CLINICAL APPLICATIONS

* Acute headache:

¡± Various kinds of acute headaches (according to Western medicine): sinus, vascular, stress, supraorbital, orbital, tension, menstrual-related or migraine headaches

¡± Various types of acute headaches (according to traditional Chinese medicine): vertex, occipital, frontal, wind-cold, wind-heat, damp-phlegm, jueyin, Liver yang rising and blood stagnation headaches

 

WESTERN THERAPEUTIC ACTIONS

* Analgesic effect to relieve pain

* Anti-inflammatory effect to reduce swelling and pain

* Muscle-relaxant effect to relieve stiffness, spasms and cramps

* Improves peripheral and micro-circulation to relieve headache and prevent cerebral ischemia

 

CHINESE THERAPEUTIC ACTIONS

* Relieves pain

* Invigorates qi and blood circulation

* Removes qi and blood stagnation

 

DOSAGE

Take 3 to 4 capsules three times daily on an empty stomach. The dosage may be increased up to 6 to 8 capsules every four to six hours as needed for severe pain.

 

INGREDIENTS

Bai Zhi (Radix Angelicae Dahuricae)

Chuan Xiong (Rhizoma Chuanxiong)

Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae)

Ge Gen (Radix Puerariae Lobatae)

Yan Hu Suo (Rhizoma Corydalis)

 

BACKGROUND

Headache is pain in any part of the head, including the scalp, face, and interior of the head. Causes of headache vary, including hypertension, stress, anxiety, injuries, infection, glaucoma, hematoma, tumor, and others. Proper diagnosis requires careful review of medical history and physical exam. Optimal treatment combines elimination of cause and relief of pain.

 

FORMULA EXPLANATION

Corydalin (AC) is an empirical formula designed to relieve a variety of headaches. Corydalin (AC) contains herbs which activate qi and blood circulation, remove qi and blood stagnation, and relieve pain.

        Yan Hu Suo (Rhizoma Corydalis) is the principle herb in this formula and is used to activate qi and blood circulation, remove blood stasis, and relieve pain. Bai Zhi (Radix Angelicae Dahuricae) is used as a channel-guiding herb, which leads the effectiveness of the formula to the head. In addition, Bai Zhi (Radix Angelicae Dahuricae) has a strong effect to dispel wind and other exterior pathogenic factors. Chuan Xiong (Rhizoma Chuanxiong) and Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) activate blood circulation in the peripheral parts of the body and remove stasis. Ge Gen (Radix Puerariae Lobatae) relieves pain in the upper body and dispels wind-cold or wind-heat from the exterior parts of the body.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated during pregnancy and nursing.

* Patients with persistent pain not relieved by Corydalin (AC) should seek further examination to rule out structural or functional abnormalities.

* Should other prominent signs of diminishing eyesight and vomiting occur in addition to the headache, refer the patient to a medical doctor immediately for a CT scan or MRI to rule out intra-cranial pressure due to tumor, aneurysms, or cerebral stenosis.

* Corydalin (AC) is designed for short-term management of acute pain, not for long-term treatment of chronic pain. Therefore, once the acute pain has subsided, Corydalin (AC) should be discontinued and another maintenance formula should be initiated.

* This herbal formula contains herbs that invigorate blood circulation, such as Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]

 

CLINICAL NOTES

* Corydalin (AC) contains herbs that exert analgesic function directly on the central nervous system. Corydalin (AC) works synergistically with acupuncture to provide pain relief for various aches and pain.

* Corydalin (AC) is best for acute headaches with severe pain, and is most effective for symptomatic relief. Corydalin (CR) is most effective when taken on a long-term basis to control and prevent the recurrence of headaches.

* In addition to treating the acute symptom of pain, efforts should be made to identify the underlying cause of pain. For optimal results, another formula should be prescribed to target the cause while using Corydalin (AC) to address the symptoms.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Headache due to wind-heat: floating and forceful pulse on the right cun, and long and forceful pulse on the right chi. Temperature above the elbows and the back of the neck will feel hot.

* Headache due to wind-cold: floating and tight pulse on the right cun, and thready and long pulse on the right chi. Temperature above the elbows and the back of the neck will feel cold.

