头痛几乎人人都痛过。但有些人是偶尔痛一下，有些人却是三天两头、一个月十几次，痛起来做不了事、脾气也变差。大多数人的应对方式只有一个——吞一颗止痛药压下去。可如果你越吃越频繁、越压越顽固，问题就来了。中医看头痛，第一步不是「止」，而是「分」：你到底是哪一种头痛？不同的头痛，来路不同，方向也完全不同。
Almost everyone has had a headache. But some get one now and then, while others get them several times a week — a dozen a month — losing the ability to work and turning short-tempered. Most people have one response: swallow a painkiller and push it down. Yet if you're taking them more and more often and the pain only gets more stubborn, there's a problem. TCM's first step isn't to "stop" the pain but to "sort" it: which kind of headache is this? Different headaches have different origins — and entirely different directions of care.
Hampir semua orang pernah sakit kepala. Tetapi sesetengah orang sekali-sekala, manakala yang lain beberapa kali seminggu — belasan sebulan — hilang keupayaan bekerja dan cepat marah. Kebanyakan orang ada satu tindak balas: telan ubat tahan sakit. Tetapi jika anda makan makin kerap dan sakit makin degil, ada masalah. Langkah pertama TCM bukan "menghentikan" sakit tetapi "mengasingkannya": jenis sakit kepala yang mana ini?
头痛不是一种病，是一个症状
A Headache Is a Symptom, Not One Disease
Sakit Kepala Ialah Simptom, Bukan Satu Penyakit
「头痛」两个字，底下藏着好几种完全不同的情况。绝大多数（约九成）反复发作的头痛是「原发性」的——头本身没长东西、没病灶，是肌肉紧张、血管、神经调节出了问题，比如紧张型头痛和偏头痛。少数是「继发性」的——头痛只是表象，背后有别的原因（颈椎、鼻窦、血压、甚至更严重的问题）。中医的做法，是先分清你属于哪一型，再从体质和诱因入手，而不是一律「头痛医头」。
Behind the word "headache" sit several entirely different situations. The vast majority (around 90%) of recurring headaches are "primary" — nothing is growing in the head and there's no lesion; it's muscle tension, blood vessels, or nerve regulation gone awry, as in tension-type headache and migraine. A minority are "secondary" — the headache is only the surface, with another cause behind it (the neck, sinuses, blood pressure, even something more serious). TCM's approach is to first sort which type you are, then work from constitution and triggers — not simply "treat the head where it hurts."
Di sebalik perkataan "sakit kepala" terdapat beberapa keadaan berbeza. Majoriti besar (sekitar 90%) sakit kepala berulang adalah "primer" — tiada apa tumbuh di kepala; ia ketegangan otot, saluran darah, atau saraf yang terganggu. Sebilangan kecil "sekunder" — sakit kepala hanya permukaan, dengan sebab lain di belakangnya. Pendekatan TCM ialah mengasingkan jenis anda dahulu.
大部分长期、反复、规律的头痛（紧张型、偏头痛）是原发性的，可以从容辨证调理。但有些头痛是身体在拉警报，必须先排除：突然爆发、几秒内达到「这辈子最痛」的头痛；伴随发烧、脖子僵硬；伴随说话不清、一侧手脚无力、面部歪斜、视力骤变；头部外伤后的头痛；50岁后新发或性质突然改变的头痛。这些是危险信号，要立即看西医。先分清「是老毛病，还是新警报」，是处理头痛最重要的第一步。
Most long-standing, recurring, patterned headaches (tension-type, migraine) are primary and can be worked through calmly. But some headaches are an alarm and must be ruled out first: a sudden burst reaching "worst-ever" in seconds; with fever and a stiff neck; with slurred speech, one-sided weakness, a drooping face, or sudden vision change; a headache after a head injury; or a new or newly-changed headache after 50. These are red flags for immediate medical care. Telling "old familiar" from "new alarm" is the single most important first step.
Kebanyakan sakit kepala lama dan berulang (jenis tegang, migrain) adalah primer dan boleh dirawat dengan tenang. Tetapi sesetengah sakit kepala ialah penggera dan mesti disingkirkan dahulu: letupan mengejut mencapai "paling teruk" dalam beberapa saat; dengan demam dan leher kaku; dengan pertuturan pelo, kelemahan sebelah, atau perubahan penglihatan mendadak; selepas kecederaan kepala; atau baru selepas usia 50. Ini isyarat bahaya untuk rawatan segera.
