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Zhang Jiyang
Associate Chief Physician
Vascular Neurogenic Headache,
The Efficacy of Traditional Chinese Medicine in Unblocking Meridians.
Wang, male, 43 years old, first diagnosed on May 17, 2020. The patient has suffered from left-sided migraines for many years, with recurrent episodes exacerbated by fatigue and emotional distress. Western medicine diagnosed it as vascular neurogenic headache, and the use of vasodilators and analgesics only temporarily alleviated the symptoms. Unable to bear the suffering, the patient sought treatment from Traditional Chinese Medicine (TCM) and requested herbal therapy. He also presented with dizziness, bitter mouth, tinnitus, irritability, poor sleep with many dreams. The tongue was red with a thin yellow coating, and the pulse was wiry. Blood pressure was 120/80 mmHg.
Diagnosis: Liver Yang rising, Qi stagnation obstructing the meridians.
Diagnosis: Migraine, Yang hyperactivity with Qi stagnation syndrome. Vascular neurogenic headache.
Treatment principle: Pacify the liver and subdue Yang, unblock the meridians and relieve pain.
Proposed formula: Modified Jin Ling Zi San from the “Tai Ping Sheng Hui Fang”.
Prescription: Bai Zhi (Angelica dahurica) 10g, Chuan Xiong (Ligusticum chuanxiong) 10g, Shi Jue Ming (Haliotis diversicolor) 30g, decocted for ten minutes first, Xi Xin (Asarum sieboldii) 3g, decocted for ten minutes first, Huang Qin (Scutellaria baicalensis) 10g, Ju Hua (Chrysanthemum morifolium) 10g, Chuan Lian Zi (Melia toosendan) 10g, Yuan Hu (Corydalis yanhusuo) 15g. 7 doses, decocted in water for oral administration.
On May 24, follow-up visit: headache significantly reduced, still experiencing dizziness, bitter mouth, and irritability. The original formula was modified by adding Tian Ma (Gastrodia elata) 10g, Xia Ku Cao (Prunella vulgaris) 10g, and Zhu Ye (Lophatherum gracile) 10g, and another 7 doses were prescribed. The headache completely ceased, and other symptoms also improved. The original formula was adjusted by removing Xi Xin, Ju Hua, Chuan Lian Zi, and Yuan Hu, and adding Chao Suan Zao Ren (Ziziphus jujuba) 30g to calm the mind, with a total of 14 doses. Symptoms resolved, and after three months of follow-up via WeChat, no recurrence was observed.
Experience: Vascular neurogenic headache is a challenging condition, and Western medicine lacks effective symptomatic treatments. Patients often rely on analgesics to relieve pain, and in severe cases, even analgesics fail to stop the pain, leading to significant suffering. In this case, the headache was attributed to liver Yang rising and Qi stagnation obstructing the meridians, where obstruction leads to pain. Symptoms such as dizziness, bitter mouth, tinnitus, irritability, poor sleep with many dreams, red tongue, and wiry pulse are all caused by hyperactive liver fire. The formula utilized Bai Zhi, Chuan Xiong, and Xi Xin to unblock the meridians and relieve pain, while Shi Jue Ming pacified the liver and subdued Yang, and Huang Qin and Ju Hua cleared liver fire, collectively achieving the goal of pacifying the liver and unblocking the meridians. The use of Jin Ling Zi San aimed to promote Qi and unblock the meridians, enhancing the analgesic effect to treat the headache. After one week of medication, the headache significantly reduced, but dizziness, bitter mouth, and irritability persisted, indicating that the pathogenic fire disturbing Yang had not been completely eliminated. Therefore, Tian Ma was added to pacify the liver, Xia Ku Cao to clear the liver, and Zhu Ye to clear the heart (to drain the excess), and after another 7 doses, the pathogenic factors significantly retreated, the meridians were unblocked, and thus the pain ceased and other symptoms improved. The original formula was adjusted by removing Xi Xin, Ju Hua, Chuan Lian Zi, and Yuan Hu, and adding Chao Suan Zao Ren to calm the mind and consolidate the therapeutic effect. After two weeks, all symptoms resolved.
Zhang Jiyang
Bachelor of Medicine from Nantong University, Associate Chief Physician, licensed physician in China, licensed pharmacist, general practitioner. Medical philosophy: “Focus on observation diagnosis, with classical formulas as the mainstay and modern formulas as the supplement, specializing in specific diseases with targeted medications.”
Specializes in treating the following diseases:
1. Dermatology: eczema, urticaria, acne, pruritus, melasma, dark circles, herpes zoster, psoriasis.
2. Internal Medicine: tumors, insomnia, cough, stomach pain, constipation, headache, low back pain, dizziness, damp-heat syndrome.
3. Gynecology: irregular menstruation, dysmenorrhea, leukorrhea, infertility, breast diseases, menopausal syndrome.
4. Andrology: prostatitis, benign prostatic hyperplasia, epididymitis, infertility.
5. Surgery: appendicitis, cholecystitis, urinary stones, acute abdominal pain, neck, shoulder, low back, and leg pain, thyroid diseases, cystitis, etc.
6. Pediatrics: diarrhea, abdominal distension, indigestion, mesenteric lymphadenitis in children, pneumonia.
7. Constitution adjustment, sub-health state adjustment, rehabilitation during disease recovery.
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