{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:09:24Z","timestamp":1753891764560,"version":"3.41.2"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Headaches are common complaints in the emergency department (ED) and have raised concern about acute medication overuse. Chinese medicine is a major complementary and alternative medicine in China and effective for headaches. This study aims to summarize characteristics of headache patients at EDs and the utilization of Chinese medicine for headache managements in EDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study conducted a retrospective analysis based on existing electronic medical records at EDs from four branches of Guangdong Provincial Hospital of Chinese Medicine. Only complete medical records with a first diagnosis of headache within the specified timeframe were included. Data was extracted, screened and standardized using a structured approach. Descriptive analyses and Apriori algorithm-based association rules were employed for the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3,355 medical records were analyzed, with over 86% of headaches classified as non-urgent. Approximately 97% of the patients received a general diagnosis of headaches without further classification. Hypertension was the most prevalent concomitant diagnosis, affecting 27.42% of the patients. Western medicine was prescribed to 66% of the patients for headaches and co-existing conditions, while each type of acute medication was prescribed to fewer than 10% of the patients. Conversely, over one-third of the patients utilized headache-specific patented Chinese herbal medicine products. Additionally, oral and topical Chinese herbal medicine treatments were also administered for headaches in the emergency departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The majority of headaches consulting in the EDs were non-urgent and treated with various forms of Chinese medicine, alone or in conjunction of western medicine. Chinese herbal medicine may be promoted as alternatives to Western acute medications for treating benign headaches.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1529874","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T05:24:29Z","timestamp":1737350669000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Chinese medicine for headaches in emergency department: a retrospective analysis of real-world electronic medical records"],"prefix":"10.3389","volume":"15","author":[{"given":"Zhenhui","family":"Mao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuzhen","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingbo","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaohua","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiaozhen","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1111\/head.13744","article-title":"ACEP guidelines on acute nontraumatic headache diagnosis and Management in the Emergency Department, commentary on behalf of the refractory, inpatient, emergency care section of the American headache society","volume":"60","author":"Peretz","year":"2020","journal-title":"Headache"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1148\/rg.2019190017","article-title":"Acute headache in the emergency setting","volume":"39","author":"Guryildirim","year":"2019","journal-title":"Radiographics"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s11739-019-02266-2","article-title":"Acute headache management in emergency department. A narrative review","volume":"15","author":"Giamberardino","year":"2020","journal-title":"Intern Emerg Med"},{"key":"ref4","first-page":"1","article-title":"Points & pearls: evaluation and management of life-threatening headaches in the emergency department","volume":"21","author":"Zodda","year":"2019","journal-title":"Emerg Med Pract"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.3760\/cma.j.issn.1671-0282.2023.12.004","article-title":"Expert consensus on emergency Management of Analgesia, sedation, and delirium in adults","volume":"32","year":"2023","journal-title":"Chinese J Emerg Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/s12906-021-03401-3","article-title":"Headache and migraine clinical practice guidelines: a systematic review and assessment of complementary and alternative medicine recommendations","volume":"21","author":"Ng","year":"2021","journal-title":"BMC Compl Med Ther"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1016\/j.neurol.2021.07.006","article-title":"Revised guidelines of the French headache society for the diagnosis and management of migraine in adults. Part 2: pharmacological treatment","volume":"177","author":"Ducros","year":"2021","journal-title":"Rev Neurol (Paris)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s10194-019-1053-5","article-title":"Headaches in the emergency department -a survey of patients' characteristics, facts and needs","volume":"20","author":"Doretti","year":"2019","journal-title":"J Headache Pain"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"821","DOI":"10.18433\/J3VW2F","article-title":"Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications","volume":"16","author":"Harirforoosh","year":"2013","journal-title":"J Pharm Pharm Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1111\/head.12645","article-title":"Survey of opioid and barbiturate prescriptions