* Headache due to Liver fire: forceful and floating pulse on the left guan. Temperature of the entire arm will feel hot.

* Headache due to poisoning: forceful pulse on both chi and left guan positions.

 

SUPPLEMENTARY FORMULAS

* For migraine headaches, add Corydalin (CR).

* For headache caused by recent traumatic or musculoskeletal injury, add Flex (TMX).

* For severe, long-term headache from previous traumatic injury or blood stagnation, add Circulation (SJ).

* For headache with excess heat, add Gardenia Complex.

* For headache due to stress and tension, add Calm, Calm (ES), or Calm ZZZ.

* For headache due to Liver fire, add Gentiana Complex.

* For migraine headache with Liver wind rising, combine with Gastrodia Complex.

* For headache due to wind-heat, add Lonicera Complex.

* For headache due to sinus congestion, add Pueraria Clear Sinus or Magnolia Clear Sinus.

* For headache with neck and shoulder stiffness, add Neck & Shoulder (AC).

* For headache due to environmental or toxic poisoning, add Herbal DTX.

* For headache due to underlying damp and phlegm with Spleen qi deficiency, add Pinellia Complex.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Hegu (LI 4). Needle 1 to 1.5 cun deep. Massage the affected area on the head.

* Renzhong (GV 26), Lieque (LU 7), Taichong (LR 3), Xingjian (LR 2), Geshu (BL 17), Baihui (GV 20), Taiyang (Extra 2), Yintang (Extra 1)

 

Classic Master Tung's Points:

* Needle contralateral to the pain. If the pain is in the center, needle bilaterally or the side with the more ah shi points. If the pain is bilateral, needle bilaterally.

* Headache (general): Linggu (T 22.05), Dabai (T 22.04), Huolian (T 66.10), Huoju (T 66.11), Huosan (T 66.12). Bleed dark veins on the dorsal aspect of the feet. Bleed before needling for best result.

* Headache (occipital): Linggu (T 22.05), Dabai (T 22.04), Fanhoujue (T 22.12)*, Zhengjin (T 77.01), Wanshunyi (T 22.08), Wanshuner (T 22.09), Tongbei (T 88.11), Huofu (T 88.41)*, Huochang (T 88.43)*, Huoliang (T 88.42)*, Dihuang (T 77.19), Boqiu (T 77.04), Zhengshi (T 77.03), Zhengzong (T 77.02). Bleed the sacral region or Weizhong (BL 40) or dark veins nearby. Bleed before needling for best result.

* Headache (frontal): Linggu (T 22.05), Dabai (T 22.04), Biyi (T 1010.22), Xinling (T 33.17)*, Zhongbai (T 22.06), Taiyang, Huoju (T 66.11), Wuhu (T 11.27), Zhenjing (T 1010.08), Sifuyi (T 1010.11), Sifuer (T 1010.10), Tongtian (T 88.03). Bleed Sihuashang (T 77.08), Sihuaxia (T 77.11), Sihuazhong (T 77.09), Fuchang (T 77.12), ST channel on the lower limb and dark veins nearby. Bleed before needling for best result.

* Headache (temporal): Linggu (T 22.05), Shangbai (T 22.03), Zhongbai (T 22.06), Xinling (T 33.17)*, Cesanli (T 77.22), Cexiasanli (T 77.23), Shangjiuli (T 88.26), Zhongjiuli (T 88.25), Xiajiuli (T 88.27), Jianzhong (T 44.06), Sihuawai (T 77.14), Liuwan (T 66.08), Menjin (T 66.05), Huoying (T 66.03), Qihu (T 77.26), Waisanguan (T 77.27), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Taiyang, Waiguan (TH 5) penetrating through Neiguan (PC 6). Bleed any dark veins or tender points nearby the lateral malleolus. Bleed at a 45 degree angle the dark veins nearby the other temporal area. Patient needs to lean downwards, hold his/her breath and exhale to help push blood out. Bleed before needling for best result.

