Xie Xin Tang to treat Chronic Migraine

Clinical case reviewed in 2014 SHL webinar with Dr. Feng

 

Mr. Zhao, 53 years old, case number 154112

 

1st consultation on April 2nd, 1965

 

 

 

The patient suffered from HBP, often accompanied by headaches and insomnia for over 20 years. He recently suffered from epistaxis for a month with vexation, nervousness and dry stools. His blood pressure was 170~200/130~140mmHg. His tongue was red with a yellow coating and his pulse was wiry and rapid.

 

Six syndrome: Yang ming syndrome attacking the upper

 

Formula Pattern: Xie Xin Tang

 

Ingredients given:

Da Huang 10g Huan Lian 6g
Huang Qin 6g Sheng Di Tan 10g

 

Treatment principle: Clear internal heat in the upper by dredging

 

Result: After taking 3 packs of the medicine, his stools were regular, the vexation was alleviated and his insomnia resolved. Since at that time the patient experienced chest tightness, one sided migraine, his formula was changed to a Da Chai Hu Tang and Gui Zhi Fu Ling Wan jia Sheng Shi Gao. After taking the formula for 1 month, the epistaxis stopped and his blood pressure reduced to 150~160/100~110mmHg.

 

 

Analysis: If we read line 17th in the Chapter on Heart Disorders in the Jing Gui Yao Lue: “Deficiency of the Heart qi, vomiting of blood and nosebleed, Xie Xin Tang Governs”. When the heart beat is irregular and there is irritability, this is due to internal Yang Ming heat. In this case, Sheng Di Tan was given instead of Sheng Di Huang to help stop the nose bleeding. On the second consultation, the Yang Ming syndrome modified symptoms so the formula pattern also needed to be modifed. The severe heat affecting the spirit was less severe and the insomnia and vexation resolved as well as the irregular stools. However, the Chest tightness and one sided headache demonstrated blood stasis, the nose bleeding and chest tightness also confirmed the Yang Ming syndrome. Da Chai Hu Tang was given to resolve the Yang Ming syndrome affecting the chest and Gui Zhi Fu Ling Wan was given to move the blood. Sheng Shi Gao was also added to resolve the Yang Ming Heat as well as cool the blood. The results in resolving the yang ming syndrome completely also reduced the chronic blood pressure.