in patients attending a tertiary care headache center","volume":"55","author":"Minen","year":"2015","journal-title":"Headache"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/ph14111091","article-title":"Opioid analgesia and opioid-induced adverse effects: A Review","volume":"14","author":"Paul","year":"2021","journal-title":"Pharmaceuticals (Basel)"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1212\/01.wnl.0000335946.53860.1d","article-title":"Excessive acute migraine medication use and migraine progression","volume":"71","author":"Bigal","year":"2008","journal-title":"Neurology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.jemermed.2007.07.068","article-title":"Evaluating the use and timing of opioids for the treatment of migraine headaches in the emergency department","volume":"36","author":"Tornabene","year":"2009","journal-title":"J Emerg Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1111\/j.1526-4610.2012.02140.x","article-title":"Opioids should not be used in migraine","volume":"52","author":"Tepper","year":"2012","journal-title":"Headache"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1111\/j.1526-4610.2012.02271.x","article-title":"Complementary and alternative medicine use for headache and migraine: a critical review of the literature","volume":"53","author":"Adams","year":"2013","journal-title":"Headache"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.phymed.2018.12.039","article-title":"Chinese herbal medicine for headache: a systematic review and meta-analysis of high-quality randomized controlled trials","volume":"57","author":"Shi","year":"2019","journal-title":"Phytomedicine"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"889336","DOI":"10.3389\/fneur.2022.889336","article-title":"Efficacy and safety of Oral Chinese herbal medicine for migraine: a systematic review and Meta-analyses using robust variance estimation model","volume":"13","author":"Lyu","year":"2022","journal-title":"Front Neurol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"936234","DOI":"10.3389\/fmed.2022.936234","article-title":"Chinese herbal medicine for migraine management: a hospital-based retrospective analysis of electronic medical records","volume":"9","author":"Lyu","year":"2022","journal-title":"Front Med (Lausanne)"},{"year":"2021","key":"ref19"},{"year":"2021","key":"ref20"},{"year":"2020","key":"ref21"},{"volume-title":"IBM SPSS statistics for windows","year":"2017","author":"Corp","key":"ref22"},{"year":"1993","author":"Agrawal","key":"ref23"},{"year":"","author":"Xiong","key":"ref24"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1111\/nhs.12159","article-title":"Current status of emergency department triage in mainland China: a narrative review of the literature","volume":"17","author":"Peng","year":"2015","journal-title":"Nurs Health Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"599","DOI":"10.3760\/cma.j.issn.1671-0282.2018.06.006","article-title":"Consensus of experts on emergency pre-examination and triage","volume":"27","author":"Shi","year":"2018","journal-title":"Chin J Emerg Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1472-6920-5-1","article-title":"Sicily statement on evidence-based practice","volume":"5","author":"Dawes","year":"2005","journal-title":"BMC Med Educ"},{"volume-title":"Patient Experiences in Australia: Summary of Findings, 2016\u201317 Quality Declaration","year":"2017","key":"ref28"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1212\/CON.0000000000001010","article-title":"Headache in women","volume":"27","author":"Pavlovi\u0107","year":"2021","journal-title":"Continuum (Minneap Minn)"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/S1474-4422(24)00038-3","article-title":"Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the global burden of disease study 2021","volume":"23","year":"2024","journal-title":"Lancet Neurol"},{"volume-title":"Acute headache Treasure Island","year":"2024","author":"Baraness","key":"ref31"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11051401","article-title":"Trends in the Management of Headache Disorders in US emergency departments: analysis of 2007-2018 National Hospital Ambulatory Medical Care Survey Data","volume":"11","author":"Yang","year":"2022","journal-title":"J Clin Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1111\/ajag.12999","article-title":"Clinical presentation and assessment of older patients presenting with headache to emergency departments: a multicentre observational study","volume":"41","author":"Beck","year":"2022","journal-title":"Australas J Ageing"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1111\/head.14230","article-title":"Epidemiology, investigation, management, and outcome of headache in emergency departments (HEAD study)-a multinational observational study","volume":"61","author":"Kelly","year":"2021","journal-title":"Headache"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"S70","DOI":"10.1016\/j.jacr.2023.02.018","article-title":"ACR appropriateness criteria\u00ae headache: 2022 update","volume":"20","author":"Utukuri","year":"2023","journal-title":"J Am Coll Radiol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s10072-020-04646-5","article-title":"Role of neuroimaging in headaches\u2019 clinical