Staging and Differentiated Treatment of Migraine Based on the Theory of Hidden

Corresponding author: Hai Ying, haiying200311@163.com

DOI: 10.12201/bmr.202605.00029

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  Abstract: Migraine is a common chronic episodic neurological disorder characterized by a prolonged course, recurrent attacks, and difficulty in resolution, often triggered by specific factors. This closely aligns with the feature of latent pathogenic factors hiding within the body and activating opportunistically. This article explains the dynamic pathogenesis evolution of migraine as caused by deficiency leading to latent pathogenic factors, which then manifest, with phlegm and blood stasis interweaving based on the theory of latent pathogenic factors. Specifically, due to insufficient vital energy, pathogenic factors remain hidden and are triggered by inducements, leading to their outward manifestation, disturbing the sensory orifices; if the pathogenic factors linger for a long time, phlegm and blood stasis interweave and penetrate the collaterals. The entire disease process is divided into the stage of vital deficiency with latent pathogenic factors, the stage of pathogenic factors manifesting in the Shaoyang, and the stage of pathogenic factors adhering to phlegm and blood stasis. Clinical treatment should be based on stage differentiation: in the stage of vital deficiency with latent pathogenic factors, external and internally injurious pathogenic factors coexist, and the primary treatment should be supporting the vital energy and dispelling pathogenic factors, focusing on constitution adjustment and avoidance of triggers; in the stage of pathogenic factors manifesting in the Shaoyang, the latent factors emerge along the Shaoyang meridians, causing dysfunction of the Shaoyang pivot and stagnation of meridian Qi, and the treatment should focus on harmonizing Shaoyang and unblocking the meridian pathways; in the stage of pathogenic factors adhering to phlegm and blood stasis, the pathogenic factors have penetrated the blood collaterals from the Qi aspect, with phlegm turbidity and blood stasis intertwining, requiring a combined approach of eliminative and tonic therapies to resolve phlegm, remove blood stasis, and unblock the meridians. It is hoped that this theoretical framework can enrich the TCM-based differentiation and treatment approaches for migraine and provide a theoretical basis for developing migraine prevention and treatment programs with distinctive TCM characteristics.

  Key words: Fuxie theory; Righteousness and deficiency and evil are hidden; migraine; Phased treatment; Reconciliation of Shaoyang

  Submit time: 6 May 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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