你的头痛，是哪一种？
Which Kind of Headache Do You Have?
Sakit Kepala Anda Jenis Yang Mana?
临床上常见的反复头痛大致有这四种。很多人是混合型——比如颈肩紧张诱发偏头痛。分清主要是哪一型，加上中医辨体质，才知道该疏、该平、该松，还是该补。
Recurring headaches commonly fall into these four. Many people are mixed — neck-and-shoulder tension setting off a migraine, for instance. Sorting which type leads, plus reading the constitution, tells whether to soothe, calm, release, or tonify.
Sakit kepala berulang biasanya terbahagi kepada empat ini. Ramai orang bercampur. Mengasingkan jenis utama, ditambah membaca perlembagaan, menentukan arahnya.
最常见。整个头像被一条紧带箍住、闷胀发紧，多在两侧或后脑，连着肩颈僵硬酸痛，程度中等、还能做事，压力大、久坐低头、睡不好后加重。中医多归肝郁气滞、颈肩劳损、气血不畅。方向是疏肝解郁、松解颈肩、通调气血——上班族最常见的一型。
The most common. The whole head feels gripped by a tight band — dull, pressing — usually on both sides or the back, tied to a stiff sore neck and shoulders, moderate in intensity, still able to function, worse after stress, long hours hunched, or poor sleep. TCM links it to liver-qi stagnation, neck-shoulder strain, and sluggish qi and blood. The direction is to soothe the liver, release the neck and shoulders, and move the qi — the office worker's classic.
Paling biasa. Seluruh kepala seperti diikat tali ketat — tumpul, menekan — biasanya kedua-dua sisi, terikat dengan leher dan bahu kaku, lebih teruk selepas tekanan atau tidur buruk. TCM mengaitkannya dengan qi hati tersekat dan ketegangan leher-bahu. Arahnya melembutkan hati dan melonggarkan leher.
多是一侧、一跳一跳的搏动痛，程度较重、常让你什么都做不了，可能伴恶心呕吐、怕光怕吵，有人发作前会看到闪光、视觉先兆，女性常和月经周期相关。中医多归肝阳上亢、肝火上扰、或痰浊瘀阻。方向是平肝潜阳、清降肝火，别乱补更别乱进补温热的东西——补错了会火上加油。
Usually one-sided, throbbing and pulsing, more intense — often leaving you unable to do anything — possibly with nausea, vomiting, and sensitivity to light and sound; some see flashes or a visual aura beforehand, and in women it often tracks the menstrual cycle. TCM links it to ascendant liver-yang, liver-fire, or phlegm-stasis. The direction is to calm the liver and clear the fire — don't over-tonify, and avoid warming tonics that pour oil on the flame.
Biasanya sebelah, berdenyut, lebih kuat — sering menyebabkan anda tak boleh buat apa-apa — mungkin dengan mual dan sensitif kepada cahaya; sesetengah melihat kilauan sebelumnya, dan pada wanita ia mengikut kitaran haid. TCM mengaitkannya dengan yang hati naik atau api hati. Arahnya menenangkan hati — jangan menambah secara salah.
痛常从后脑勺、脖子根部往上「爬」到头顶或太阳穴，转脖子、低头久了加重，多有长期颈椎劳损、姿势不良的底子——现代人低头看手机、盯电脑是主因。中医多归颈部气血瘀阻、经络不通。方向是松解颈椎周围、通络活血，这一型推拿、针灸效果往往很直接。
Pain often "climbs" from the back of the head or base of the neck up to the crown or temples, worse after turning the neck or hunching, over a background of long-standing cervical strain and poor posture — phone and screen hunching being the modern culprit. TCM links it to blocked qi and blood and obstructed channels in the neck. The direction is to release the neck and free the channels; tuina and acupuncture are often directly effective here.
Sakit sering "memanjat" dari belakang kepala atau pangkal leher ke mahkota atau pelipis, lebih teruk selepas memusing leher, atas latar ketegangan servikal lama. TCM mengaitkannya dengan qi dan darah tersekat di leher. Arahnya melonggarkan leher; tuina dan akupunktur sering berkesan langsung.