* Headache (vertex): Linggu (T 22.05), Dabai (T 22.04), Xinling (T 33.17)*, Zhenghui (T 1010.01), Qianhui (T 1010.05), Shuitong (T 1010.19), Shuijin (T 1010.20), Zhengjin (T 77.01), Shenting (GV 24), Shangxing (GV 23), Huozhu (T 66.04), Huolian (T 66.10), Huoju (T 66.11), Huosan (T 66.12), Zhengzong (T 77.02)

* Headache (migraine): Linggu (T 22.05), Dabai (T 22.04), Cesanli (T 77.22), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Liuwan (T 66.08), Zhongjiuli (T 88.25)  

* Headache (supraorbital): Erjiaoming (T 11.12), Shangbai (T 22.03), Sanchayi (T 22.15)*, Huaguyi (T 55.02), Shangli (T 1010.09), Tianhuangfu [Shenguan] (T 77.18)  

* Headache (hypertension): Linggu (T 22.05), Dabai (T 22.04), Xinling (T 33.17)*, Zhenghui (T 1010.01), Qianhui (T 1010.05), Shuitong (T 1010.19), Shuijin (T 1010.20), Sansheng (T 55.07)*, Weizhong (BL 40), Shenting (GV 24), Shangxing (GV 23), Huozhu (T 66.04), Tongtian (T 88.03), Fuding (T 44.04), Houzhi (T 44.05), Jianfeng (T 44.31)*, Tongshan (T 88.02), Tongguan (T 88.01), Zhitong (T 44.13). Bleed Huoshan (T 33.06), Huoling (T 33.05) or dark veins nearby. Bleed before needling for best result.

* Headache (common cold): Linggu (T 22.05), Dabai (T 22.04), Xinling (T 33.17)*, Zhenghui (T 1010.01), Qianhui (T 1010.05), Shuitong (T 1010.19), Shuijin (T 1010.20), Sanzhong (T 77.07), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuawai (T 77.14), Sihuaxia (T 77.11), Shenting (GV 24), Shangxing (GV 23), Huozhu (T 66.04), Dizong (T 44.09)

* Headache (menstruation): Linggu (T 22.05), Dabai (T 22.04), Xinling (T 33.17)*, Zhenghui (T 1010.01), Qianhui (T 1010.05), Shuitong (T 1010.19), Shuijin (T 1010.20), Sanzhong (T 77.07), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuawai (T 77.14), Sihuaxia (T 77.11), Shenting (GV 24), Shangxing (GV 23), Huozhu (T 66.04), Dizong (T 44.09)

* Headache (injury): Zhengjin (T 77.01), Zhengzong (T 77.02) with strong stimulation, Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Zhengshi (T 77.03). Bleed dark veins nearby the medial malleolus or Shuijing (T 66.13). Bleed before needling for best result.

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Headache

¡± Frontal: Cesanli (T 77.22), Tianhuangfu [shenguan] (T 77.18)

¡± Temporal: Cesanli (T 77.22), Zhongjiuli (T 88.25)

¡± Occipital: Cesanli (T 77.22), Zhengjin (T 77.01), Zhengzong (T 77.02)

¡± Vertex: Needle bilaterally Cesanli (T 77.22), Huozhu (T 66.04).

¡± Migraine: Cesanli (T 77.22), Menjin (T 66.05)

¡± Behind the eyes: Cesanli (T 77.22), Tianhuangfu [shenguan] (T 77.18)

 

Balance Method by Dr. Richard Tan:

* Left side: Zhongchong (PC 9), Shaochong (HT 9), Shaoshang (LU 11), Zusanli (ST 36), Weizhong (BL 40), Yanglingquan (GB 34)

* Right side: Hegu (LI 4), Houxi (SI 3), Zhongzhu (TH 3), Fuliu (KI 7), Zhongfeng (LR 4), Sanyinjiao (SP 6)

* Left and right sides can be alternated from treatment to treatment.

 

Ear Acupuncture:

* Taiyang, Adrenal Gland, Hypothalamus, Temporal Lobe

* Use metal ear balls. Switch ears every three days. Five sessions equals one treatment course.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Frontal headache: Sympathetic, Forehead, Nervous Subcortex. Bleed Ear Apex.

¡± For sinus headaches, add Internal Nose.

