In traditional Chinese medicine, amenorrhea is called amenorrhea, which is mostly caused by congenital deficiency, infirmity, labor pains, kidney qi deficiency and essence and blood deficiency. Serious illness, long illness, postpartum blood loss, or insufficient spleen biochemistry, and less blood volume in Chongren; Modality disorder, mental stress, or stimulation, qi and blood stagnation is not good; Obese people, phlegm-dampness, phlegm-dampness blocking chong ren, etc. Common syndromes are: ① amenorrhea due to kidney deficiency and essence deficiency. In the late period of menstruation, the menstrual flow is less, the color is red, amenorrhea gradually occurs, dizziness and tinnitus, soreness of waist and knees, dry mouth, fever of hands and feet, hot flashes and sweating, red tongue with little fur, and thin or astringent pulse. Prescriptions for invigorating kidney and essence include Guishen Pill and Zuogui Pill. ② amenorrhea due to deficiency of both qi and blood. In the late period of menstruation, there is little menstrual flow, which gradually becomes amenorrhea, dizziness and fatigue, dull complexion, forgetfulness and insomnia, shortness of breath and laziness, dull hair and skin, pale tongue and weak pulse. Treatment to tonify qi and blood, can use ginseng nourishing soup, Guipi decoction. ③ Qi stagnation and blood stasis type amenorrhea. Irregular menstrual period, gradual or sudden amenorrhea, chest and hypochondriac pain, breast and lower abdomen pain, irritability, dark tongue with blood stasis and astringent pulse. It is advisable to use Xuefu Zhuyu Decoction and Xiaoyao Pill to promote qi, promote blood circulation and remove blood stasis. ④ amenorrhea due to phlegm-dampness stagnation. Menstruation gradually reaches amenorrhea, obesity, nausea, burnout, anorexia, nausea, leucorrhea, white greasy tongue coating and slippery pulse. Treating phlegm-dampness with Baizhu and Xiangsha Liu Jun Decoction.
If a woman is over 18 years old and has not menstruated, or an unmarried young woman has normal menstruation, but has stopped menstruating for more than 3 months, it is called amenorrhea. The former is called primary amenorrhea and the latter is called secondary amenorrhea. Some girls can't be regarded as amenorrhea because the interval between menarche and the second menstruation is several months, or the menstruation is irregular within one or two years, and the interval between two menstruation is relatively long. This is because their reproductive organs are not yet mature and the function of their ovaries is not perfect, which is a normal physiological phenomenon.
Modern reports on acupuncture treatment of amenorrhea appeared as early as the 1920s [1], but until the 1960s, articles on treatment of amenorrhea mainly focused on individual cases, lacking convincing statistical data. Since 1970s, there have been many clinical observation cases. Since the 1980s, there have been more and more reports. Acupuncture, acupoint massage, warm acupuncture and auricular point pill pressing have all achieved good results. But in general, the experience of acupuncture in treating amenorrhea is still accumulating, and its clinical law needs to be further revealed.
treat cordially
Acupuncture needle applied to body
(1) acupoint selection
Key points: grow stronger.
Matching points: Shenshu, Yinjiao, Sanyinjiao, Diji and Bajiao.
(2) treatment
Give priority to with long strength, and add acupuncture points if the effect is not obvious. Schilling patients take prone position, take an acupoint in the middle depression between the lower end of coccyx and anus, and use No.28 needle to penetrate into the depth of 1 inch, and apply intensive stimulation. Leave the needle for 20 minutes and sew 1 needle every 5 minutes. Matching points, needling the first three points, moderate stimulation, reinforcing method or flat reinforcing Xie Ping method; Press and knead the last two points with the pointer for 5 ~ 6 minutes. Every day or every other day 1 time,1time is a course of treatment.
(3) Evaluation of curative effect
40 cases were treated by the above method. Results 36 cases were cured, 4 cases were ineffective, and the total effective rate was 90% [3,4]. This method is suitable for secondary amenorrhea.
Body Acupuncture Therapy (Ⅱ)
(1) acupoint selection
Key points: Zhongji, Subversion 17, Gongsun, Chin Xia.
Acupoint matching: Type I: Chong Ren Du Meridian Deficiency, Qi and blood deficiency, vein dystrophy, with Guanyuan, Air Cavity, Baihui, Shenmen, Ganshu, Fructus Aurantii Immaturus, Yishu, Fuliu and Qimen; Type II: Pathogen entering into ren meridian, qi stagnation and blood stasis, failing to know pulse, adding Zhong Wan, Dahe, Uterus, Shu Yao, Ganshu, Pishu, Guo Li and Sanyinjiao.