隐隐作痛、绵绵不休，越累越痛、睡不够或饿了就发作，休息后减轻，常伴头晕、面色偏白或萎黄、心悸、乏力。多见于产后、月经量多、大病后、长期操劳、饮食不规律的人。中医认为「清阳不升、脑失所养」。方向是补气养血、升清养脑，是需要慢慢补的一型。
A dull, unremitting ache, worse the more tired you are, flaring when short on sleep or hungry and easing with rest, often with dizziness, a pale or sallow face, palpitations, and fatigue. Common after childbirth, heavy periods, serious illness, long overwork, or irregular meals. TCM sees it as "clear yang failing to rise, the brain unnourished." The direction is to boost qi and blood and lift the clear yang — a type that tonifies slowly.
Sakit tumpul berterusan, lebih teruk apabila penat, muncul apabila kurang tidur atau lapar dan reda dengan rehat, sering dengan pening dan muka pucat. Biasa selepas bersalin, haid banyak, atau kerja berat. TCM melihatnya sebagai "yang jernih gagal naik, otak tidak dipupuk." Arahnya menambah qi dan darah secara perlahan.
安心中医怎么处理头痛？
How Does An Xin TCM Treat Headaches?
Bagaimana An Xin TCM Merawat Sakit Kepala?
中医处理头痛，不只想着「这次痛怎么止」，更想着「怎么让它发得没那么勤」。先辨清你是哪一型、诱因是什么，再决定该疏肝、平肝、松颈，还是补气血。方向对了，好转是痛的程度减轻、发作的次数减少、每次持续的时间缩短，也慢慢摆脱对止痛药的依赖。
TCM doesn't only think about "how to stop this attack," but "how to make them come less often." First tell which type you are and what your triggers are, then decide whether to soothe the liver, calm it, release the neck, or tonify qi and blood. Get the direction right and improvement shows as less severe pain, fewer attacks, and shorter episodes — and a gradual weaning off painkillers.
TCM tidak hanya memikirkan "cara menghentikan serangan ini," tetapi "cara menjadikannya kurang kerap." Kenal pasti jenis dan pencetus anda dahulu. Arah yang betul menunjukkan sakit kurang teruk, kurang serangan, dan tempoh lebih pendek — dan beransur bebas daripada ubat tahan sakit.
头痛是针灸的经典适应症之一。常取百会、太阳、风池、率谷等头部局部穴止痛，配合谷、太冲（合称「四关」）疏通全身气机，肝阳上亢加行间、太溪平肝。很多人针后当下就觉得头「松开」了一些。规律做一个疗程，发作频率往往能明显往下走——这也是国际上研究较多、认可度较高的针灸应用之一。
Headache is one of acupuncture's classic indications. Local head points — Baihui, Taiyang, Fengchi, Shuaigu — ease the pain, paired with Hegu and Taichong (the "Four Gates") to move the whole-body qi, adding Xingjian and Taixi to calm ascendant liver-yang. Many feel the head "loosen" right after a session. Over a regular course, the frequency of attacks often drops markedly — among the more researched, better-recognised uses of acupuncture internationally.
Sakit kepala ialah salah satu petunjuk klasik akupunktur. Titik kepala tempatan — Baihui, Taiyang, Fengchi — melegakan sakit, digandingkan Hegu dan Taichong untuk menggerakkan qi seluruh badan. Ramai perasan kepala "longgar" selepas sesi. Sepanjang rawatan, kekerapan serangan sering menurun.
紧张型、肝郁常用逍遥散、川芎茶调散疏肝理气止痛；偏头痛、肝阳上亢用天麻钩藤饮平肝潜阳；痰浊型用半夏白术天麻汤化痰；气血虚用八珍汤、补中益气补养。安心用的是科学中药（浓缩颗粒），冲水就能喝，不必自己煎，方便长期调理。用药永远跟着证型走——同样喊头痛，疏和补几乎相反。
For tension-type and liver-qi stagnation, Xiaoyao San or Chuanxiong Chatiao San to soothe and relieve; for migraine and ascendant liver-yang, Tianma Gouteng Yin to calm and anchor; for the phlegm type, Banxia Baizhu Tianma Tang; for qi-blood deficiency, Bazhen Tang or Buzhong Yiqi. An Xin uses concentrated herbal granules — mix with water, no boiling — making long-term care easy. Herbs always follow the pattern — the same "headache" calls for near-opposite formulas.