* Temporal headache: Temple, Sympathetic, External Sympathetic, Nervous Subcortex, Coronary Vascular Subcortex. Bleed Ear Apex.

* Occipital headache: Occiput, Lesser Occipital Nerve, Nervous Subcortex. Bleed Ear Apex.

* Vertex headache: Vertex, External Sympathetic, Nervous Subcortex. Bleed Ear Apex.

 

NUTRITION

* Avoid intake of ice drinks or cold food, as they constrict vessels, channels and collaterals.

* Drink plenty of water throughout the day to avoid dehydration.

* Diet is important to control and prevent headaches that are food related.

* Encourage the patient to consume an adequate amount of fruits, vegetables, grains, and raw nuts and seeds.

* Caffeine withdrawal is one of the most common causes of headache. In such cases, gradually decrease and stop the consumption of caffeine-containing foods, such as coffee, tea, soda and energy drinks.

* Avoid foods containing tyramine, which can cause headaches, such as alcohol, chocolate, banana, citrus fruits, avocado, cabbage, and potato. Also, avoid the consumption of cakes, coffee, dairy products (except yogurt), processed or packaged foods, tobacco, or any junk foods.

* Monosodium glutamate (MSG) should be avoided in individuals who are sensitive to it. MSG is generally found in canned soups, TV dinners, some meats, and restaurant foods.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Make tea from ginger and green onions, boiling for five minutes; drink and try to sweat.

* Steam aching portion of head over mint and cinnamon tea that is cooking, then dry head afterwards, avoiding drafts.

* Drink tea made from chrysanthemum flowers and cassia seeds.

* Make buckwheat meal into a paste and apply to painful area until it sweats.

* Drink green tea.

* Make rice porridge and add garlic and green onions. Eat while hot then get under covers and sweat.

* Avoid spicy food, lack of sleep, alcohol, smoking, excessive stimulation, eye strain, and stress.

 

LIFESTYLE INSTRUCTIONS

* Avoid allergens as much as possible if the headache is triggered by allergy. Installation of an air purifier will minimize the presence of allergens in the air and reduce the risk of allergy and headache.

* Avoid direct exposure to air conditioning, fans, or wind to the head or neck region.

* Avoid stressful situations and environments whenever possible. Ease the tension with massage, warm baths, and an exercise program.

* Tension headaches can be relieved by gentle massage of the neck and shoulders to relax the muscles. A hot Epsom salts bath is also helpful.

* Headache due to poor circulation will respond to vigorous scalp massage.

* Regular exercise, adequate rest, and normal sleeping habits are essential for optimal health.

 

CASE STUDIES

* M.M., a 42-year-old female, presented with chronic jaw pain located on the left side of her face. The patient had been experiencing it for ten years and was grinding her teeth at night. Upon palpation, nodules were found around Jiache (ST 6), the jaw was visibly misaligned, and it was difficult for the patient to open her mouth. The practitioner diagnosed this condition as Liver qi stagnation, blood stasis, and Liver and Kidney yin deficiencies. Her Western diagnosis was temporomandibular joint disorder (TMJ). Corydalin (AC) was given at a dosage of two spoonfuls, as needed, for her tension and pain. Administration of the recommended doses produced excellent results. The patient reported a decrease in tension, circulation to the area returned, and being able to open her mouth easier immediately after drinking the herbs. The combination of doing acupuncture and self-massage also helped the jaw¡¦s alignment and caused many of the nodules to disappear. Submitted by M.M., Alameda, California.

* F.R., a 48-year-old female, presented with tension cluster headaches, about five to seven headaches per week. The practitioner diagnosed this condition as qi and blood stagnation, along with Liver blood and yin deficiencies. For treatment, Corydalin (CR) was prescribed at three capsules three times per day, as well as taking Corydalin (AC), as needed. Acupuncture treatment was received as well. During the first two weeks of taking the herbs, the patient reported four to six headaches per week. By the 5^th week of taking the herbs, the headaches reduced to only one per week. After eight weeks of taking the herbs, she seldom experienced headaches. Submitted by S.L., Yuma, Arizona.

