The establishment of normal menstruation depends on the functional coordination of hypothalamus-pituitary-ovary axis and the periodic response of the target organ endometrium to sex hormones. The failure of any link, whether organic or functional, will lead to amenorrhea. The common causes of amenorrhea are as follows: ① Uterine amenorrhea, including congenital absence of uterus or dysplasia, endometrial injury (such as physical trauma, tuberculosis infection, postpartum or post-abortion infection, etc. ) or hysterectomy, and endometrial adverse reactions. ② Ovarian amenorrhea, such as congenital hypoplasia or dysplasia, ovarian injury or resection, ovarian tumor, premature ovarian failure, etc. 8 Pituitary amenorrhea, such as hypofunction caused by pituitary injury (such as Sheehan's syndrome), pituitary adenoma, primary pituitary hypogonadism, etc. (extremely rare). ④ Subthalamic amenorrhea, including mental and neurological factors (such as mental stress, schizophrenia, environmental changes, etc. ), wasting diseases (such as malnutrition, severe anemia, etc. ), obesity and reproductive malnutrition, drug inhibition syndrome, such as long-term use of contraceptives, amenorrhea and galactorrhea syndrome, polycystic ovary syndrome, and other endocrine glands.
To diagnose this disease, we must first know the medical history in detail and distinguish whether it is primary amenorrhea or secondary amenorrhea; Conduct a comprehensive physical examination, including development and nutrition. And pay attention to the development of external genitalia, the distribution of pubic hair, and whether there is congenital malformation in the uterus. Auxiliary examinations often include curettage or endometrial biopsy, ovarian function examination (such as basal body temperature determination, vaginal smear examination, cervical mucus examination, etc.). ), pituitary function test (such as FSH determination), pituitary excitation test, therapeutic test (such as progesterone test, estrogen test). In the treatment of amenorrhea, we must find the cause and treat it according to the cause. For example, tuberculosis infection is given anti-tuberculosis treatment, and anemia patients actively correct anemia; Pituitary tumor and polycystic ovary syndrome can be treated by surgery. Hypothalamic-pituitary-ovarian axis dysfunction amenorrhea, hormone therapy, etc.
The clinical manifestations, etiology and pathogenesis of amenorrhea have been discussed in detail by doctors in past dynasties. The cause of its formation may be due to the deficiency of qi and blood biochemistry and menstrual blood; Or because of deficiency of liver and kidney essence and blood; Or because of qi stagnation and blood stasis, blood circulation is not smooth; Or because of phlegm-dampness and blood stasis, it affects menstrual blood circulation; Or deficiency of essence and blood with qi stagnation and blood stasis or phlegm blocking uterus. Clinical treatment should be based on examining the syndrome, benefiting qi and nourishing blood for those with deficiency of qi and blood, nourishing liver and kidney for those with deficiency of liver and kidney, and regulating qi and promoting blood circulation for those with qi stagnation and blood stasis. If there is phlegm-dampness and blood stasis in deficiency, attack and supplement should be carried out simultaneously.
In this section, primary and secondary amenorrhea 10 formula is selected. Among them, Jiawei Guipi Decoction is mainly used for amenorrhea after induced abortion, and Jiawei Xiaochi Decoction and medicinal amenorrhea prescription are used for amenorrhea caused by antipsychotics. In addition, the "Sheehan syndrome prescription" introduced in this chapter should also be an effective prescription for amenorrhea, which can be selected according to the condition in clinic.
1. Huayu Tongjing Powder consists of Radix Angelicae Sinensis, Radix Paeoniae Rubra, Flos Carthami, Semen Persicae, Rhizoma Sparganii, Rhizoma Curcumae, Radix Cyathulae, Radix Linderae, Squama Manis, Radix Salviae Miltiorrhizae, Herba Artemisiae Anomalae, 5g of Rhizoma Chuanxiong and 3g of Cortex Cinnamomi.
Change of addition and subtraction: add cortex moutan 10g for those who are hot, and remove cinnamon; Eupolyphaga Seu Steleophaga (10g) should be added to those with blood stasis for a long time.
The treatment method is decoction, daily 1 dose. Generally take about 60 doses.
Indications: promoting blood circulation and removing blood stasis, regulating qi and dispelling cold. Suitable for amenorrhea (primary amenorrhea and secondary amenorrhea belong to qi stagnation and blood stasis).
