1) Etiological mechanism
This disease is mainly caused by qi and blood. If the body is deficient in blood, the feeling of benefit is insufficient during menstruation, and the blood is not glorious, or because of internal resistance of blood stasis and obstruction of collaterals, or because of internal injury of clearing heart-fire, qi stagnation can lead to this disease.
1. Blood deficiency: physical weakness, or long-term serious illness, long-term chronic blood loss, or deficiency of spleen deficiency. When menstruation and seminal blood pour down, they rush to Ren, yin blood feels insufficient, and the brain loses nutrients, resulting in headache.
2. Liver-fire: It is mostly caused by internal injuries such as clearing the heart, anger stagnation, qi stagnation and fire. When passing through, the gas rush is high, and the gas fire is easy to cause pain with the gas rush.
3. Blood stasis: it is often caused by poor mood, liver failure, poor qi movement, poor blood circulation, and blood cells during menstruation. However, the liver meridian of Foot Jueyin runs in the upper part and collaterals in the brain, so blood stasis is blocked, and it hurts if the vein is blocked.
2) Treatment based on syndrome differentiation
Menstrual headache is different from deficiency. Clinically, the time and nature of pain are used to distinguish between deficiency and excess. Generally speaking, people who are really in pain are more painful or stinging before or during menstruation; Deficiency is generally pain, dizziness and dull pain after menstruation or when menstruation will be clean. The main treatment is to regulate qi and blood, harmonize qi and blood, clear the orifices and nourish the essence, and the pain will stop.
1. Blood deficiency
Main symptoms: dizziness, headache, palpitation, insomnia and fatigue during or after menstruation. The tongue is pale with thin fur and weak and thin pulse.
Analysis: The factors are insufficient body blood and insufficient transformation sources. Excessive menstrual flow leads to blood deficiency and blood dishonour, which causes dizziness and headache. If the blood does not nourish the heart, palpitation will lead to sleep loss and mental fatigue. A pale tongue with thin fur and thin pulse is a symptom of blood deficiency.
Treatment: nourishing blood and benefiting qi
Prescription: Bazhen Intestine ("Zhengti Yao Lei"), adding Lycium barbarum and Polygonum Multiflori Radix as appropriate to nourish yin and blood. Angelica sinensis, Ligusticum Chuanxiong and Radix Paeoniae Alba in the prescription nourish blood and enrich blood; Radix Rehmanniae Preparata, Fructus Lycii and Radix Polygoni Multiflori nourish liver blood and kidney essence; Ginseng Radix, Atractylodis Rhizoma and Radix Glycyrrhizae Preparata are beneficial to qi and spleen; Poria cocos strengthens the spleen, calms the heart and calms the nerves. The whole prescription has the function of nourishing blood and benefiting qi, which makes qi full of blood and has no headache since menstruation.
2. Liver fire
Main symptoms: menstrual headache, even apical headache, dizziness, irritability, bitter taste and dry throat. The tongue is red, the fur is thin and yellow, and the pulse is thin.
Analysis: hyperactivity of liver yang, blood blocking blood injection into meridians, and strong qi and fire. Because the liver meridian and du meridian of foot-Jue yang will be at the top, and the pulse will be attached to the liver, and the liver fire will move with the qi, which will easily cause pain at the top. When the liver fire is raging inside, it will make you dizzy, irritable, bitter in mouth and dry in throat. Red tongue, thin yellow fur and thin pulse are all manifestations of yin deficiency and liver fire.
Treatment: nourishing yin and clearing heat, softening liver and calming wind.
Prescription: Qijudihuang Pill ("medical grade") plus Kudingcha, Prunella vulgaris and Bailuyuan Pingfeng. In the prescription, Liuwei Dihuang decoction nourishes the kidney and liver, and Lycium barbarum and chrysanthemum nourish the blood and calm the liver. Add Kudingcha, Prunella vulgaris and Bailuli to help clear liver and calm wind, nourish liver and kidney, calm liver fire, and then eliminate headache.
3. Blood stasis
Main symptoms: severe headache before and during menstruation. Menstruation is purple and dark, accompanied by abdominal pain, refusing to press it. The tongue is dark or has petechiae on the sharp edge, and the pulse is thin or astringent.
Analysis: Smooth qi and blood is the basis of menstruation, and qi and blood are harmonious, so there is no pain. Because the blood stasis stops, the collaterals are blocked, and the blood stasis moves with the blood during menstruation, so the headache is severe. When the blood is blocked in the cell, the menstrual blood is purple and dark, and the abdomen hurts, and it refuses to be pressed. The tongue is dark or has petechiae on the sharp edge, and the pulse is thin, astringent or stringy, all of which are manifestations of poor qi and blood circulation and poor qi movement.
Treatment: regulating qi and promoting blood circulation, removing blood stasis and dredging collaterals.
Prescription: Tongqiao Huoxuechang (Lin Yi Calcium CuO). In this prescription, Radix Paeoniae Rubra, Semen Persicae and Flos Carthami directly enter the blood to remove blood stasis and dredge collaterals; Take the old onion and musk to activate the upper and lower qi, and the qi will promote blood circulation; Ginger and jujube harmonize camp and health. * * * Play the functions of regulating qi, promoting blood circulation, removing blood stasis and dredging collaterals.
Headache is a common disease in clinic. At present, the main symptoms are infectious febrile diseases, hypertension, intracranial diseases, neurosis, concussion and migraine.