* A 55-year-old female, M.V., presented with acute pounding headaches with no known cause. The practitioner diagnosed this condition as Liver overacting on Spleen. Upon diagnosis, Corydalin (AC) was prescribed. Within 24 hours of taking the herbs, the onset of the headaches were either delayed or not present. The results were very quick and effective. Later, it was discovered that the headaches were triggered by lack of sleep and by increased consumption of processed food. Submitted by V.G., Virginia Beach, Virginia.

* N.P., a 51-year-old perimenopausal female, presented with hot flashes, joint pain, difficulty sleeping, and headaches that would last 2 to 3 days. Her cycle was currently every 28 days, with heavy bleeding and clots. The patient was also overweight. The TCM diagnosis was qi, blood and yin deficiencies; the Western diagnosis was perimenopausal hormonal headaches. Corydalin (AC) was prescribed, and she was directed to take it at the first sign of a headache and continue taking it for a few days following. By taking the Corydalin (AC) as instructed, it prevented her headaches from occurring. Due to its effectiveness, she continues taking the Corydalin (AC) four days before her menstruation. Submitted by N.V., Muir Beach, California.

* A 43-year-old female nurse presented with severe menstrual cramping and pain, along with nausea and vomiting. She was unable to work because of her illness. Tenderness and pain were felt in the abdominal region with Zhongfeng (LR 4) and Ligou (LR 5) being the most tender distal points upon palpation. The practitioner diagnosed the condition as qi and blood stagnation in the abdomen and Liver qi stagnation. In addition to the stagnation were damp accumulation with multiple uterine fibroids (7.3 cm in size) and an ovarian cyst. She was instructed to take Corydalin (AC), 6 to 8 capsules, two to four times a day, which helped to control the pain and, in turn, reduced the need for her missing more work. With the help of the herbs, not only did the severity and intensity of her menstrual cramping subsided, but the occurrence lasted only for a few hours instead of one to two days. Eventually the patient did not experience any more vomiting associated with pain. The practitioner concluded that Corydalin (AC) worked as a superb analgesic herbal formula during the treatment. Submitted by T.W., Santa Monica, California.

* A 31-year-old male administrative assistant with migraines since the age of six had been treated with Imitrex (sumatriptan) with limited success. The migraines were diagnosed as qi and blood stagnation with Liver qi stagnation stirring up wind. The doctor prescribed Corydalin (AC), upon which the patient experienced almost immediate and positive results! The patient subsequently stopped using Imitrex (sumatriptan) completely which, in turn, reduced occurrences of rebound headaches. Submitted by J.K., Woodland Hills, California.

* A 47-year-old female acupuncturist presented with one-sided severely debilitating migraines, which occurred particularly during the weekends. The TCM diagnosis was Kidney yin deficiency leading to Liver yang rising. A dose of Corydalin (AC) relieved the pain especially when the drug Imitrex (sumatriptan) was unsuccessful. Within two weeks of taking Corydalin (AC), she was free from headaches. She supplemented her treatment with Gastrodia Complex in addition to acupuncture treatments. She has experienced no migraine episodes for more than six months, and continues using the herbal combination of Corydalin (AC) and Gastrodia Complex. Submitted by D.W., Hashbrouck Heights, New Jersey.

* A 44-year-old female police officer presented with chronic headaches located in the occipital and temporal regions. She stated that stress aggravated the problem. There was acute tenderness at the Fengchi (GB 20) area as well as in the cervical spine. She also experienced pain on her zygoma. The practitioner diagnosed the condition as qi and blood stagnation in Gallbladder, Urinary Bladder, and Small Intestine channels in addition to myofascial syndrome, which was stress-induced because of the nature of her job. She was treated with Corydalin (AC), Neck & Shoulder (AC), and Calm (ES), which were all so effective that they subsequently replaced her medication, Imitrex (sumatriptan). The practitioner concluded that a critical aspect in the treatment was to assist the patient in coping with her stress, which in turn made the herbal treatment more effective. Submitted by S.C., La Crescenta, California.

* A 64-year-old female retired editor presented with severe sinus headaches and acute/chronic sinusitis. There was severe sinus pain on palpation above and below her eyebrows. Her tongue had a reddish tip, and the coat was thin with a whitish yellow color. Pulse diagnosis was slightly elevated at the Lung position. The practitioner diagnosed the condition as damp-heat in the upper jiao. Administration of the recommended doses of Corydalin (AC) produced excellent results. The patient also reported that the most immediate relief from her sinus headaches occurred upon taking the Corydalin (AC) formula exclusively. The practitioner also noted similar positive outcomes from other patients. Submitted by R.K., San Diego, California.

* A 50-year-old female public information specialist who was emotionally labile presented with pain in the shoulder, neck, thoracic area, lumbar area, and foot. Her lumbar discs at L4 and L5 were herniated. In addition to migraines and bouts of constipation, she also complained of anxiety, depression and insomnia, all of which may be attributed to some side effects of taking multiple pharmaceuticals. The practitioner diagnosed her condition as qi and blood stagnation as well as Liver depression. Corydalin (AC) and Schisandra ZZZ were given. Corydalin (AC) significantly reduced her pain. She was able to lessen the use of oxycontin and Duragesic (fentanyl) patches significantly. In fact, the dosages of oxycontin and Duragesic (fentanyl) patches were reduced by as much as 75%. Furthermore, the practitioner observed that Corydalin (AC) was also effective to maintain other patients who suffered from occasional pain. The majority of patients (about 90%) who took Corydalin (AC) responded favorably, especially since most were experiencing digestive side effects with ibuprofen. Submitted by F.G., Sykesville, Maryland.

* An 85-year-old retired female presented with excruciating pain in the neck and shoulder that causes difficulty sleeping. Objective findings included limited range of motion of the neck. The tongue had a dirty yellow coat and a red tip. The Western diagnosis included psoriatic arthritis, arthritis, fibromyalgia, hiatal hernia, hypertension, depression, chronic constipation, leaky gut syndrome, sciatica, and insomnia. The patient was instructed to take Neck & Shoulder (AC) and Corydalin (AC), 3 capsules of each three times daily in between meals. Calm (ES) was given at night to help sleep. The patient responded that the formulas were effective in reducing the acute pain in the neck and shoulder region. After the acute phase two weeks later, the patient was switched to Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) and Shao Yao Gan Cao Tang (Peony and Licorice Decoction), a combination recommended by Dr. Richard Tan that consistently helped patients with fibromyalgia. Submitted by J.B., Camarillo, California.

* L.N., a 42-year-old female, had a history of headaches and migraines triggered by stress and/or environmental factors. She presented with sinus headache for two days following a migraine headache. Clinical manifestations included orbital pain with photophobia, and neck and shoulder pain. The TCM diagnosis was qi and blood stagnation. Acupuncture treatment was combined with Corydalin (AC) at three capsules, three times daily, or as needed for headache. The practitioner commented that all symptoms were resolved after treatments. Submitted by C.L., Chino Hills, California.

* At a seminar in Providence, Rhode Island, a question was raised as whether Yan Hu Suo (Rhizoma Corydalis) would cause a person treated with this herb to test positive in a drug screen (as do a number of analgesic substances). A very small study was conducted in a laboratory at the Rhode Island Clinical Research Center: two people taking 6 capsules of Corydalin (AC) were screened for drugs three hours later. Both were completely negative in the seven drug panels. A solution of 5% Yan Hu Suo (Rhizoma Corydalis) powdered extract (freed from excessive carbohydrate) was also tested in the drug-screening test, again with negative results. It was concluded by the researchers that a person being treated for pain with the usual dosage of Corydalin (AC) would not risk testing positive for substances such as opiates, benzodiazepines, and barbiturates. [Note: Yan Hu Suo (Rhizoma Corydalis) is the main ingredient that is present in both Corydalin (AC) and Herbal ANG.] Submitted by D.W., Hadley, Massachusetts.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Corydalin (AC) is an empirical formula designed to relieve various kinds of headaches. Corydalin (AC) contains herbs with strong effects to relieve pain, reduce inflammation, and improve blood circulation.