The clinical application of this prescription is the self-made experience prescription by Xu Zhihua, deputy director of the Affiliated Hospital of Anhui College of Traditional Chinese Medicine. Used to treat amenorrhea, quite effective. For example, a patient with amenorrhea infertility took 60 doses (including 600g of Rhizoma Sparganii and 600 g of Rhizoma Curcumae) within 2 months, and finally achieved good results. Another example is that a female worker suffered from secondary amenorrhea, secondary infertility and chronic adnexitis for more than 3 years, treated for 3 months, and recovered after taking more than 60 doses.
Experience Dr. Xu pointed out: most people think that amenorrhea is deficient in reality and deficiency in reality, and advocate warming and nourishing, which makes the clinic afraid to use drugs for promoting blood circulation and removing blood stasis, and patients dare not take such drugs. But clinically, functional amenorrhea is more active than deficiency syndrome, especially secondary amenorrhea and blood stasis block. Therefore, he advocated that the treatment should be based on promoting blood circulation and removing blood stasis, supplemented by regulating qi and dispelling cold. This is the principle of self-made prescription for removing blood stasis and dredging collaterals. It is considered that "drugs for promoting blood circulation and removing blood stasis have no side effects and absolute contraindications" and "have certain curative effect on infertility caused by tubal obstruction".
Syndrome and treatment of amenorrhea. Journal of traditional chinese medicine, 1985, (5): 9.2. Drug composition of Zhouji Tiaojing Decoction ① Follicle-promoting decoction: Angelica sinensis, Ligusticum Chuanxiong, Lycium barbarum and Cyperus tuber each 65438±00g, Cuscuta chinensis, Epimedium, Ligustrum lucidum, Radix Rehmanniae and Eupatorium adenophorum each 65438±05g.
② Ovulation-promoting soup: Angelica sinensis, Ligusticum Chuanxiong, Carthamus tinctorius, Achyranthes bidentata and Cyperus rotundus each 65438±00g, Cuscuta chinensis, Ligustrum lucidum, Epimedium and Cistanche deserticola each 65438±05g, Eupatorium adenophorum, Radix Rehmanniae Preparata and Caulis Spatholobi each 20g.
③ Luteinization decoction: angelica sinensis, radix paeoniae rubra, epimedium, cistanche deserticola and wolfberry fruit each 65438±00g, dodder seed, glossy privet fruit and rehmannia root each 65438±05g, astragalus root, codonopsis pilosula, salvia miltiorrhiza and Spatholobus stem each 20g.
④ Tiaojing Huoxue Decoction: Radix Angelicae Sinensis, Rhizoma Chuanxiong, Semen Persicae and Flos Carthami each 65438±00g, Radix Paeoniae Rubra, Herba Lycopi, Rhizoma Cyperi, Radix Achyranthis Bidentatae, Herba Leonuri and Radix Dipsaci each 65438±05g, Radix Rehmanniae Preparata 20g and Caulis Spatholobi 30g.
Changes of addition and subtraction: Radix Curcumae, Fructus Toosendan each 65,438 00 g, Radix Bupleuri 6g, Fructus Evodiae, Folium Artemisiae Argyi each 65,438 00 g, 3 pieces of ginger, and Ramulus Cinnamomi 6 g are used for patients with uterine deficiency and cold; 20 grams of Codonopsis pilosula, 20 grams of Astragalus membranaceus and 20 grams of Dioscorea opposita for patients with qi deficiency; Each; For patients with severe blood stasis, Rhizoma Sparganii and Radix Salviae Miltiorrhizae15g are added; Each; 20g of Polygonum Multiflori Radix Preparata and 5g of Colla Corii Asini/Kloc-0 are added for patients with blood deficiency. .
The treatment method is to take 5 doses of follicle-stimulating decoction in the later period (cycle 6 ~ 10 day); Take 5 doses of ovulation-promoting decoction before ovulation and during ovulation (cycle 1 1 ~ 16 days); In the late stage of ovulation (cycle 17 ~ 25 days), take 7 doses of luteinizing decoction; Take 3 ~ 5 doses of Tiaojing Huoxue Decoction during menstruation (cycle 26 ~ 30 days). All the above materials are decocted in water, daily 1 dose.
Efficacy is mainly used for tonifying kidney and nourishing blood, promoting blood circulation and regulating menstruation. Indications of amenorrhea (including primary amenorrhea and secondary amenorrhea).
The clinical application in this group was 3 1 case, and all the organic diseases of uterus and ovary were excluded. Through the medical history, the symptoms were diagnosed as amenorrhea of kidney deficiency and blood stasis, including primary amenorrhea 15 cases and secondary amenorrhea 16 cases, with a course of 5 months to 3 years. Treatment results: 3 1 case all recovered menstrual cycle. 16 infertility 13 pregnancy. The shortest course of treatment is 1 cycle, generally 2 ~ 5 cycles, and the longest is 7 cycles.
Experience shows that this group of cases is kidney deficiency and blood stasis, kidney deficiency as the foundation, blood stasis as the standard, tonifying kidney and promoting blood circulation, treating both the symptoms and root causes, which is better than simply tonifying deficiency or promoting blood circulation. In order to consolidate the curative effect, it is best to take it for 5 ~ 6 cycles, and continue to take it even if menstruation comes to avoid recurrent diseases. In addition, we should pay attention to flirting, be careful about sex, and be aware of ourselves.
The origin of the prescription is Bai Li Quan. Amenorrhea is treated with Chinese medicine to regulate menstruation periodically. Sichuan Traditional Chinese Medicine, 1990, (7): 44.3. Jiawei Zhenwu Decoction consists of dried ginger 10g, aconite root 15g, Atractylodes macrocephala, Paeonia lactiflora, Poria, Cistanche deserticola and peach kernel.
Treatment: add appropriate amount of water, decoct twice, make 200ml thick juice, and take it twice. Generally, it can be cured in 35 ~ 40 doses.
Efficacy is mainly indicated for warming yang and tonifying kidney, strengthening spleen and dredging channels, and amenorrhea (patients with kidney-yang deficiency).
In clinical application, 60 cases of amenorrhea in this group, 54 cases were cured, accounting for 90%, and 4 cases were markedly effective, with a total effective rate of 96.6%. For example, a 28-year-old patient has been menstruating for 2-3 months and amenorrhea for 4 years. The diagnosis shows: thin body, pale face, depressed spirit, conscious cold, warm hands and feet, cotton-padded clothes still in early summer, sluggish pulse. This is caused by deficiency of kidney yang. Use Zhenwu decoction to improve the taste, only take 13 dose, menstruation has come. Wuji Baifeng Pill consolidated the curative effect. After 3 months, the menstrual cycle was normal and her face was rosy.
Experience shows that kidney is the dirty of fire and water, and its connotation is true yin and true yang. Under the constant warmth of kidney yang, the pulse condition is smooth and strong, so menstruation is now. If the kidney is yang-deficient, the pulse is weak, the pulse is too strong and weak, the blood sea is not full, the uterus is empty, and amenorrhea occurs without blood. The treatment of amenorrhea due to kidney-yang deficiency with Jiawei Zhenwu decoction is rarely recorded in ancient books, and it has also been reported in modern times. In the prescription, aconite root warms kidney yang, dried ginger warms middle warmer to dispel cold, and cistanche deserticola nourishes yin and strengthens yang, warms uterus and opens meridians. The three are pungent, warm and thick, which can make the pulse pass, too strong, the day comes again, and menstruation comes from time to time. Jialing, Jianpi Yiqi, Taoren Huoxue Tongjing, Paeonia lactiflora astringent Yin and Yang to relieve pain. The combination of various drugs is an ideal prescription for the treatment of amenorrhea due to kidney-yang deficiency, which is beneficial to life and fire, eliminates yin stagnation, warms the channels and collaterals.
Clinical summary of 60 cases of amenorrhea treated by warming yang and tonifying kidney. Journal of traditional chinese medicine, Hubei Province, 1982, (4): 26.4. Jiawei Guipi Decoction consists of 30g of Radix Astragali Preparata, Radix Codonopsis 10g, fried atractylodes, Radix Angelicae Sinensis, Poria, Arillus Longan, 5g of Radix Aucklandiae and 5g of Placenta Hominis powder.
Changes of addition and subtraction: limb numbness plus stir-fried Radix Paeoniae Alba and Caulis Spatholobi each12g; ; Rhizoma Corydalis and Carapax Trionycis preparata12g for abdominal pain; Each; Cold forming, adding Herba Epimedii 12g and Cornu Cervi10g; ; Add fried Fructus Aurantii, Folium Lycopi and raw Fructus Crataegi10g each; Used for body fat and abdominal distension; Lumbago plus Eucommia ulmoides Oliv. and Achyranthes bidentata each 12g.
The treatment method is decoction, and placenta hominis powder is swallowed with decoction. Daily 1 dose, twice per dose.
Indications: invigorating spleen and nourishing heart, benefiting qi and enriching blood. Indications of amenorrhea after induced abortion.
24 cases of amenorrhea after induced abortion were treated with Guipi decoction. Among them, 1 case combined with western medicine ethylphenol during taking traditional Chinese medicine, and other cases did not use western medicine. All 24 cases were cured. It is effective to take 5 doses for those with the fastest menstrual recovery. The slowest person takes 35 doses and it is effective. The average dose was 65438 05 doses. No amenorrhea occurred during the follow-up period after menstruation returned to normal.
Experience shows that amenorrhea after induced abortion is mainly caused by various psychological factors affecting patients' emotional changes to varying degrees, which leads to the obstruction of qi and blood production and the cessation of menstruation. Or induced abortion damages the uterus, causing physical weakness and excessive blood loss, leading to amenorrhea. Guipi decoction is a commonly used prescription for treating deficiency of both heart and spleen. This is to treat amenorrhea by strengthening the spleen and nourishing the heart, replenishing qi and blood, regulating emotions and restoring the function of regulating blood and generating blood.
24 cases of amenorrhea after induced abortion were treated with Guipi decoction. Journal of Integrated Traditional Chinese and Western Medicine, 1992, (10g): 7 17.5. Jiawei Xiaochi Decoction consists of gypsum 30-90g, Radix Rehmanniae, Herba Dendrobii, Radix Ophiopogonis and Magnetite 30g each.
Plus or minus changes: excitement, agitation, auditory hallucination, auditory hallucination, raw keel 30g, raw oyster 30g, mother of pearl 30g, calamus 15g, rhubarb 10 ~ 15g (processed without alcohol); 40-80g, 20g of fried jujube kernel; Insomnia and dreaminess plus salvia miltiorrhiza; 10 ~ 20g Yujin is used for chest and hypochondriac distension discomfort; Adding Coptidis Rhizoma 10g or Radix Gentianae 10g to bitter taste; Caulis Spatholobi and Radix Paeoniae Alba 20-40g are added to patients with tardive dyskinesia.
The treatment method is decoction, daily 1 dose. Generally take 2 ~ 2 1 dose. After menstruation, you can continue to recuperate by taking Jinnvdan or Compound Danshen Tablets. You can also continue to take this prescription before the next menstrual period. Continue to take western medicine antipsychotics during the treatment with this prescription.
Indications: clearing away heat and promoting fluid production, nourishing blood and dredging channels. Indications: amenorrhea caused by antipsychotics.
Clinical application: In this group, 20 married or unmarried young and middle-aged women with different types of mental diseases were given antipsychotic drugs such as chlorpromazine, perphenazine, fluperphenazine, sulpiride, terden and intramuscular injection of piperazine palmitate, respectively, and stopped menstruating for more than 2 months to 1 year. 15 cases were effective after upper treatment, among which 10 cases had good long-term effect. 5 cases were ineffective (mostly due to prolonged menopause, or failure to insist on taking medicine, or adding western medicine because of unstable condition).
Experience shows that female mental patients are treated with antipsychotic drugs, and their condition is controlled, but some patients have a series of side effects, and amenorrhea is one of the common symptoms. To analyze the clinical symptoms such as amenorrhea, dysphoria, thirst, dry stool, red tongue, and insufficient body fluid. The syndrome is that heat is abundant in blood and amenorrhea is less. Therefore, the treatment should be clearing away heat and promoting fluid production, nourishing blood and dredging menstruation. Xiaochi decoction uses gypsum, Radix Rehmanniae, Radix Ophiopogonis, Radix Angelicae Sinensis, Semen Persicae, Achyranthis Radix and other essences, all of which have such effects. And can achieve bet clinical curative effect.
Prescription source: Huo Lihua. Xiaochi decoction in treating 20 cases of amenorrhea caused by antipsychotics. Journal of traditional chinese medicine, 1989, (4): 20.6. Medicine composition of amenorrhea prescription ① Liver depression and qi stagnation type: Bupleurum, Salvia miltiorrhiza and Paeonia lactiflora each 20g, Rhizoma Cyperi, Angelica sinensis and Radix Curcumae each 65438 00g, Scutellariae Radix and Salvia miltiorrhiza each 65430g.
② Yin deficiency and excessive fire type: gypsum 60-80g, Rhizoma Anemarrhenae, Radix Rehmanniae, Radix Scrophulariae and Radix Salviae Miltiorrhizae 20g each, Fructus Lycii, Herba Leonuri and Radix Scutellariae 0g each 15g, and nine bacteria 6g each.
③ Spleen deficiency and dampness excess type: chlorite 40-60g, yam and Poria 20g, bamboo shavings 12g, Pinellia ternata, dried tangerine peel 10g, bile duct and Amomum villosum 6g.
④ Yin deficiency of liver and kidney: 20g raw and cooked, 20g yam, 20g dogwood, 20g dodder, 20g angelica, 20g Eucommia ulmoides, Cao Kun 15g, Lycium barbarum 10g and Jiao Sanxian 10g.
The treatment method is decoction, daily 1 dose, 7 doses 1 course of treatment.
The main effects are soothing the liver and regulating qi, promoting blood circulation and dredging menstruation; Nourishing yin and clearing heat, nourishing blood and dredging menstruation; Strengthening the spleen and eliminating dampness, resolving phlegm and dredging menstruation; Nourish liver and kidney, regulate chong and ren. Indications: amenorrhea caused by antipsychotics.
Clinical application: 30 patients in this group, the youngest is 20 years old and the oldest is 40 years old. Unmarried 17, married 13. Psychiatric diagnosis: 22 cases of schizophrenia, 6 cases of paranoid psychosis and 2 cases of bipolar disorder. Amenorrhea lasted for 3 ~ 6 months 18 cases, 6 ~ 12 months in 6 cases, and 12 months in 6 cases. After the above dialectical treatment, 30 patients were cured 12 cases, 8 cases were markedly effective, 7 cases were improved and 3 cases were ineffective. The effective rate is 90%.
The use of chlorpromazine, fluphenazine and other antipsychotic drugs is easy to cause amenorrhea. On the basis of continuous medication, the treatment based on syndrome differentiation has achieved satisfactory results.
Zhou Xiaobo, wait. Treatment of amenorrhea caused by antipsychotics with traditional Chinese medicine. Beijing Traditional Chinese Medicine, 1987, (2): 15.7. Composition of Yishen Artificial Cycle Formula ① Follicle-promoting Decoction: Radix Rehmanniae Preparata, Radix Angelicae Sinensis, Polygoni Multiflori Radix and Fructus Leonuri are used for kidney yin deficiency (dry mouth, burning hands and feet, red tongue, etc. Kidney yang deficiency (fatigue, fear of cold, pale tongue, etc. ) add 6 grams of Rhizoma Curculiginis and 0/0 grams of Herba Epimedii/kloc.
② Ovulation soup: Salvia Miltiorrhiza, Paeonia Rubra, Eupatorium adenophorum and Placenta Hominis each 65438±00g, Cyperus rotundus, Angelica sinensis each 6g, and safflower 3g. Kidney yin deficiency plus Ligustrum lucidum and Eclipta prostrata each10g; ; Kidney-yang deficiency plus Rhizoma Curculiginis 6g, Herba Epimedii 10g.
③ Luteinization decoction: 65438±00g for Radix Rehmanniae Preparata, Carapax et Plastrum Testudinis, Rhizoma Atractylodis Macrocephalae, Radix Dipsaci, Herba Cistanches, Fried Flos Sophorae Immaturus and Radix Angelicae Sinensis. Kidney yin deficiency plus Ligustrum lucidum and Eclipta prostrata each10g; ; Kidney-yang deficiency plus Radix Astragali and Radix Morindae Officinalis each 10g.
④ Tiaojing Huoxue Decoction: Salvia Miltiorrhiza, Paeonia Rubra, Eupatorium adenophorum, Motherwort and Taxilli each 65438±00g, Cyperus rotundus and Angelica 6g; Kidney-yang deficiency plus Ligusticum chuanxiong 6g, Angelica sinensis 10g.
The dosage and drugs of the above four parties can be slightly increased or decreased according to syndrome differentiation.
The treatment method is decoction, daily 1 dose. On the fifth day of menstruation or the fifth day of withdrawal bleeding, the drugs are given in the following order: 7 doses of follicle-promoting soup are taken first; After taking 5 doses of ovulation soup; Take 7 doses of luteinizing decoction again; Finally, take 5 doses of Tiaojing Huoxue Decoction. Generally take medicine for 2 ~ 4 menstrual cycles according to the condition.
The efficacy is mainly indicated in the above series of prescriptions, focusing on tonifying kidney, strengthening spleen, promoting blood circulation and regulating menstruation. Indications: amenorrhea (I and II degrees), adolescent functional uterine bleeding, luteal insufficiency, anovulatory menstruation and other diseases.
Thirty-six cases of different types of ovulation disorders (2 1 cases of Ⅰ and Ⅱ degree amenorrhea, 4 cases of luteal insufficiency, 5 cases of dysfunctional uterine bleeding, 6 cases of anovulatory menstruation) were treated with traditional Chinese medicine prescription. The control group was treated with clomiphene citrate. Results: There was no significant difference in ovulation rate, pregnancy rate and effective rate between the two groups (P > 0.05). 0.05)。 Calculated by cycle, there was no significant difference in ovulation rate between the two therapies (P & gt0.05). There was significant difference in effective rate (P
Experience Through clinical observation, compared with the western medicine group, there is no significant difference in ovulation, pregnancy, effective rate and ovulation rate calculated by cycle (P & gt0.05). The effective rate calculated only by cycle is lower than that of western medicine group. It is suggested that the short-term curative effect of traditional Chinese medicine cycle is not as good as that of western medicine, and the gradual recovery of gonadal function often takes some time. Good long-term curative effect. At the same time, the traditional Chinese medicine group has the advantages of small side effects, paying attention to adjusting the patient's internal environment and low recurrence rate after drug withdrawal, which is beyond the clomiphene citrate therapy.