(2) treatment
The main point is given priority to, and points are added according to different syndrome types. Get 6 ~ 8 points at a time. Routine disinfection of acupoints. Use twisting to lift and insert, make up for diarrhea, peck at sacral points after getting angry. Type I waist Guanyuan and air pocket gradually go from shallow to deep after qi is exhausted, and acupuncture repeatedly for 1 ~ 3 minutes until they feel warm, or warming moxibustion for 1 ~ 3 minutes; Type Ⅱ back point shallow needling and twisting reinforcing method. Treatment every other day 1 time, 3 months as a course of treatment. Stop treatment when menstruation comes, and continue acupuncture when menstruation comes. The general treatment is 1 course.
(3) Evaluation of curative effect
* * * 30 cases were treated, and the results were 13 cases, effective 14 cases and ineffective in 3 cases, with a total effective rate of 90%[5].
Auricular point pill pressing
(1) acupoint selection
Key points: internal genitalia, endocrine, subcortical.
Matching points: liver, kidney and heart.
(2) treatment
The main points are given priority to and supplemented as appropriate. Take 2 ~ 3 points at a time and choose both ears. Insist on using seeds without seeds. After application, press repeatedly with thumb and forefinger until the auricle is red and congested. Patients are required to press themselves 3 ~ 4 times a day. 3 days 1 time. After menstrual cramps, it is advisable to apply pressure for another course of treatment to consolidate the effect. Generally 3 to 5 times is a course of treatment.
(3) Evaluation of curative effect
40 cases were treated with the above method, 38 cases were effective and 2 cases were ineffective, with a total effective rate of 95% [2].
Main references
[1] Liu Ying. Experience in treating female amenorrhea with acupuncture. Shanxi medical journal1922; ( 10):23。
[2] Zhao Guang. 40 cases of late menstruation and amenorrhea treated by auricular point sticking and pressing. Xinjiang Traditional Chinese Medicine1988; (2):42。
[3] Liu Shouquan. Treatment of secondary amenorrhea by acupuncture at Changqiang point. China Acupuncture1986; 6(3):36。
[4] Huo Jinshan. Acupuncture combined with massage for amenorrhea 1 1 case. Journal of traditional chinese medicine1983; 24(7):47。
[5] Pu Yunxing. Analysis of therapeutic effect of acupuncture on amenorrhea. Shanghai Journal of Acupuncture1994; (6):257。
There are many reasons for amenorrhea, and the common ones are as follows:
(1) disease. It mainly includes consumptive diseases, such as severe tuberculosis, severe anemia and malnutrition. And unique endocrine diseases, such as "obesity and reproductive dysfunction malnutrition"; Some endocrine disorders in the body, such as adrenal gland, thyroid gland, pancreas and other dysfunction. The influence of these reasons may not necessarily come to menstruation. But the amenorrhea caused by these conditions, as long as the disease is cured, menstruation will naturally come.
(2) Inferior atresia of reproductive tract. Such as cervix, vagina, hymen, labia, etc. Others are congenital atresia or adhesive atresia caused by acquired injury. Although there is menstruation, but the menstrual blood flow does not come out. This condition is called recessive or pseudoamenorrhea. The atresia of the lower reproductive tract can be completely cured by the doctor's treatment.
(3) The genital litigation is imperfect or stunted. Some people are born without ovaries, or the ovaries are poor, or the ovaries are bad, so they can't produce estrogen and progesterone, so the endometrium can't change periodically, and there will be no endometrial shedding, so there will be no menstrual cramps. Some are born without uterus, or endometrial dysplasia, or endometrial damage, even if the ovarian function is sound and the secretion of estrogen and progesterone is normal, they do not come to menstruation.
④ Tuberculous endometritis. This is because mycobacterium tuberculosis invades the endometrium, causing different degrees of inflammation and injury, and finally scar tissue appears, leading to amenorrhea. Therefore, if you have tuberculous endometritis, you should treat it in time without delay.
(5) Dysfunction of pituitary or hypothalamus. The pituitary gland can secrete gonadotropins. Gonadotropin can regulate ovarian function and maintain menstruation. If the pituitary gland is dysfunctional, it will affect gonadotropin secretion and ovarian function, and abnormal ovarian function will cause amenorrhea. In addition, abnormal hypothalamic function can also cause amenorrhea. There are many reasons for hypothalamic dysfunction, such as mental stimulation, sadness, anxiety, tension, fatigue, environmental changes, cold stimulation and so on. Amenorrhea caused by hypothalamus is more common.