management","volume":"41","author":"Finocchi","year":"2020","journal-title":"Neurol Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1007\/s11916-021-00995-8","article-title":"Updates in the diagnostic approach of headache","volume":"25","author":"Do","year":"2021","journal-title":"Curr Pain Headache Rep"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1212\/WNL.0000000000006697","article-title":"Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list","volume":"92","author":"Do","year":"2019","journal-title":"Neurology"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"100473","DOI":"10.1016\/j.ensci.2023.100473","article-title":"Secondary headaches\u2014red and green flags and their significance for diagnostics","volume":"32","author":"Wijeratne","year":"2023","journal-title":"eNeurologicalSci"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.emc.2020.09.004","article-title":"Headache in the emergency department: avoiding misdiagnosis of dangerous secondary causes, an update","volume":"39","author":"Raam","year":"2021","journal-title":"Emerg Med Clin North Am"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12873-019-0236-3","article-title":"Emergency department visits in older patients: a population-based survey","volume":"19","author":"Ukkonen","year":"2019","journal-title":"BMC Emerg Med"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S0254-6272(13)60093-X","article-title":"Effect of Tianshu capsule in treatment of migraine: a meta-analysis of randomized control trials","volume":"33","author":"Xia","year":"2013","journal-title":"J Tradit Chin Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1186\/s12906-019-2775-2","article-title":"Treatment of migraines with Tianshu capsule: a multi-center, double-blind, randomized, placebo-controlled clinical trial","volume":"19","author":"Yu","year":"2019","journal-title":"BMC Complement Altern Med"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"4120","DOI":"10.1002\/jssc.201700665","article-title":"Simultaneous determination of ferulic acid and gastrodin of Tianshu capsule in rat plasma by ultra-fast liquid chromatography with tandem mass spectrometry and its application to a comparative pharmacokinetic study in normal and migraine rats","volume":"40","author":"Guan","year":"2017","journal-title":"J Sep Sci"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"155766","DOI":"10.1016\/j.phymed.2024.155766","article-title":"Exploring the anti-migraine effects of Tianshu capsule: chemical profile, metabolic behavior, and therapeutic mechanisms","volume":"131","author":"Liu","year":"2024","journal-title":"Phytomedicine"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"5057","DOI":"10.19540\/j.cnki.cjcmm.20200903.502","article-title":"Clinical practice guideline for migraine with traditional Chinese medicine (draft version for comments)","volume":"45","author":"Xu","year":"2020","journal-title":"Chinese J Trad Chin Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"51","DOI":"10.16040\/j.cnki.cn15-1101.2024.05.034","article-title":"Effect of Tongtian oral liquid for migraine with Chinese medicine syndrome of blood stasis and wind","volume":"43","author":"Zhang","year":"2024","journal-title":"Inner Mongolia J Trad Chin Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/jebm.12378","article-title":"Report of guidelines for diagnosis and treatment of common internal diseases in Chinese medicine: headache","volume":"13","author":"Ren","year":"2020","journal-title":"J Evid Based Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"995559","DOI":"10.3389\/fphar.2022.995559","article-title":"Natural products for migraine: data-mining analyses of Chinese medicine classical literature","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Pharmacol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/j.ctim.2015.06.012","article-title":"Chuanxiong chadiao powder, a famous Chinese herbal prescription, for headache: a systematic review and meta-analysis","volume":"23","author":"Li","year":"2015","journal-title":"Complement Ther Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2019\/2301680","article-title":"A Chinese prescription chuanxiong Chatiao san for migraine: a systematic review and Meta-analysis of randomized controlled trials","volume":"2019","author":"Wang","year":"2019","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"100134","DOI":"10.1016\/j.prmcm.2022.100134","article-title":"Preliminary study on potential compounds and mechanism of chuanxiong Chatiao granules in treating migraine","volume":"4","author":"Wang","year":"2022","journal-title":"Pharma Res"},{"volume-title":"Evidence-based Clinical Chinese Medicine: Episodic Migraine","year":"2023","author":"Xue","key":"ref53"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s41572-022-00415-0","article-title":"Medication overuse headache","volume":"9","author":"Ashina","year":"2023","journal-title":"Nat Rev Dis Primers"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1529874\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T05:24:35Z","timestamp":1737350675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1529874\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,20]]},"references-count":54,"alternative-id":["10.3389\/fneur.2024.1529874"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1529874","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2025,1,20]]},"article-number":"1529874"}}