Study On Correlation Between Primary Headache And Clinical Syndromes Of Headache In TCM

一Aim and significanceHeadache may appear as a clinical symptom usually,which refers aches defined in half superior part of skull,including location above the line between superior border of superciliary arch, helix and carina of occipital bone. Primary headache contains migraine, tension-type headache(TTH), trigeminal autonomic cephalalgias(TACs) and other types of primary headache. The criterions of primary headache in all types base on symtoms and remove other diseases through auxiliary examination.Diagnostic in TraditionalChineseMedieine(TCM) collects information of patient and disease by inspection,listening and smelling examination,inquire,pulse-feeling and palpation. Primary headache is a heat topic in TCM currently. Especially over TCM treatment with migraine and tension-type primary headache, different people have different views and can't acquire a common consensus.With regard to the pathological nature,causes and genesis of headache, TCM has different opinions from modern medicine, without exception of criterion about classification and diagnostic. but one point in common is diagnostic dependent with symtoms. TCM is the nature of disease pathology at different stages of the reaction, the formation and existence of the disease itself necessarily linked, since both are symptoms of diagnosis, is the nature of disease response, then between Chinese and Western Medicine have in common? Diagnostic classification of headache have the same understanding of whether it? Such as which type of TCM is most relevant with Migraine? Syndroms in which type are frequency of most?The study has two parts:literature review and clinical inquiry. So it can explore that whether there is any association between primary headache and clinical syndroms of headache in TCM.二Literature review1 Objective:By literature retrieval, analysis and sum up primary headache from point of view as follows:course of disease, characteristic of the ache, complication and frequent types of syndrome in TCM.2 Object:Ancient medical books in the Qing Dynasty and Dynasties before the Qing Dynasty.3 Methods:Through hand-made retrieval and computer retrieval, refer to Ancient medical books to find enters associated with headache, sum up information as name of diseases, clinical symptoms, manifestation of tongue, pulse tracings, and compare with the diagnostic standards of primary headache to acquire correspondence between primary headache and clinical syndroms of headache in TCM.4 Results and conclusions:(1) Primary headacheIn Ancient medical books there are many names of headache,but migraine is the only one corresponding with the classification of primary headache.(2) MigraineMigraine has existed in Ancient medical books, and has other names such as "Tou Pian Tong" etc. But it didn't record jumping pain as the nature of headache, frequency of onset, persistence time, aggravating or relieving factors and fear with sound. The genesis is close with many factors as follows:wind-evil, phlegmatic hygrosis, stagnated blood, malignant mood, fire-evil, etc.(3) TTHThe disease didn't appear in literature. discription of the nature of headache,such as "Headaehe, like wrapped, Top-heavy pain", is similar to tension-type primary headache. Literature points that the pain can emerge in both sides of head. TCM considers that the headache above is caused by damp pathogen mainly, and can be treated with Decoction of Notoperygium for Rheumatism.(4) TACsThe disease didn't emerge in literature, but register some relevant diseases,such as Orbital pain,Etc. Literature describes this diseases more severe, Disease located in orbital,supraorbital or temporal, with conjunctival hyperemia, tearing, nasal congestion, runny nose, sweating, such as performance. But no description of whether a unilateral headache and seizure frequency and duration. The genesis is close with wind-heat, phlegmatic hygrosis, stagnated blood and irascibility, and other factors related to liver disease-based organs.(5)Other primary headacheQi-deficiency type headache characteristics consistent with the performance of primary exertional headache, Blood-deficiency headache is similar with headache occurred before sleep,Also about the description of burst-type of primary headache and tingling type of primary headache,but more general.