The results of this study show that it has a good effect on primary amenorrhea, luteal insufficiency, dysfunctional uterine bleeding and anovulatory menstruation, especially on adolescent dysfunctional uterine bleeding. However, the curative effect on second-degree amenorrhea with low ovarian function is very poor.
Prescription source: Xu Jinxun, et al. Traditional Chinese medicine artificial cycle treatment of ovulation disorder. Chinese Journal of Obstetrics and Gynecology, 1984, (4): 193.8. A series of prescriptions for tonifying kidney and regulating menstruation consists of 30g of Cuscuta chinensis and Achyranthes bidentata, 20g of Polygonum Multiflori Radix, 20g of Lycium barbarum, 20g of Radix Astragali and 20g of Radix Dipsaci, and 0g of Ligusticum Chuanxiong, Ligustrum Lucidum and Radix Angelicae Sinensis.
Treatment method ① All amenorrhea patients were treated with Bushen Huoxue Decoction 10 ~ 15 days, and then treated with progesterone 15 days, 20mg daily, in order to expect menstrual cramps. ② On the 5th day of menstruation, diethylstilbestrol 1mg, daily 1 time, a total of 2 1 day; Menstrual cycle starts from day 12, and chorionic gonadotropin is used at a daily dose of 1000u for 5 days. On day 18, progesterone 20 mg was used on day 1 day for 5 days. ③ On the 6th ~10 day of menstrual cycle, nourish yin and kidney, nourish chong ren and promote follicular development: 30g for Ziyingshi and Dipsacus, 0g for Radix Rehmanniae Preparata, Herba Cistanches, Radix Angelicae Sinensis, Herba Leonuri and Rhizoma Cyperi, 20g for Fructus Ligustri Lucidi and Fructus Lycii, 20g for Radix Paeoniae Alba, Semen Cuscutae and Rhizoma Dioscoreae. ; On the first11~16th day of menstrual cycle (before ovulation and ovulation), tonifying kidney and promoting blood circulation are the main methods to induce ovulation: Ziyingshi, Semen Cuscutae and Radix Dipsaci each 30g, Fructus Lycii and Fructus Ligustri Lucidi 20g, Rhizoma Curculiginis, Herba Epimedii, Herba Cistanches, Rhizoma Cyperi and Herba Leonuri each/kloc-0. On the 7th to 25th day of menstrual cycle (secretory phase), tonify kidney-yang, regulate chong and ren, and improve luteal function: Cuscuta chinensis and Taxilli each 30g, Rhizoma Curculiginis, Herba Epimedii, Herba Cistanches, Radix Paeoniae Alba preparata, Radix Dipsaci, Radix Codonopsis, Rhizoma Cyperi preparata and Herba Leonuri each15g, and Radix Angelicae Sinensis15g. The menstrual cycle is 26-28 days (premenstrual period), mainly promoting blood circulation and regulating menstruation, supplemented by promoting blood circulation and dredging collaterals: Radix Angelicae Sinensis, Eupatorium adenophorum, Achyranthis Radix, Fructus Leonuri, Rhizoma Cyperi 10g, Rhizoma Chuanxiong, Radix Paeoniae Rubra and Ramulus Cinnamomi 6g each; During menstrual period, promoting blood circulation to remove blood stasis and promoting endometrial shedding: peach kernel, safflower, angelica, red peony root, Ligusticum chuanxiong, parched white peony root, Achyranthes bidentata, Eupatorium adenophorum, Cyperus rotundus 10g, cassia twig 6g; At the same time, on 12 ~ 15, acupuncture at Sanyinjiao, Guanyuan, Zhongji, Huilai and Dahe was selected for 3 days, and the method of stopping diarrhea was adopted.
Efficacy: it is mainly used to improve estrogen level and luteal function in artificial cycle of western medicine; The artificial cycle of traditional Chinese medicine changes according to the periodicity of the ovary, which can tonify the kidney, nourish yin, promote blood circulation and tonify the kidney, strengthen yang and promote blood circulation, and regulate menstruation, thus promoting the function of the kidney and making menstruation from. Combination of traditional Chinese and western medicine, attending amenorrhea.
