Identifying Chinese Medicine Patterns of Tension-Type Headache and Understanding Its Subgroups

Xinyu Hao; Fanrong Liang; Linpeng Wang; Kenneth Mark Greenwood; Charlie Changli Xue; Zhen Zheng; Ying Li

doi:10.1155/2021/5544571

Identifying Chinese Medicine Patterns of Tension-Type Headache and Understanding Its Subgroups

Evid Based Complement Alternat Med. 2021 Sep 23:2021:5544571. doi: 10.1155/2021/5544571. eCollection 2021.

Authors

Xinyu Hao^{1

2}, Fanrong Liang^{1

2}, Linpeng Wang³, Kenneth Mark Greenwood⁴, Charlie Changli Xue⁵, Zhen Zheng⁵, Ying Li^{2

6}

Affiliations

¹ Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
² Acupuncture and Chronobiology Key Laboratory of Sichuan Province, Chengdu 610075, China.
³ Department of Acupuncture, Beijing Traditional Chinese Medical Hospital, Capital Medical University, Beijing 100010, China.
⁴ School of Social Science, University of Sunshine Coast, Queensland QLD4558, Australia.
⁵ School of Health and Biomedical Sciences, RMIT University, Melbourne VIC3083, Australia.
⁶ Graduate School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.

Abstract

Tension-type headache (TTH) is common among adults. Individualized management strategies are limited due to lack of understanding of subtypes of TTH. Chinese medicine (CM) uses the pattern differentiation approach to subtype all health conditions. There is, however, a lack of evidence-based information on CM patterns of TTH. This study aimed to identity common CM patterns of TTH. TTH sufferers were invited for a survey, consisting of a validated Chinese Medicine Headache Questionnaire (CMHQ), Migraine Disability Assessment Test, and Perceived Stress Scale. The CMHQ consisted of information about headache, aggravating and relieving factors, and accompanying symptoms. Principal component analysis was used for factor extraction and TwoStep cluster analyses for identifying clusters. ANOVA was used to compare cluster groups with disability and stress. In total, 170 eligible participants took part in the survey. The commonest headache features were continuous pain (64%); fixed location (74%); aggravated by overwork (74%), stress (74%), or mental strain (70%); and relieved by sleeping (78%). The commonest nonpain symptoms were fatigue (71%) and neck stiffness (70%). Four clusters, differing in their key signs and symptoms, could be assigned to three different CM patterns including ascendant hyperactivity of liver yang (cluster 1), dual qi and blood deficiency (cluster 2), liver depression forming fire (cluster 3), and an unlabelled group (cluster 4). Additionally, over 75% participants in clusters 1 and 2 have episodic TTH, over one-third participants in cluster 3 have chronic TTH, and a majority of participants in cluster 4 have infrequent TTH. The three patterns identified also differed in levels of disability and some elements of coping as measured with PSS. The three CM patterns identified are common clinical presentations of TTH. The new information will contribute to further understanding of the subtypes of TTH and guide the development of targeted intervention combinations for clinical practice and research.