ZHANG Xuran,CAO Kegang.Traditional Chinese and Western medicine integrative analysis on migraine pathogenesis of "disease originating from yin"[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(3):44-49.
ZHANG Xuran,CAO Kegang.Traditional Chinese and Western medicine integrative analysis on migraine pathogenesis of "disease originating from yin"[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(3):44-49. DOI: 10.16305/j.1007-1334.2026.z20250108001.
Traditional Chinese and Western medicine integrative analysis on migraine pathogenesis of "disease originating from yin"
With "disease originating from yin" serving as the theoretical pivot for integrated traditional Chinese medicine (TCM) and Western medicine (WM), the multidimensional pathogenesis of emotion-induced migraine is explored through literature review and analysis of both TCM and WM mechanisms. In TCM pathogenesis, "yin deficiency with yang hyperactivity" is considered the core pathogenesis, where emotional disturbance triggers dysfunction of the internal organs, causing qi and blood disorders and obstruction of the clear orifices. Modern research reveals that emotional stress induces a neuro-endocrine-immune network dysregulation, which disrupts cerebrospinal fluid (CSF) homeostasis and activates the trigeminovascular system through non-synaptic modulation. This paper for the first time explains that the TCM concept of "yin" governing essence preservation and regulation corresponds to the modern medical concept of CSF homeostasis maintenance. "Yin deficiency with yang hyperactivity" is reflected as a vicious cycle of CSF homeostasis imbalance and trigeminal nerve sensitization. A systematic pathological chain is constructed as "emotional imbalance – multi-system dysfunction – CSF homeostasis imbalance – trigeminal nerve activation." These findings provide new thoughts for integrated TCM and WM clinical practice, proposing a bidirectional strategy of regulating emotions and intervening in CSF homeostasis.
关键词
Keywords
references
GBD 2016 Neurology Collaborators . Global,regional,and national burden of neurological disorders,1990-2016:a systematic analysis for the Global Burden of Disease Study 2016 [J]. Lancet Neurol , 2019 , 18 ( 5 ): 459 - 480 .
ASHINA M , KATSARAVA Z , DO T P , et al . Migraine:epidemiology and systems of care [J]. Lancet , 2021 , 397 ( 10283 ): 1485 - 1495 .
GBD 2016 Headache Collaborators . Global,regional,and national burden of migraine and tension-type headache,1990-2016:a systematic analysis for the Global Burden of Disease Study 2016 [J]. Lancet Neurol , 2018 , 17 ( 11 ): 954 - 976 .
AMIRI S , BEHNEZHAD S , AZAD E . Migraine headache and depression in adults: a systematic review and meta-analysis [J]. Neuropsychiatr , 2019 , 33 ( 3 ): 131 - 140 .
OH K , CHO S J , CHUNG Y K , et al . Combination of anxiety and depression is associated with an increased headache frequency in migraineurs:a population-based study [J]. BMC Neurol , 2014 , 14 : 238 .
AMOOZEGAR F . Depression comorbidity in migraine [J]. Int Rev Psychiatry , 2017 , 29 ( 5 ): 504 - 515 .
HIDESE S . Search for cerebrospinal fluid biomarkers in patients with major psychiatric disorders:Multiplex immunoassay findings and proximity extension assay prospects [J]. Neuropsychopharmacol Rep , 2024 , 44 ( 2 ): 314 - 320 .
KAAG RASMUSSEN M , MØLLGARD K , BORK P A R , et al . Trigeminal ganglion neurons are directly activated by influx of CSF solutes in a migraine model [J]. Science , 2024 , 385 ( 6704 ): 80 - 86 .
ZARCONE D , CORBETTA S . Shared mechanisms of epilepsy,migraine and affective disorders [J]. Neurol Sci , 2017 , 38 ( Suppl 1 ): 73 - 76 .
ZHANG Q , SHAO A , JIANG Z , et al . The exploration of mechanisms of comorbidity between migraine and depression [J]. J Cell Mol Med , 2019 , 2 3 ( 7 ): 4505 - 4513 .
GUERRERO-TORO C , KOROLEVA K , ERMAKOVA E , et al . Testing the role of glutamate NMDA receptors in peripheral trigeminal nociception implicated in migraine pain [J]. Int J Mol Sci , 2022 , 23 ( 3 ): 1529 .
PARK C G , CHU M K . Interictal plasma glutamate levels are elevated in individuals with episodic and chronic migraine [J]. Sci Rep , 2022 , 12 ( 1 ): 6921 .
VIUDEZ-MARTÍNEZ A , TORREGROSA A B , NAVARRETE F , et al . Understanding the biological relationship between migraine and depression [J]. Biomolecules , 2024 , 14 ( 2 ): 163 .