Clinical application of 30 cases of amenorrhea in this group, 25 cases were cured, accounting for 83.3%, of which 20 cases were pregnant, accounting for 66.6%, and 4 cases were effective. The total effective rate was 96.6%. For example, a patient who has been married for three years and is not pregnant has a menstrual cycle 1 day of 40-60 days, amenorrhea for 5 months, and a pale tongue and weak pulse. It is called weakness of waist and knees, tepid limbs and low sexual desire. Syndrome differentiation is amenorrhea due to kidney-yang deficiency and cold coagulation. Adopt the method of combining traditional Chinese and western medicine, 2 months, regulate menstruation, and get pregnant in the third month.
Experience the artificial cycle of western medicine to improve estrogen level and luteal function. The artificial cycle of traditional Chinese medicine changes periodically, tonifying kidney and nourishing yin, promoting blood circulation and regulating menstruation, regulating the balance of kidney yin and kidney yang, promoting renal function, and restoring the balance between dysfunctional kidney and uterus every day, thus regulating endocrine and promoting normal menstruation. Kidney stores essence, controls reproduction, such as kidney qi, urges heaven to reach the top, and leads ren meridian to pass. Excessive impulse leads to irregular menstruation at present, so in the treatment of amenorrhea, tonifying kidney runs through, with good curative effect and quick effect.
This party was first written by Wu. 30 cases of amenorrhea treated by combination of traditional Chinese and western medicine. New traditional chinese medicine, 1992, (7): 25.9. Prescriptions for regulating menstrual cycle: ① Radix Angelicae Sinensis, Radix Rehmanniae, Radix Rehmanniae Preparata, Radix Paeoniae Alba, Radix Polygoni Multiflori Preparata, Rhizoma Polygonati Preparata, Fructus Lycii, Fructus Ligustri Lucidi, Fructus Broussonetiae, Rhizoma Dioscoreae, and Radix Ophiopogonis were used for kidney yin deficiency in the later stage. Kidney-yang deficiency type: Curculigo, Epimedium, Morinda officinalis, Semen Cuscutae, Ruby, Dipsacus, Placenta Hominis, Psoralea corylifolia, Cornu Cervi Degelatinatum, Cistanche deserticola each 65438±05g, Cinnamomum cassia 65438±00g；; ; For patients with deficiency of both yin and yang, drugs should be used according to different priorities.
② Prescriptions before and during ovulation: Salvia Miltiorrhiza, Eupatorium adenophorum, Achyranthes bidentata, Motherwort, Spatholobus Spatholobus, Cuscuta chinensis and Epimedium each 65438±05g, Ramulus Cinnamomi, Radix Paeoniae Rubra, Carthami Flos, Radix Aucklandiae and Rhizoma Cyperi each 65438±00g.
③ premenstrual prescription: same as premenstrual prescription.
④ Menstrual prescription: same prescription before ovulation and during ovulation.
Addition and subtraction: Platycladus orientalis, Os Draconis and Cortex Albizziae 15g, Gardenia, Scutellariae Radix and Cortex Moutan10g; ; Bupleurum root 9g, Green tangerine peel and Cyperus tuber 10g, Radix Curcumae15g; The number of patients with liver depression and qi stagnation increased; For patients with spleen deficiency, Radix Codonopsis, Poria, Radix Astragali each 15g, and Rhizoma Atractylodis Macrocephalae 12g are added.
The treatment is to take "Menstrual Prescription" in the later period, "Prescription before ovulation" during ovulation and before ovulation, "Menstrual Prescription" in the earlier period and "Prescription before ovulation" during menstruation. Administration method: oral decoction, 1 day, 1 dose.
Its main functions are tonifying kidney and nourishing blood, nourishing yin and strengthening yang, promoting blood circulation and regulating menstruation. Indications: Secondary amenorrhea with scanty menstruation.
Clinical application: 85 cases in this group, aged from 65438 08 to 465438 0 years old, 52 cases were married. 33 cases were unmarried; The age of menarche is between 12- 18. The shortest course of disease is 3 months and the longest is 14 years. Some patients were treated with western medicine and relapsed after drug withdrawal. 47 cases of amenorrhea in this group were all amenorrhea for more than 3 months, and the basal body temperature was monophasic. There were 38 cases of rare menstruation, the menstrual cycle was prolonged for more than 38 days, 20 cases of anovulation by basal body temperature measurement, and 8 cases of rare ovulation/kloc-0. After treatment, 46 cases were cured, with 14 cases effective, 7 cases improved and 8 cases ineffective. Among them, amenorrhea was cured in 23 cases, effective in 7 cases, improved in 4 cases and ineffective in 13 cases. There were 38 cases of rare menstruation, 4 cases were cured/kloc-0, 7 cases were effective, 3 cases were improved and 5 cases were ineffective. Of the 52 married cases, except 12 had children, 22 of the other 40 cases (12 had amenorrhea and 10 had scanty menstruation) were pregnant.