Formula berbeza mengikut corak — jenis tegang, migrain, jenis kahak, atau qi-darah lemah. An Xin menggunakan granul herba tumpat — cukup dicampur air. Herba sentiasa mengikut corak — "sakit kepala" yang sama memerlukan formula hampir bertentangan.
紧张型和颈源型头痛，根子常在颈肩——肌肉长期紧绷、颈椎劳损，把痛「牵」上头。推拿松解颈肩、放松枕后和斜方肌，配合拔罐，往往能直接减轻这两型的头痛。对久坐低头的上班族尤其对症。头和颈从来是连着的，松了颈肩，头才轻。
For tension-type and cervicogenic headaches, the root often lies in the neck and shoulders — chronically tight muscles and cervical strain that "pull" the pain up to the head. Tuina to release the neck and shoulders, relaxing the sub-occipital and trapezius muscles, with cupping, often eases these two types directly. Especially fitting for hunched office workers. The head and neck are always connected — loosen the neck and the head lightens.
Untuk sakit kepala jenis tegang dan dari leher, puncanya sering di leher dan bahu — otot ketat kronik yang "menarik" sakit ke kepala. Tuina untuk melonggarkan leher dan bahu, dengan bekam, sering melegakan kedua-dua jenis ini secara langsung. Kepala dan leher sentiasa berkait.
急性发作、单纯的紧张型，方向对了往往几次就有感。反复多年的偏头痛、气血虚型，一般需要1–3个月，让发作程度减轻、次数减少、时长缩短，逐步减少止痛药的用量。目标不是保证「从此一次都不痛」，而是找出你的诱因和体质弱点、把发作压到可控范围，让头痛不再主宰你的工作和心情。
An acute flare or a simple tension-type often responds within a few sessions. A years-long migraine or qi-blood-deficient type usually needs 1–3 months to reduce severity, frequency, and duration, and to taper the painkillers. The goal isn't to guarantee you never hurt again, but to find your triggers and constitutional weak points and keep attacks in a manageable range, so headaches no longer run your work and mood.
Serangan akut atau jenis tegang mudah sering bertindak balas dalam beberapa sesi. Migrain bertahun biasanya memerlukan 1–3 bulan untuk mengurangkan keterukan, kekerapan, dan tempoh. Matlamatnya bukan menjamin anda tak pernah sakit lagi, tetapi mengekalkan serangan dalam julat terurus.
两件事请一定记住。第一，警惕「药物过量性头痛」。如果你每周都要吃好几次止痛药来压头痛，药吃太频繁反而会让头痛变得更顽固、更频繁，形成恶性循环——很多慢性头痛越来越难缠，就是这样来的。第二，认得危险信号。出现以下任何一个，请立即就医、别只靠中医观察：突然爆发、几秒达到「这辈子最痛」的雷击样头痛；头痛伴发烧、脖子僵硬无法低头；伴说话不清、一侧肢体无力、面部歪斜、视力骤变、意识模糊、抽搐；头部外伤后持续头痛；50岁后新发、或越来越频繁越来越重的头痛。这些可能是脑出血、脑膜炎、中风等急症。中医调理与必要的西医检查从不冲突。
Two things to remember. First, beware "medication-overuse headache." If you're taking painkillers several times a week to suppress headaches, taking them too often can make the headache more stubborn and more frequent — a vicious cycle behind much chronic headache. Second, know the red flags. Seek care immediately, rather than watching with TCM, for any of: a sudden "worst-ever" thunderclap headache peaking in seconds; headache with fever and a stiff neck; with slurred speech, one-sided weakness, a drooping face, sudden vision change, confusion, or seizure; persistent headache after a head injury; or a new, or increasingly frequent and severe, headache after 50. These can be brain haemorrhage, meningitis, or stroke. TCM care and necessary medical checks never conflict.
