Middle-aged woman Zhao Mou was stressed by work and had amenorrhea for half a year. Now I feel weak, tired, dry throat, and unrealistic sleep. Last menstrual period: March 8. The tongue is clean and the veins are thin and slow. There are no abnormalities in western medicine gynecological examination. Diagnosis is for amenorrhea of hepatic depression and spleen deficiency.
The patient is weak, has less menstrual flow in the past, and has a dark color. Since the beginning of this year, due to the tension of work, the liver and spleen are depressed and spleen deficiency, the spleen is the foundation of the day after tomorrow, the source of qi and blood biochemistry, the lack of temper, and the lack of menstrual blood biochemistry and amenorrhea. Liver blood, liver depression blood deficit, yin deficiency blood less, dry blood and heat, resulting in dry mouth, fatigue and fatigue; insufficient yin blood, mental loss, sleep unreality. The formula harmonizes the liver and spleen, and nourishes the qi and nourishes the blood. Fang with angelica, white peony, dang ginseng, chai hu, poria, incense stick, fried white art, Su stem, jujube, mint (later down), hot licorice, raw and cooked yellow, zelan leaf, salvia. Decoction, 7 doses.
After the second diagnosis, the spirit improved, the menstruation was still in the future, the lower abdomen seemed to have discomfort, there were many secretions in recent days, the stool was adjusted, the tongue was clean, and the pulse was smooth.
In front of the added beech meat, wheat dong, 7 doses, take 1 day stop 1 day. Menstruation is on the third day, the amount is not much, with menstruation for 2 days, and the color is dark. The pulse is gentle and the tongue is clean. This is due to insufficient qi and blood, so the menstrual volume is small. The two supplements of qi and blood are added and subtracted to nourish the soup.
Prescription ginseng, poria, baishu, burning licorice, angelica, ripe ground, white peony, tangerine peel, wood fragrance, jujube, goji berries, mai dong, burning astragalus. 7 doses.
The production of menstruation is the result of the action of the qi and blood of the organ meridians on the female cells. Among them, the kidney is the innate foundation, and the kidney hides the essence. The regulation of menstruation is closely related to the three organs of the liver, spleen and kidneys, the second pulse of Chong Ren and the prosperity and decline of qi and blood throughout the body.
The patient's menstrual amenorrhea is caused by work tension, so the cause is stagnation in the liver qi, lost in the strip, Fangzhong Chai Hu, Su Stem, XiangFu, Peppermint Li Qi Shu Yu; Angelica, White Peony, Raw Land, Cooked Land Nourishing Blood Soft Liver, and then with Party Ginseng, Fried White Technique, Burning Licorice Healthy Spleen and Qi, So that The Qi Line is Bloody, Plus Zelan, Danshen Activates the Blood Passage, Plays The Temper, Nourishes the Liver And Blood, and Adjusts the Effect of Flushing. The second diagnosis plus the meat of the mountain, the third diagnosis switched to the tonic soup from the complementary sperm and blood, so that menstruation came to an endeavor.
Women over 18 years of age, menstruation has not yet come, or menstruation after menstruation and then interrupted for more than 6 months, called "amenorrhea", the former called primary amenorrhea, the latter called secondary amenorrhea, ancient called "women do not come", "menstruation does not come", "menstrual water is not clear", "menstrual amenorrhea" and so on. Menstrual closure during pregnancy, lactation or menopause is a physiological phenomenon, not amenorrhea, and some adolescent girls occasionally have menstrual closure within 2 years of menarche and can not be treated.
The treatment of amenorrhea in Traditional Chinese medicine is mainly based on the disease, the deficiency of the person to supplement it, or to supplement the liver and kidneys, or to nourish the qi and blood; The real one leaks through it, or activates the blood and dissolves the stasis, or straightens out the stagnation of qi, or removes evil spirits and regulates the scriptures. The treatment of amenorrhea in Chinese medicine must not be indiscriminate, abuse of prescription drugs, nor blindly supplement, anti-dry menstrual blood. In the treatment of other diseases leading to amenorrhea, but also or first treat other diseases, the cure of the disease can be adjusted.