Tiaojing recipe is a therapeutic prescription for regulating kidney yin and kidney yang according to the law of yin and yang changes in menstrual cycle. The time of the fourth medication should be based on basal body temperature, vaginal smear and estrogen level indicated by cervical mucus examination. When there is a contradiction between syndrome types and stages, it is necessary to distinguish between syndrome types and diseases. This group pays attention to the changes of both the whole body and the local endocrine cycle of the ovary, and grasps the pathological characteristics of ovulation dysfunction, aiming at improving the inherent regulatory function of the human body, balancing yin and yang, thus restoring ovulation function and menstrual cycle, with good results.
The prescription came from Jin. 85 cases of amenorrhea and menorrhagia were treated by regulating menstrual cycle. Shaanxi traditional Chinese medicine, 1990, (4): 148. 10. Zishen Jiang Huo Huoxue Decoction consists of Anemarrhena asphodeloides, Cortex Phellodendri, Carapax et Plastrum Testudinis, Carapax Trionycis, Fructus Ligustri Lucidi, Herba Epimedii, Fructus Psoraleae and Semen Persicae, with each taste of 65,438.
The treatment method is decoction, daily 1 dose. After two weeks of continuous administration, the western medicine etofenol was given 0.5 ~ 1mg/ day for 20 days except the upper part. After menstrual cramps, the amount of ethiol can be gradually reduced to 0.25mg/ day for ***20 days. Repeated cycle treatment like this. It generally takes 2 ~ 7 months to achieve ovulation in the treatment of this disease with combination of traditional Chinese and western medicine.
Efficacy: This prescription can nourish yin, reduce fire, tonify kidney and promote blood circulation. It is suitable for the treatment of high gonadotropic amenorrhea. The diagnostic criteria are as follows: ① Amenorrhea (infertility) with symptoms such as fever, dry mouth, five upset and fever, poor secondary sexual characteristics, but no Tunner syndrome, atrophy of vaginal epithelium, small uterus and no mass in bilateral appendages; ② The level of follicle stimulating hormone is close to menopause (secondary blood or urine sample determination); ⑧ The ovary is small or normal, there is no growing follicle or corpus luteum by laparotomy, and there is fibrous tissue in the cortex. Only a few primordial follicles were diagnosed as unresponsive nested syndrome, and those without primordial follicles were diagnosed as premature ovarian failure.
Clinical application of high gonadotropic amenorrhea accounts for about 10% of amenorrhea patients, which is generally difficult to cure. 1985 ~ 1987 * * 6 cases of this disease, aged 22 ~ 32, were treated with estrogen or artificial cycle and traditional Chinese medicine for a long time, but they still had amenorrhea after stopping taking the medicine. After the treatment of the above-mentioned integrated traditional Chinese and western medicine methods, symptoms such as baking fever, dry mouth, and five-upset fever were obviously improved, and sexual requirements were improved. After taking 0.25 mg/day acetochlor, moderate menstrual cramps may occur. Three patients with ovarian unresponsive syndrome began to have biphasic basal body temperature (BBT) at 2, 2 and 4 months after treatment, respectively, and their body temperature increased by >: 10 day, accompanied by menstrual cramps, abdominal pain and other symptoms, among which 2 cases were pregnant (second pregnancy 1 case) and delivered. Three patients with premature ovarian failure also achieved certain curative effect.
Experience shows that hypergonadotropic amenorrhea refers to amenorrhea in women before the age of 35. The clinical manifestations are dry mouth, irritability, fever, constipation, palpitation, easy to catch a cold, red tongue, rapid pulse and other symptoms of kidney yin deficiency and excessive fire, so the treatment of this disease should be mainly based on nourishing yin and tonifying kidney, purging fire and promoting blood circulation; At the same time, estrogen is used in combination to promote ovulation. Results The ovulation time was generally 2 ~ 7 months, and 2 cases were pregnant after 4 months of treatment, which was earlier than that reported in the literature after 2 ~ 120 months of treatment. The pregnancy rate is also significantly higher than that reported in the literature. Judging from the therapeutic effect, the effect of premature ovarian failure is not as good as that of patients with ovarian unresponsive syndrome.
Yu Jin, et al. Treatment of hypergonadotropic amenorrhea with combination of traditional Chinese and western medicine. Journal of traditional chinese medicine, 1989, (12): 29.