Italy Qihuang College of Traditional Chinese Medicine
Shuhua He, Jun He, Bin He
Regulating the Chong and Ren Meridians Method: The onset of migraines is often tied to the menstrual cycle. In most cases, migraines occur within the week before menstruation, while a small number of patients experience migraines after menstruation. Often patients will begin to have issues at menarche, and the migraines will spontaneously resolve after menopause. One can also have relief from migraine headaches during pregnancy.
Traditional Chinese medicine believes that this disease stems from insufficient liver blood and loss of kidney essence, or stagnation of liver qi and stagnation of blood, leading to headaches. During the premenstrual phase, the uterus is building up a reserve of essence and blood, while the liver needs to mobilize yinblood to enter the uterus system, because the liver has the function of storing the blood and regulating the yin. Insufficient liver blood leads to an imbalance of liver yin and yang, and hyperactivity of liver yang leads to headache. In the case of vacuity, the loss of essence and blood of the kidneys and the lack of nourishment of the brain network can also cause headache. In the case of stagnation of liver qi, the movement of qi is not smooth, and blood circulation is blocked, resulting in headaches.
Main Acupoints: Baihui (GV 20), Fengchi (GB 20), Taiyang (Ex-HN-5), Daling (PC 7), Guanyuan (CV 4), Zigong (Extra point on abdomen), Gongsun (SP 4), Sanyinjiao (SP 6).
Additional Acupoints: For hyperactivity of liver yang, add Taichong (LV 3) and Hegu (LI 4); for deficient kidney essence, add Quchi (LI 11), Taixi (KD 3), and Qihai (CV 6); for liver qi stagnation, add Taichong (LV 3) .
Needling Method: For Taixi (KD 3) and Quchi (LI 11), use twisting and reinforcing technique; for other acupoints, use even reinforcing and reducing technique.
Analysis: Guanyuan and Zigong are the main acupoints. Guanyuan point belongs to the Ren vessel, and it is also the confluence point of the foot three yin meridians, It has the effect of regulating the liver, spleen and kidney,.It is the place where the original yin and yang of the body are stored up and conserved, so it is named “Guanyuan” (Locking the original). In the “Ling Shu·Five Sounds and Five Tastes,” it is stated: “The Chong Mai and Ren Mai both originate from the uterus.” Furthermore, in the “Su Wen·Discussion on Pain,” it is mentioned: “The Chong Mai originates from Guanyuan.” This explains why Guanyuan can affect the uterus via the Ren Mai and Chong Mai, regulating the qi and blood dynamics and yinyang imbalance within the uterus. Therefore, Guanyuan is a crucial acupoint for treating uterine disorders. Zigong belongs to the extraordinary acupoints outside the meridians, located 3 inches away from Zhongji, near the ovaries, has the function of regulating ovarian function and is an important point for treating menstrual irregularities and infertility. In Sun Si Miaos “Qian Jin Fang,” it is said: “The Zigong acupoint treats women with a colduterus and inability to conceive.” In “Zhen Jiu Da Cheng,” it says: “[The point] treats people who have been childless for a long time.” The combination of Guanyuan and Zigong is essential for treating gynecological disorders and ovarian dysfunction. Neiguan and Gongsun are confluence points for the eight extraordinary vessels. Neiguan belongs to the Pericardium Meridian of Hand Jueyin, and connects with the YinWei Mai, regulating the various yin meridians and the uterus. Gongsun belongs to the Foot Taiyin Spleen Meridian and connects with the Chong Mai, which originates from the uterus. The Chong Mai travels upward through the head, down to the feet, runs along the back, and spreads in the chest and abdomen. The upper pathway runs along the spine and permeates the yang meridians, while the lower pathway permeates the yin meridians. It has the ability to accommodate and regulate the qi and blood of the twelve regular channels and the ZangFu organs. This is why it is referred to as the “Sea of the twelve channels” and the “Sea of the ZangFu Organs.” Therefore, the combination of Neiguan and Gongsun can help regulate deficiencies in qi and blood, nourish the essence and blood of the uterus, descend liver yang counterflow, alleviate meridian blockages, and when combined with Sanyinjiao, it can further increase its power of nourishing yin and suppressing yang.
Case Study:
Patient: Milena, Female, 42 years old, Italian.
Chief Complaint: Suffering from migraines for 11 years.
Medical History: Milena started to have headaches about 11 years ago, and it was diagnosed as “migraine” by many doctors. Their treatment was ineffective. Her headaches typically began 1-2 days before menstruation, on either the left or right side of her head, with no fixed location. The pain usually originated from the occipital area and then intensified, spreading to her forehead and temples. She also had symptoms such as tearing, nausea, abdominal bloating, lower back pain, and fatigue. Her menstrual flow was light and pale in color.
Examination: Pulse was deep and thin, tongue was pale.
Diagnosis: Migraine (due to qi and blood deficiency).