Because the pathogenesis of amenorrhea is different from virtual and real, it should follow the principle of "making up for it in the treatment of amenorrhea, and diarrhea in reality". For example, the "Class Sutra? "Disease Category" cloud: "The disease of the next person occurs temporarily, and its evidence becomes pain, and the general is healed by blood, and the attackable one is also." Those who wither come and go, rush to exhaustion, and their evidence is invisible, and they will not be able to understand it. "When the specific treatment, the weak should supplement the kidney qi, fill the essence and nourish the liver, nourish the blood, nourish the yin and dryness, so that the kidney qi is full, the circulation is rushed, the blood sea is nourished, and the menstruation can respond to the times." According to the different causes and symptoms of coldness, depression, phlegm and stasis, the actual person should be treated by the cold passage of the warm passage, the depressure of qi, the expectorant dehumidification, and the activation of the blood through the menstruation, and it is not simply the blood that can be included.
Amenorrhea is a blood disease, there are fewer people who are fully real, and there are more people who are weak and solid, so when treating amenorrhea, "do not see blood through menstruation as fast". We must not see the menstrual ausculture as a blood stagnation, abuse the method of breaking through the benefits, and seriously injure the qi and blood. It is also not possible to see that menstrual amenorrhea is to be a deficiency of blood and withering, and frequent use of nourishing and nourishing products, so that the spleen and stomach are injured or the kidneys and yang are contained, and the source of chemicals is insufficient to dry the sperm blood. In addition, the treatment of amenorrhea also distinguishes between menstrual diseases and other diseases, if the first amenorrhea caused by other diseases, then the first treatment of other diseases, the cure of the disease through water. However, as far as the evidence of amenorrhea is concerned, the main manifestations of liver and kidney loss and kidney qi deficiency should still be grasped.
1. Cold coagulation blood stasis
Clinical manifestations: normal menstruation in the past, sudden closure, several months of non-stop, lower abdominal pain refusal to press, heat pain reduction or limbs are not warm, with a lower amount of multi-colored white, tongue purple dull, or the edge tip has petechiae, pulse depression.
Treatment: Disperse cold and dissolve stasis.
Prescription medicine: Warm jing soup plus or minus. Evodia, angelica, Sichuan root, peony, ginseng, cinnamon, ejiao, danpi, ginger, licorice, half summer, wheat winter.
Addition or subtraction: if the abdominal pain is even added frankincense, myrrh to relieve stasis and pain; If the cold pain in the lower abdomen is obvious, add cumin and mugwort leaves to warm the palace to relieve the pain; If there is a fistula in the body, the blood stasis block is obvious, such as the righteous qi is still solid, you can use rhubarb worm pills to dissolve the blood stasis, if the long attack is ineffective, then switch to the method of nourishing blood and adjusting the menstruation, so as not to hurt the correct.
2. Evidence of insufficient kidney qi
Clinical manifestations: over 16 years of age has not yet menstruated, or menarche is late, the cycle is delayed, the amount is small, the color of the menstruation is light or dark, the quality is thin, gradually develops amenorrhea, the face is pale or obscure, the waist is sore and the legs are soft, dizziness and tinnitus, the nocturnal urination is frequent, the stool is not solid, or the limbs are not warm, the belt is very little, the tongue is pale and white, and the pulse is thin or late.
Metallurgical method: tonify the kidney qi and regulate the menstruation.
Prescription medicine: Beneficial kidney through the soup. Ripe land, angelica, red peony, cypress kernel, zelan, curly cypress, fairy spleen, continuous break, ox knee, salvia, agaricus.
Addition and subtraction: If the limbs are cold and cold, cinnamon can be added to warm the kidney and yang meridians; If the belt is cold, the waist is sore and the abdomen is cold, purple quartz and bayan can be added to warm the kidney to warm the palace; If you also see a person with a weak temper, you can add the Four Gentlemen's Soup.
3. Liver and kidney loss certificate
Clinical manifestations: the amount of late menstruation is small, gradually to amenorrhea, dizziness, soft waist and knees, heel pain, dry pussy. There is very little under the belt, or even nothing, or insomnia and forgetfulness, the tongue is thin and thin, and the veins are thin and weak.
Treatment: nourish the kidneys and nourish the liver.
Prescription medicine: Gui kidney pills plus chicken blood vine, Shou Wu. Ripe ground, yam, dogwood, poria, goji berries, eucommia, silk seeds, angelica.
