Objective

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To analyze the medication patterns of traditional Chinese medicine （TCM） external therapy for migraines based on TCM classics， providing a reference for establishing technical operation standards for the treatment of migraines.

Methods

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Relevant entries from ancient texts on TCM external therapy for migraines were searched and retrieved. Information on the names of the formulas， ingredients， dosage forms， administration routes， and onset time was extracted， standardized， and entered into a database using Excel. The frequency of the four properties， five flavors， and meridian tropism of the TCM ingredients was analyzed using the TCM inheritance support system V3.0 （TCMISS V3.0）. Additionally， association rule analysis and cluster analysis were performed on the TCM external therapy formulas.

Results

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①A total of 171 external therapy formulas， involving 206 traditional Chinese herbal medicines （TCHMs）， were included， of which 44 were identified as fast-acting. ②The formulas involved six routes of administration： nasal， ocular， aural， oral， dermal， and other routes， with nasal administration being the most frequent （97 instances）. Over ten different dosage forms were identified， including powders， plasters， pastes， fresh herbs， aerosols， and pills， with powders being the most commonly used （74 instances）. ③The distribution of the four properties showed a predominance of warm properties， followed by cold properties； among the distribution of the five flavors， pungent is the most dominant， followed by bitter； the meridian tropism analysis showed a primary focus on the liver meridian， followed by the spleen and heart meridians. ④A total of 15 high-frequency TCHMs were identified， mainly including herbs for relieving exterior syndromes， blood-activating and stasis-dissolving herbs， and orifice-opening herbs. Seven core formula combinations were identified through association rule analysis， and five core herbal clusters were obtained through cluster analysis. ⑤Among the 44 fast-acting formulas， four routes of administration were identified： nasal， aural， ocular， and dermal， involving 11 dosage forms and 71 TCHMs， with nasal administration being the most frequent （27 instances） and powders being the most commonly used （20 instances）. The high-frequency TCHMs primarily included herbs for relieving exterior syndromes and blood-activating and stasis-dissolving herbs.

Conclusion

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There are many effective TCM external therapy formulas for migraines documented in ancient TCM texts， which hold valuable potential for further exploration. These findings can provide a reference for establishing technical operation standards for the TCM external treatment of migraines.