Treatment: Baihui, Taiyang, Fengchi, Neiguan, Zhongwan, Guanyuan, Zigong, Gongsun, Zuqiaoyin (GB 44).
Acupuncture Method: Using reinforcement method. Moxibustion on Guanyuan and Zigong for 2 minutes each. Moxibustion on Zuyin for 5 breaths. Treatment was conducted twice a week.
After 3 sessions, Milena experienced a lighter degree of headache during her menstrual period. Subsequently, after 7 additional acupuncture sessions, her menstrualrelated headaches ceased. The treatment frequency was then adjusted to once a week. After receiving acupuncture 5 more times, her headaches did not recur, and acupuncture treatment was discontinued. At a one year follow up there was no recurrence of headache.
About the Author:
Shuhuai He,graduated from the Beijing Traditional Chinese Medicine College in 1963, he founded the Italian Qihuang Tradition Chinese medicine college in 2018, and serves as academic Dean.
偏頭痛的治療經驗
何樹槐 何駿 何斌
調節衝任法:
偏頭痛的發作與月經週期有明顯關係,大多在月經來潮前一周內偏頭痛發作,也有少數病人在月經來潮之後發作,並具有偏頭痛的特點。許多患者是在月經初潮時患病,到絕經期之後偏頭痛緩解,還有在懷孕期偏頭痛也可緩解。
中醫認為本病的發作源於肝血不足,腎精虧損;或由於肝氣鬱結瘀血阻滯,導致頭痛發作。月經來潮之前,胞宮需要有精血儲備,需要肝臟調動陰血輸入胞宮,因為肝藏血,即肝有儲存和調節陰血的功能。若肝血不足,可引起肝內陰陽失調,肝陽上亢導致頭痛發作;或腎之精血虧損,腦絡失養,也可引起頭痛發作;或由於肝氣鬱結,氣機不暢,血液運行受阻,致使頭痛發作。
主穴:百會、風池、太陽、大陵、關元、子宮、公孫、三陰交。
配穴:肝陽上亢者加太衝、合谷; 腎精虧損者加曲泉、太谿、氣海;肝氣鬱結者加太衝。
刺灸法:太谿、曲泉採用捻轉補法,其餘諸穴平補平瀉法。
解析:關元、子宮是主穴,關元穴屬於任脈,又是足三陰經的交會穴,有調補肝脾腎的作用,為人身元陰元陽關藏之處,故名關元。 《靈樞·五音五味》:“衝脈、任脈,皆起於胞中。”又《素問·舉痛論》說:“衝脈起於關元”,說明關元可通過任脈、衝脈作用於胞中,調節胞中的氣血盛衰和陰陽失調,所以關元是治療胞中病變的最重要穴位。子宮屬於經外奇穴,位於中極傍開3寸處,臨近卵巢,有調節卵巢功能的作用,是治療月經不調和不孕症的重要穴位,《千金方》:“子宮穴主治女人胞宮久冷,不受胎孕。”《針灸大成》:“治人久無子嗣”。關元與子宮配合是治療婦科病和卵巢功能紊亂的重要組合。內關和公孫屬於八脈交會配穴,內關屬於手厥陰心包經,通於陰維脈,有調節諸陰經及胞中的作用。公孫屬於足太陰脾經,通於衝脈,衝脈起於胞中,其經脈向上循行於頭部,下行至足,後行背部,在前佈於胸腹,其上行者行於脊內滲諸陽,下行者滲諸陰,能容納調節十二經脈及五臟六腑之氣血,故有“十二經之海”和五臟六腑之海“之稱。所以內關和公孫配合,可調氣血之虧損,補胞宮之營血,降肝陽之上逆,通脈絡之阻滯,再配以三陰交,更增其補陰潛陽之力。
驗案舉例
米萊娜,女,42歲,意大利人。
主訴:患偏頭痛11年。
病史:大約在11年前開始頭痛,經多位醫生檢查診斷為“偏頭痛”,治療無效。每於月經來潮前1~2天開始頭痛,或左或右,無固定部位,通常從頭項部開始,劇烈後波及到額顳部,兼見流淚、噁心、腹脹、腰酸、乏力等症,月經量少、色淡。
檢查:脈沉細,舌質淡。
診斷:偏頭痛(氣血虛弱)。
治療:百會太陽 風池 內關 中脘 關元子宮公孫 足竅陰
刺灸法:針刺補法,艾條灸關元、子宮各2分鐘,足竅陰用艾柱灸5壯,每周治療2次。
採用上述方法治療3次後月經來潮,頭痛有輕度發作,之後又針灸7次後,月經來潮頭痛無再發作,後改為每週針灸1次,連續治療5次後頭痛一直未作,停止針灸治療。一年後隨訪頭痛未再發作。
作者簡介:
何樹槐 1963畢業於北京中醫學院,2018年創立了意大利岐黄中醫學院,並擔任學術院長。