Addition and subtraction: if the throat is dry, the hands and siblings are hot, add the mother, and the skin of the bone to clear the hypothermia; If you sigh with joy, Nagu is not fragrant, add incense and ginseng to adjust the liver and spleen, which is beneficial to sperm and blood metaplasia; If you see forgetfulness and insomnia, you can add fried jujube kernels, schisandra seeds, and night vines to nourish blood and calm the spirit.
4. Evidence of stagnant blood stasis
Clinical manifestations: menstrual period for several months, mental depression, irritability, chest swelling, less abdominal distension or refusal to press, purple on the tongue, or petechiae, pulse sinking or dullness.
Treatment: Rational qi and invigorate blood, dispel stasis and pass through menstruation.
Prescription medicine: Blood House adds and subtracts from stasis soup one by one. Peach kernel, safflower, angelica, raw ground yellow, Sichuan root, red peony, ox knee each, platycodon, chai husk, citrus shell, licorice root each.
Addition and subtraction: partial stagnation, evidence of chest flank and less abdominal distention, upper plus curcuma, green skin; Partial to blood stasis, witnessing less abdominal pain refusal to press, above the addition of turmeric, three ridges; If the qi is depressed and the fire is dissolved, the mouth is bitter and upset, the chest is full, the tongue is red and thin, and the pulse strings are counted, skullcap and gardenia can be added to clear the liver fire.
5. Evidence of weakness of qi and blood
Clinical manifestations: menstruation gradually delayed, the amount is small, the color of menstruation is light and thin, and then the menopause is not good, or dizziness, or palpitations, shortness of breath, fatigue and fatigue, or loss of appetite, hair is not lustrous or easy to fall off, win thin and yellow, slow or imaginary pulse, tongue less moss or thin white.
Treatment: Nourish qi and nourish blood and regulate menstruation.
Prescription: Ginseng Yang Rong Tang plus or minus. Ginseng, guixin, hot licorice, sautéed angelica, white peony, cooked ground, baishu, poria, astragalus. Addition and subtraction: If the menstrual amenorrhea is caused by postpartum hemorrhage, in addition to seeing signs of weakness in qi and blood, it is more like seeing indifference, vaginal dryness, pubic hair and armpit hair loss, decreased libido, atrophy of reproductive organs, etc., which is the failure of sperm and blood, kidney qi deficiency, and the evidence of weakness, which can be added to the top of the deer antler cream, purple river car and other flesh and blood products, long-term use.
6. Sputum wet block certificate
Clinical manifestations: menstrual auscultation, body obesity, chest full of stuffiness, vomiting phlegm, tiredness, or puffy foot swelling, or with a lower amount of multi-colored white, mossy, smooth pulse.
Treatment: sputum dehumidification and menstruation.
Prescription medicine: Cangfu guide sputum pills combined with bergamot scatter addition and subtraction. Cangshu, Xiangfu, Citrus Aurantium, Tangerine Peel, Southern Star, Licorice, Half Summer, Divine Comedy, Angelica, Sichuan Root.
Addition and subtraction: if vomiting, the stuffiness can be thickened, bamboo ru to broaden the chest and stomach to stop vomiting; If you are infected with the evil of damp heat during menstruation or after abortion, or the sputum is wet and depressed, the damp heat is blocked, and the menstrual closure can be treated with four mysterious scatter flavors to clear the damp heat and activate the blood through menstruation. After a period of expectorant dehumidification treatment of this type of amenorrhea, it is advisable to use warm kidney medicine, and can choose to use silk seeds, bayantian, and xianling spleen to warm the kidneys and make the phlegm go and pass through.
7. Yin deficiency and blood dryness
Clinical manifestations: menstrual blood from less to amenorrhea, five upset fever, hot flashes sweating, two cheeks flushing, or cough spit blood, less red tongue moss, number of pulse strings or fine numbers.
Treatment: Nourishing yin, clearing heat and regulating menstruation.
Prescription medicine: add or subtract one yin decoction plus or minus. Raw land, ripe land, white peony, zhimu, ground bone skin, wheat winter, hot licorice.
Addition and subtraction: if the hypocrisy is hot flashes or even hot, add artemisia annua and turtle nails; Cough, spit blood, add schisandra, lilies, Sichuan shellfish, ejiao (stewed punch); Restless and sleepless, palpitations, Kabai Ziren, NightShade; If the blood is dry and amenorrhea due to the real fire, it is advisable to use fang zhongyuan ginseng and cooked land.