WACHOWSKA K , BLIŹNIEWSKA-KOWALSKA K , SŁAWEK J , et al . Common pathomechanism of migraine and depression [J]. Psychiatr Pol , 2023 , 57 ( 2 ): 405 - 419 .
ERDENER Ş E , KAYA Z , DALKARA T . Parenchymal neuroinflammatory signaling and dural neurogenic inflammation in migraine [J]. J Headache Pain , 2021 , 22 ( 1 ): 138 .
CHEN Y H , WANG H . The association between migraine and depression based on miRNA biomarkers and cohort studies [J]. Curr Med Chem , 2021 , 28 ( 27 ): 5648 - 5656 .
VAFAEI A , VAFAEIAN A , IRANMEHR A , et al . Effects of β‑sitosterol on anxiety in migraine-induced rats:The role of oxidative/nitrosative stress and mitochondrial function [J]. CNS Neurosci Ther , 2024 , 30 ( 9 ): e14892 .
SUN X , ZHU F , ZHOU J , et al . Anti-migraine and anti-depression activities of Tianshu capsule by mediating monoamine oxidase [J]. Biomed Pharmacother , 2018 , 100 : 275 - 281 .
EREN-KOÇAK E , DALKARA T . Ion channel dysfunction and neuroinflammation in migraine and depression [J]. Front Pharmacol , 2021 , 12 : 777607 .
NILIUS B , OWSIANIK G , VOETS T , et al . Transient receptor potential cation channels in disease [J]. Physiol Rev , 2007 , 87 ( 1 ): 165 - 217 .
THAPAK P , VAIDYA B , JOSHI H C , et al . Therapeutic potential of pharmacological agents targeting TRP channels in CNS disorders [J]. Pharmacol Res , 2020 , 159 : 105026 .
YANG F , SIVILS A , CEGIELSKI V , et al . Transient receptor potential (TRP) channels in pain,neuropsychiatric disorders,and epilepsy [J]. Int J Mol Sci , 2023 , 24 ( 5 ): 4714 .
YANG Y , WEI K , ZHANG H , et al . Identifying functional brain abnormalities in migraine and depression comorbidity [J]. Quant Imaging Med Surg , 2022 , 12 ( 4 ): 2288 - 2302 .
ZHANG Y , LIU Y , HAN R , et al . Hypoechogenicity of the midbrain raphe detected by transcranial sonography:an imaging biomarker for depression in migraine patients [J]. Ther Adv Neurol Disord , 2021 , 14 : 17562864211007708 .
SÜßE M , KLOETZER C , STRAUß , et al . Increased CX3CL1 in cerebrospinal fluid and ictal serum t-tau elevations in migraine:results from a cross-sectional exploratory case-control study [J]. J Headache Pain , 2024 , 25 ( 1 ): 46 .
ONDERWATER G L J , VAN DONGEN R M , HARMS A C , et al . Cerebrospinal fluid and plasma amine profiles in interictal migraine [J ]. Ann Neurol , 2023 , 93 ( 4 ): 715 - 728 .
NELSON-MANEY N P , BÁLINT L , BEESON A L , et al . Meningeal lymphatic CGRP signaling governs pain via cerebrospinal fluid efflux and neuroinflammation in migraine models [J]. J Clin Invest , 2024 , 134 ( 15 ): e175616 .
LEVY D , MOSKOWITZ M A . Meningeal mechanisms and the migraine connection [J]. Annu Rev Neurosci , 2023 , 46 : 39 - 58 .
SPEKKER E , TANAKA M , SZABÓ Á , et al . Neurogenic inflammation:the participant in migraine and recent advancements in translational research [J]. Biomedicines , 2022 , 10 ( 1 ): 76 .
Mechanism of Chinese materia medica in regulating MAPK signaling pathway for treatment of rheumatoid arthritis
Theoretical exploration and acupuncture and moxibustion intervention strategies for mild cognitive impairment from perspective of spleen treatment
Progress in kidney‑tonifying and liver‑regulating traditional Chinese medicines for Parkinson's disease via regulating mitophagy
Mechanistic study on regulation of wide‑interacting nude‑associated matrix‑associated region 2 by 5R‑5‑hydroxytriptolide (LLDT‑8) in collagen‑induced arthritis mice
Mechanism of isoginkgetin in improving zebrafish behavioral disorders and neuronal injury
Related Author
HU Xiangyi
PAN Xin
YAO Chonghua
SHEN Jiaying
QIU Manli
SONG Zheyu
CHEN Yuan
ZHAO Chaorong
Related Institution
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
Acupuncture and Moxibustion Department, Traditional Chinese Medicine Hospital of Putuo District
Department of Traditional Chinese Medicine, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
Central Laboratory, Nanxiang Branch of Ruijin Hospital
Acupuncture and Moxibustion Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine