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J. Acupunct. Tuina. Sci. 2010, 8 (1): 52-54 DOI: 10.

1007/s11726-010-0052-5

Case Report

Two Case Reports on Headache Cured by Acupuncture


HUANG Qiang () Acupuncture Department of Shanghai Putuo Chinese Medical Hospital, Shanghai 200062, P.R. China

Key WordsAcupuncture Therapy; Headache; Syndrome Differentiation Treatment; Medical Records CLC NumberR246.1 Document CodeB Headache is a common clinical symptom, which brings great pain to the patients. Acupuncture has a good therapeutic effect in treating headache. The author has used acupuncture in treating 2 cases of headache. The report is given as follows. Treatment procedure: Right Fengchi (GB 20), bilateral Hegu (LI 4) and Sanyinjiao (SP 6) were chosen. Needles of 40 mm in length were inserted perpendicularly in the above acupoints and kept for 30 min. Needles were manipulated every 10 min. Twirling-reducing method was used on Fengchi (GB 20). When withdrawing the needles, the doctor rotated the needle for a bigger pinhole without pressing the hole. Twirling-reinforcing method was used on Hegu (LI 4). The doctor pressed the hole when withdrawing the needles. When inserting the needles, a twirling-reducing needling method was used on Sanyinjiao (SP 6) while twirling-reinforcing method was used in the remaining time, and the pinhole was pressed after the needles were withdrawn. The reinforcing method meant that the thumb was moving forward, which twisted the body of the needle clockwise, the range of rotation was less than 180, and the number of rotation within one respiration was less than 3 times. Reducing method meant that the thumb was moving backward, which twisted the body of the needle counterclockwise, the range of rotation was more than 180, and the number of rotation within one respiration was more than 5 times. After withdrawing all needles, cupping therapy was used on the Back-Shu points for 5 min. The patient visited on the second day and said that after treatment, her headache had improved gradually throughout that afternoon, and had no discomfort that time. She was given the treatment of reinforcing Hegu (LI 4) and Sanyinjiao (SP 6) for better healthcare. Note: The patient had had a headache for several years, which always occurred after tiredness. This time, the patient had a headache and felt dizzy after

1 Case One
A patient, female, 42 years old. Chief complaint: The patient had had a headache for 5 years, which became especially aggravated for 1 d. History of present illness: In the recent 5 years, the patient always had a headache after tiredness. The headache had occurred once every half a year in the beginning, but in the recent 2 years, it occurred once every 2 or 3 months. Chinese nor Western medicine had no obvious effect. The patient had to rest on the bed for one weekand only then could she be relieved from pain. Because of the exhaustion of work in recent days, she always felt tired. When she got up in the morning of the day prior to treatment, she felt dizzy and had pain on the right occipital and posterior region of the head. She had been lying on the bed for one day, but couldnt sleep well. She had no strength, felt dizzy, nauseous, felt like vomiting, and had a poor appetite. The tongue was dark, with thin and white coating. The pulse was thin and slippery. Diagnosis: Headache (deficiency of qi and blood). Therapeutic principle: tonifying qi and dredging collaterals, nourishing and invigorating blood.

Author: HUANG Qiang (1979- ), female, resident, master of medicine 52 Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2010

J. Acupunct. Tuina. Sci. 2010, 8 (1): 52-54

tiredness again. After the comprehensive analysis based on the four examination methods, the patient was diagnosed with headache of qi and blood deficiency pattern. According to LI Shi-zhens Ba Zhen Fang[1], we reinforced Hegu (LI 4) and Sanyinjiao (SP 6) to nourish qi and blood. The patient also had syndromes of spleen deficiency and reversal of qi, such as poor appetite, vomiting and nausea, so fewer reducing method were used first and more reinforcing methods were used on Sanyinjiao (SP 6) in order to nourish the blood without stagnation of qi and blood. Meanwhile, according to syndrome differentiation of the six meridians, the pain was located on the occipital and posterior region of the head, so Fengchi (GB 20) was chosen to dredge local meridians. Though the patient had the syndrome of qi and blood deficiency, she was otherwise healthy and recovered after 2 treatments.

2 Case Two
A patient, female, 65 years old. Chief complaints: The patient had had a headache for more than 20 years, which had been aggravated for 3 months. History of present illness: The patient had had a headache for more than 20 years, and a cranial CT showed no abnormality. Rheoencephalogram showed brain blood supply deficiency, and cervical vertebra X-ray suggested that hyperosteogeny of C4-6. In the recent 3 months, the patient always felt dizzy and had a headache, especially on the right occipital and temporal side of the head. Sometimes pain occurred at the frontal angle, and was aggravated after tiredness or a bad mood. It had been cloudy and rainy during those days; and the patient felt dizzy, heavy but particularly felt a pain in the head. Appetite, sleep, urine and stool were normal. Her tongue was dark red with a thin and white coating. The pulse was wiry and slippery. Diagnosis: Headache (qi deficiency with dampness accumulation, blockage of meridians and collaterals) Therapeutic principle: Tonifying qi and dispelling dampness, dredging meridians to stop the pain. Treatment procedure: For the first treatment, right Fengchi (GB 20), bilateral Quchi (LI 11) and

Yinlingquan (SP 6) were selected to puncture with a reducing method. For the second and third treatments, bilateral Hegu (LI 4) and Sanyinjiao (SP 6) were given the reinforcing method while right Qiuxu (GB 40) was given the reducing method. On the fourth to tenth treatments, right Fengchi (GB 20) and right cervical Jiaji (Ex-B 2) points were given the reducing method. Needles of 40 mm in length were chosen, remained in for 30 min, and twisted with reinforcing-reducing method every 10 min. After the first treatment, the patient said the heavy and painful feeling in the head was relieved, but she still felt uncomfortable on the posterior and temporal side of the head. After four treatments, the occurrence of the headache reduced. After ten treatments, the patient was basically cured and the treatment was finished. Note: When the patient first visited, it was cloudy and rainy. The patient felt that her head was clouded by dizziness and pain. It was considered a winddampness headache, so we reduced Fengchi (GB 20) to dredge the meridians, reduced Quchi (LI 11) to dispel wind, and reduced Yinlingquan (SP 6) to dispel dampness. On the second treatment, the patient said the heaviness feeling of the head was noticeably relieved, but still felt uncomfortable on the posterior and temporal side. Dizziness and pain were the main symptoms. Because the patient was old and had had a headache for a long time, we considered she had the syndrome of qi and blood deficiency. We reinforced Hegu (LI 4) and Sanyinjiao (SP 6) in order to nourish qi and blood. The painful position was located on the Gallbladder Meridian. According to meridian differentiation, reducing Qiuxu (GB 40) to dredge qi activity of Gallbladder Meridian. After two treatments, hypodynamia and the bitter taste were relieved, but the patient still felt uncomfortable at the posterior side of the head. Although there was no discomfort on the neck, Fengchi (GB 20) and cervical Jiaji (Ex-B 2) points were chosen for diagnostic treatment. On the fifth treatment, the patient said the headache was noticeably relieved and the occurrence was reduced, so we considered it was a cervical headache and continued the former treatment. After ten treatments, the patient was basically cured. A headache of this case belongs to deficiency-excess complex syndrome. The location

Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2010 53

J. Acupunct. Tuina. Sci. 2010, 8 (1): 52-54

of pain was between the Gallbladder Meridian and Bladder Meridian. We should determine carefully the nature and location of the pain and adopt right therapeutic method in order to achieve a satisfactory result. The root of the cervical headache was at the cervical vertebra but the pain was located on the head, so its syndrome differentiation of Chinese medicine has yet to be considered. Over and above all, headaches can be caused by qi and blood deficiency, pathogenic factors of wind, cold and dampness, blood stasis and phlegm, excess fire of liver and gallbladder. Complicated cases of deficiency-excess mixing syndrome can be seen clinically. Acupuncture treatment should be considered through syndrome differentiation of the six meridians, Zang-fu organs or qi and blood[2-4]. Modern medicine also enriched our knowledge of

the cause of headache and provided new therapeutic thoughts.

References
[1] LI Wan-liang, LI Chuan-qi. Ancestral Acupuncture Common Prescriptions. Beijing: Peoples Medical Publishing House, 2006: 137. [2] HUANG Qin-feng, QI Li-zhen, CUI Xue-jun. Review of Vascular Headache Treated by Acupuncture from 1949-2004. Journal of Acupuncture and Tuina Science, 2006, 4(1): 1-3. [3] ZHENG Qian-hua, LI Ying. Domestic Recent Research on Acupuncture for Treating Acute Migraine Attack. Journal of Jiangxi University of TCM, 2009, 21(2): 49-51. [4] LI Hua-zhang, YAN Zhen-guo, PEI Ming. Analysis on the Laws of Acupoint Selection in Acupuncture Treatment of Headache. Journal of Acupuncture and Tuina Science, 2009, 7(3): 181-184. Translator: ZHANG Shen-yu () Received DateDecember 10, 2009

Related Link

Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta-analyses
Objectives: There is controversy as to whether or not acupuncture is more effective than placebo. To help clarify this debate, we synthesized the evidence gathered from systematic reviews on the pooled data of high-quality randomized controlled trials comparing acupuncture to sham acupuncture for chronic pain. Method: Systematic reviews of acupuncture for the most commonly occurring forms of chronic pain (back, knee, and head) published between 2003 and 2008 were sourced from Ovid databases: Medline, Allied and Complementary Medicine database, Cochrane Library and Web of Science during December 2008. Eight systematic reviews with meta-analyses of pooled data were eligible for inclusion. Data were extracted for short- and longer-term outcomes for the most commonly occurring forms of pain. Two independent reviewers assessed methodological quality. Results: For short-term outcomes, acupuncture showed significant superiority over sham for back pain, knee pain, and headache. For longer-term outcomes (6 to12 months), acupuncture was significantly more effective for knee pain and tension-type headache but inconsistent for back pain (one positive and one inconclusive). In general, effect sizes (standardized mean differences) were found to be relatively small. Discussion: The accumulating evidence from recent reviews suggests that acupuncture is more than a placebo for commonly occurring chronic pain conditions. If this conclusion is correct, then we ask the question: is it now time to shift research priorities away from asking placebo-related questions and shift toward asking more practical questions about whether the overall benefit is clinically meaningful and cost-effective?
Selected from Hopton A, Macpherson H. Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta-analyses. Pain Pract, 2010 [Epub ahead of print]. 54 Shanghai Research Institute of Acupuncture and Meridian and Springer-Verlag Berlin Heidelberg 2010