Dua perkara untuk diingat. Pertama, berhati-hati dengan "sakit kepala akibat lebihan ubat." Jika anda makan ubat tahan sakit beberapa kali seminggu, ia boleh menjadikan sakit kepala lebih degil dan kerap. Kedua, kenali isyarat bahaya. Dapatkan rawatan segera untuk mana-mana: sakit kepala "paling teruk" mengejut; dengan demam dan leher kaku; dengan pertuturan pelo atau kelemahan sebelah; selepas kecederaan kepala; atau baru selepas usia 50. Ini boleh jadi pendarahan otak atau strok. Penjagaan TCM dan pemeriksaan perubatan tidak pernah bercanggah.
在看诊之前，你现在可以先做的3件事
3 Things to Do Before Your Appointment
3 Perkara Yang Boleh Dilakukan Sebelum Temujanji
- 写一本简单的「头痛日记」。连续记两三周：什么时候痛、痛在哪、怎么个痛法、持续多久、痛之前吃了什么、睡得好不好、压力大不大、女性还可记月经日期。你会慢慢看出自己的诱因规律——是熬夜、是饿、是特定食物（有人对巧克力、味精、酒、咖啡因戒断敏感）、还是月经前后。这本日记不只帮你，也让医师辨型和找诱因又快又准，比只说「我经常头痛」有用得多。 Keep a simple "headache diary." For two or three weeks, note: when it hurts, where, how it hurts, how long it lasts, what you ate before, how you slept, your stress level, and for women the period dates. You'll start to see your trigger pattern — late nights, hunger, specific foods (some react to chocolate, MSG, alcohol, or caffeine withdrawal), or around menstruation. The diary helps you and lets the practitioner type it and find triggers fast — far more useful than "I get headaches a lot." Simpan "diari sakit kepala" ringkas. Selama dua tiga minggu, catat: bila sakit, di mana, berapa lama, apa yang dimakan sebelumnya, dan tidur anda. Anda akan nampak corak pencetus — tidur lewat, lapar, makanan tertentu, atau sekitar haid. Diari ini membantu pengamal mengenali jenis dan pencetus dengan cepat.
- 先顾好三件最基本的：睡、水、餐。很多头痛的诱因其实很朴素——睡眠不规律（太少或太多都会诱发）、喝水不够、跳过正餐血糖低、咖啡因忽多忽少。试着作息固定、每天补够水、别饿过头、咖啡量稳定别骤停。马六甲天热出汗多，脱水诱发的头痛不少，随身带水。这些调好，一部分人的头痛就减了大半。 Cover the three basics first: sleep, water, meals. Many headache triggers are humble — irregular sleep (too little or too much both trigger), too little water, skipped meals and low blood sugar, caffeine swinging up and down. Keep a steady routine, drink enough daily, don't get over-hungry, and keep caffeine steady rather than stopping abruptly. Melaka's heat means a lot of sweating, and dehydration headaches are common — carry water. Fix these and some people's headaches halve. Uruskan tiga asas dahulu: tidur, air, makan. Banyak pencetus sakit kepala sederhana — tidur tak teratur, kurang air, langkau makan, dan kafein naik-turun. Kekalkan rutin tetap, minum cukup, jangan terlalu lapar. Haba Melaka bermakna banyak berpeluh — bawa air.
- 给颈肩松绑，别让止痛药越吃越勤。如果你的头痛连着肩颈紧，试试每工作40–50分钟就起来动一动、转转脖子、耸肩放松，别一直低头看手机——很多紧张型、颈源型头痛就是这样堆出来的。同时，留意自己止痛药的用量：如果发现越吃越频繁、不吃就不行，别自己一直加，尽快找医师，一边调理一边帮你逐步减少依赖，避免陷入药物过量性头痛的循环。 Unload the neck and shoulders, and don't let painkillers creep up. If your headache ties to a tight neck and shoulders, get up every 40–50 minutes to move, turn the neck, and roll the shoulders, and stop hunching over the phone — much tension-type and cervicogenic headache builds up exactly this way. Meanwhile, watch your painkiller use: if you're taking them more and more and can't do without, don't keep adding on your own — see a practitioner soon to taper the reliance while you treat the cause, avoiding the medication-overuse cycle. Longgarkan leher dan bahu, dan jangan biar ubat tahan sakit meningkat. Jika sakit kepala anda terikat dengan leher tegang, bangun setiap 40–50 minit untuk bergerak dan pusing leher. Sementara itu, perhatikan penggunaan ubat tahan sakit anda — jika makin kerap, jumpa pengamal untuk mengurangkannya sambil merawat punca.