        Yan Hu Suo (Rhizoma Corydalis) is one of the strongest and most potent herbs for treatment of pain. Its effects are well documented in both historical references and modern research studies. According to classical texts, Yan Hu Suo (Rhizoma Corydalis) has been shown to treat chest and hypochondriac pain, epigastric and abdominal pain, hernial pain, amenorrhea or menstrual pain, and pain of the extremities. According to laboratory studies, the extract of Yan Hu Suo (Rhizoma Corydalis) has been found to be effective in both acute and chronic phases of inflammation. The mechanism of its anti-inflammatory effect is attributed to its effect to inhibit the release of histamine and pro-inflammatory mediators.[2]^,[3] Furthermore, it has a strong analgesic effect. With adjustment in dosage, the potency of Yan Hu Suo (Rhizoma Corydalis) has been compared to that of morphine. In fact, the analgesic effect of Yan Hu Suo (Rhizoma Corydalis) is so strong and reliable that it has been used with satisfactory anesthetic effect in 98 out of 105 patients (93.4%) who underwent surgery.[4] The analgesic effect can be potentiated further with concurrent acupuncture therapy. In one research study, it is demonstrated that the analgesic effect is increased significantly with concurrent treatments using Yan Hu Suo (Rhizoma Corydalis) and electro-acupuncture, when compared to a control group, which received electro-acupuncture only.[5] Overall, it is well understood that Yan Hu Suo (Rhizoma Corydalis) has a marked effect to treat pain. Though the maximum analgesic effect of Yan Hu Suo (Rhizoma Corydalis) is not as strong as morphine, it has been determined that the herb is much safer, with significantly less side effects, less risk of tolerance, and no evidence of physical dependence even with long-term use.[6] Clinically, 47 patients with angioneurotic headache were treated successfully (24 had complete relief of pain, 22 had partial relief, and 1 had no effect) using an herbal formula with Yan Hu Suo (Rhizoma Corydalis) as the chief ingredient.[7]

        Bai Zhi (Radix Angelicae Dahuricae), an important herb in Corydalin (AC), has both analgesic and anti-inflammatory properties.[8] The mechanism of action is attributed in part to the inhibition of lipopolysaccharide-induced production of nitric oxide, prostaglandin E2 and tumor necrosis factor-alpha (TNF-£\) via mitogen-activated protein kinases and nuclear factor-kappaB in macrophages.[9] Clinically, Bai Zhi (Radix Angelicae Dahuricae) is used to treat vertex headache, sinus headache, orbital headache, and headache due to wind-heat or wind-cold.[10] In one study of 73 patients with occipital headache, after receiving two doses of Bai Zhi (Radix Angelicae Dahuricae), 69 patients experienced complete relief, 3 patients experienced partial relief, and 1 patient noted no relief.[11] In another study involving 62 patients with chronic headache, 54 patients reported satisfactory results after approximately two weeks of herbal treatment.[12] Furthermore, 130 patients with vascular headache were treated with complete recovery in 84 cases, significant improvement in 25 cases, and moderate improvement in 21 cases. The herbal formula contained Bai Zhi (Radix Angelicae Dahuricae), Chuan Xiong (Rhizoma Chuanxiong) and others as needed. The treatment protocol was to administer one dose (approximately 6.9 grams of the powdered herbs) two times daily with warm water.[13] Lastly, a 5% solution of Bai Zhi (Radix Angelicae Dahuricae) was given to 62 patients with headaches. One course of treatment ranged from 10 to 15 days, and patients received one to two courses of treatment. Of 62 patients, 54 showed significant improvement.[14]

        Chuan Xiong (Rhizoma Chuanxiong) is a potent herb to relieve pain and reduce inflammation. It exerts an anti-inflammatory effect via an inhibitory activity on TNF-£\ production and bioactivity, and shows a promising effect to treat inflammation and related diseases.[15] Clinically, it has been used in various formulas to effectively treat various types and causes of headaches. One study reports 95.1% success rate to treat various types and causes of headache using Chuan Xiong (Rhizoma Chuanxiong) and Dang Gui (Radix Angelicae Sinensis) as the chief herbs.[16] In another study, 50 patients with headaches were treated with great success using herbal formulas with Chuan Xiong (Rhizoma Chuanxiong) as the main ingredient.[17] Lastly, one herbal formula with Chuan Xiong (Rhizoma Chuanxiong) demonstrated a 96.3% rate of effectiveness for treatment of vascular headache among 54 patients (40 showed complete recovery, 12 showed improvement, and 2 had no effect).[18]

        Ge Gen (Radix Puerariae Lobatae) is an excellent herb to relax the muscle and reduce stiffness. It contains many isoflavonoid compounds which have significant analgesic and muscle-relaxant activities.[19] Traditionally, it has been commonly used to treat stiffness and pain in the neck and shoulder regions. Today, by relaxing the neck and shoulder muscles, it has also been shown to treat migraine headache with an 83% rate of effectiveness.[20] According to one study, 44 patients (83%) reported significant reduction in pain after taking Ge Gen (Radix Puerariae Lobatae) three times daily for 2 to 22 days.[21]

        Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) is used primarily to improve peripheral blood circulation.[22] Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) improves microcirculation and is commonly used to increase blood perfusion to the brain.[23] Two studies showed Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) to offer protection against cerebral ischemia by increasing cerebral perfusion and reducing ultra-structural abnormalities.[24]^,[25] Other studies demonstrated that by increasing cerebral perfusion, Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) reduces neurological deficits and repairs cellular damage.[26]^,[27]

        In summary, Corydalin (AC) is an excellent formula to treat pain in patients suffering from headaches. It contains herbs with analgesic effects to alleviate pain, anti-inflammatory effects to reduce swelling and inflammation, and muscle-relaxant effects to relieve stiffness, spasms and cramps.

 

COMPARATIVE ANALYSIS

Pain is a basic bodily sensation induced by a noxious stimulus that causes physical discomfort (such as pricking, throbbing, or aching). Pain may be of acute or chronic state, and may be of nociceptive, neuropathic, or psychogenic origin. Two classes of drugs commonly used to treat pain include non-steroidal anti-inflammatory drugs (NSAID) and opioid analgesics. NSAIDs [such as Motrin (ibuprofen) and Voltaren (diclofenac)] are generally used for mild to moderate pain, and are most effective to reduce inflammation and swelling. Though effective, they may cause such serious side effects as gastric ulcer, duodenal ulcer, gastrointestinal bleeding, tinnitus, blurred vision, dizziness and headache. Furthermore, the newer NSAIDs, also known as COX-2 inhibitors [such as Celebrex (celecoxib)], are associated with significantly higher risk of cardiovascular events, including heart attack and stroke. Opioid analgesics [such as Vicodin (APAP/hydrocodone) and morphine] are usually used for severe to excruciating pain. While they may be the most potent agents for pain, they also have the most serious risks and side effects, including but not limited to dizziness, lightheadedness, drowsiness, upset stomach, vomiting, constipation, stomach pain, rash, difficult urination, and respiratory depression resulting in difficult breathing. Furthermore, long-term use of these drugs leads to tolerance and addiction. In brief, it is important to remember that while drugs offer reliable and potent symptomatic pain relief, they should only be used if and when needed. Frequent use and abuse leads to unnecessary side effects and complications.

        Treatment of pain is a sophisticated balance of art and science. Proper treatment of pain requires a careful evaluation of the type of disharmony (excess or deficiency, cold or heat, exterior or interior), characteristics (qi and/or blood stagnations), and location (upper body, lower body, extremities, or internal organs). Furthermore, optimal treatment requires integrative use of herbs, acupuncture and tui-na therapies. All these therapies work together to tonify the underlying deficiencies, strengthen the body, and facilitate recovery from chronic pain. TCM pain management targets both the symptom and the cause of pain, and as such, often achieves immediate and long-term success. Furthermore, TCM pain management is often associated with few or no side effects.

        For treatment of mild to severe pain due to various causes, TCM pain management offers similar treatment effects with significantly fewer side effects than Western medicine. However, as in any therapeutic approach, it is important to recognize the limitations of TCM pain management. In some cases, such as excruciating cancer pain in terminally ill patients, drugs are simply superior to herbs. Under these circumstances, potent and consistently reliable pain relief is the main objective, and this can be accomplished more effectively by use of drugs such as intravenous injection of morphine. Herbs should be used to support the underlying constitution of the body, and to alleviate the side effects of the drugs.