(6) Pulse tracingsIn the literature on headache,also more discussion of pulse diagnosis that tense pulse, shortpulse,floating pulse and wiry pulse are all expressed headache,and headache with short and unsmooth pulse can't be healed easily.The six meridians headache have different pulse,Taiyang headache express floating and tense pulse; Shaoyang headache express thready or wiry pulse; Yangming headache express floating,slow and long pulse;Taiyin headache express slow or deep pulse;Jueyin headache express floating and slow pulse; Shaoyin headache express deep and thready pulse. And that the performance of different causes have different pulse.(7)Manifestation of tongueThere is scanty record in this aspect. Heat disease with headache appears red tongue.三Clinical inquiry1 Objective:first,check whether there is comorbidity between manifestation of tongue and pulse tracings in primary headache. second study on correspondence between primary headache and clinical syndromes of headache in TCM by statistical analysis.2 Object:307 patients with primary headache.3 Methods:cross-sectional study is adopted, select patients according to internalizing standard and inquiry.4 Statistic method:set up database through SPSS 13.0. General data is analyzed by discriptive analysis,and quatitative data including course of disease and age of patients, are expressed with mean±standard deviation. The correspondence between two or more categorical variables using Correspondence Aanalysis or Optimal Scaling.P score were measured by two tails, P<0.05 is setted as the significant level.5 Results and conclusions:(1) General dataThe study indicates that female patients suffer primary headache more than male, Middle-Age patients more than other ages, course of the disease longer. The male female ratio is 0.2:1 in migraine,0.5:1 in tension-type headache,4:1 in cluster headache,0.5:1 in other primary headache.(2) Optimal Scaling Analysis of Tongue Pictures and Pulse Condition in Primary headacheData astringe after 32th iterations, with step length at the last time 0.0000009. The eigenvalue of 1 dimensions and 2 dimensions is 0.363 and 0.315, showing the relationship between variables and two dimensions than those closer, the variables in two dimensions on the discrimination are high.The Optimal Scaling Analysis Chart indicate that:Migraine have the close relationship with the dark tongue,white- greasy tongue fur and wiry pulse; TTH have the close relationship with the wiry and slow pulse; TACs may be relevant with red tougue;other types of primary headache may be closed with thin and yellowish fur.The results can be drawn from the above that there is a comorbidity between manifestation of tongue and pulse tracings of Migraine.Most Migraine appears dark tongue,white- greasy tongue fur and angry pulse; TTH usually appears angry and infrequent pulse; TACs may be relevant with red tougue;other types of primary headache may be closed with thin and yellowish fur. However, due to small number of cases between the latter two, needs to be further expanded the amount of data to verify this conclusion.There is comorbidity between manifestation of tongue and pulse tracings of primary headache.(3) Correspondence analysisIn correspondence analysis, distance measurement selects chi square value(P<0.05). Inertia in Dimension 1 is 0.589, while in Dimension 2 is 0.256. Dimension 1 and Dimension 2 define 55.7%,24.2% of total data respectively. Therefore, two-dimensional graphics can be fully expressed information between two variables, and the first dimension when viewed in the main. In primary headache migraine and other primary headache don't scatter well in Dimension l,but they do better in Dimension 2.Correspondence analysis graph indicates that migraine is close with headache caused by stagnation of phlegm,while TTH with wind-damp type headache in TCM. There is no similar type of headache in TCM with cluster headache and other primary headache.The symptoms of headache caused by stagnation of phlegm are headache with dizziness,vomiting of sputum and saliva whitish greasy fur,slippery pulse. Nausea and vomiting as the characteristic Western with migraine symptoms, migraine diagnosis in the diagnostic value and positive predictive values were high. Diagnosis of migraine its diagnostic value and positive predictive value are high. According to research collected in this case found that the majority of migraine patients often feel muddle-headedness, Appetite was significantly diminished when the headache, vomit mostly spit, not for the stomach contents.TTH is characterized by a sense of pressure or Jinshu, rheumatic headaches main symptoms of "headaches, such as wrap," meaning the same.Huang Di Nei Jing.Sheng Qi Tong Tian Lun third chater."Due to wet,headache as been wrapped.' Think that the "headaches, such as wrap" caused by dampness.