outcomes Study

With the increased incidence of migraine headaches noted in the military population it becomes imperative to find safe and effective treatment options for soldiers. Acupuncture may be one of those options. This pilot study used a standardized set of well-known acupuncture points over a predetermined time interval on 26 subjects suffering from chronic daily headache, the majority being migraineurs, and found a reduction in the frequency and intensity of their headaches. Headache calendars and validated measurements were compared 12 weeks before and 12 weeks after the acupuncture intervention. Results showed continued improvements 12 weeks after the last treatment. Traditionally, acupuncture treatments are individualized at each visit. However the absence of a standardized treatment regimen obstructs data reproducibility across the discipline. A standardized approach may be useful. Variations of these acupuncture points have been used in recent research studies for migraines and acupuncture for headaches for the past 2 000 years.
Selected from Plank S, Goodard J. Effectiveness of Acupuncture for Chronic Daily Headache: An Outcomes Study. Mil Med, 2009, 174(12): 1276-1281.

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