If amenorrhea is found, you should go to the hospital in time, find out the reasons and treat the symptoms, which will generally get satisfactory results. Don't be afraid of illness and doctors. Otherwise, the longer the amenorrhea time, the more severe the uterine contraction and the worse the therapeutic effect. Whether adolescent female amenorrhea can be cured depends on the cause of amenorrhea. For example, secondary amenorrhea in adolescence is mostly caused by environmental changes, emotional fluctuations and weight changes. After removing these reasons, menstruation can gradually recover. A few amenorrhea caused by diseases, such as polycystic ovary syndrome, thyroid dysfunction, tuberculosis and so on. After treatment, menstruation can also be restored. However, some amenorrhea can't be cured, such as no uterus delivery, too small uterus or amenorrhea caused by endometrial damage caused by pathological changes. No matter what kind of amenorrhea it is, you should check it clearly. Even if it is incurable amenorrhea, it should be examined clearly to determine the short-term impact.
Generally speaking, women who can't cure amenorrhea can get married in the future, but they can't have children. When looking for a partner, they should make it clear to each other that they will get married on the basis of full understanding and trust, even if they have no children.
( 1)
Syndrome differentiation of liver depression and qi stagnation, disharmony of stomach, and obstruction of meridians.
Treat liver and stomach, promote blood circulation and dredge menstruation.
Fangming Shugan Huoxue Tongjing Decoction.
Is prepared from fried Rhizoma Cyperi10g, Evodia rutaecarpa 6g, ginger 6g, salvia miltiorrhiza15g, Toosendan Fructus10g, fried Rhizoma Corydalis 6g, peach kernel 6g, Fructus Aurantii Immaturus 6g, Angelica sinensis12g, and Cortex Moutan10g.
Usage: decoct in water, daily 1 dose, three times a day.
The source is Quwenlou.
(2)
Syndrome differentiation of deficiency of both qi and blood.
Treatment regulates qi and blood, strengthens spleen and tonifies kidney.
Prescription name plus or minus Bazhen Decoction.
Consists of Radix Codonopsis 12g, Poria 9g, Atractylodis Rhizoma 9g, Radix Angelicae Sinensis 9g, Ramulus Cinnamomi 9g, Rhizoma Chuanxiong 9g, Radix Rehmanniae Preparata 15g, Caulis Spatholobi 15g, Radix Aconiti Lateralis Lateralis, Rhizoma Zingiberis and Radix Glycyrrhizae Preparata 6g.
Usage: decoct in water, daily 1 dose, three times a day.
Source of information.
(3)
Syndrome of liver depression and qi stagnation.
Soothing liver and relieving depression, benefiting qi and regulating menstruation.
Fang Ming Wu Si Xiao Tang Yao
Consists of 9 grams of Bupleurum, 9 grams of Angelica sinensis, 9 grams of Ligusticum Chuanxiong, 9 grams of Cyperus rotundus, 9 grams of Rhizoma Corydalis, 9 grams of peach kernel, 9 grams of safflower, 0/2 grams of red peony root/kloc-,0/2 grams of dried rehmannia root/kloc-and 6 grams of green tangerine peel.
Usage: decoct with water, 1 dose, twice a day.
Source of information.
(4)
Syndrome differentiation of qi stagnation and blood stasis.
Promoting blood circulation and regulating qi.
Fangming Huoxue decoction
Comprises 9 grams of peach kernel, 9 grams of safflower, 9 grams of angelica, 9 grams of lycopi, 9 grams of white peony root, 9 grams of Cyperus rotundus, 9 grams of dried tangerine peel, 9 grams of Achyranthes bidentata, 0/2 grams of motherwort/kloc-,30 grams of salvia miltiorrhiza, 6 grams of bupleurum and 3 grams of licorice.
Usage: decoct with water, 1 dose, twice a day.
The source is Sun Yimin.
(5)
Syndrome differentiation and blood stasis block.
Treatment: promoting blood circulation and dredging collaterals.
Fang Ming Tang Jianhua
It consists of 65438±00g Dipsacus, 6g Camptotheca acuminata, 6g Radix Rubiae, 6g Fructus Leonuri, 6g Rhizoma Corydalis, 6g Radix Angelicae Sinensis with wine, 65438 05g Rhizoma Chuanxiong with wine, 65438 05g Radix Salviae Miltiorrhizae with wine, 5g Folium Artemisiae Argyi and 3g Radix Glycyrrhizae Preparata.
Usage: decoct with water, 1 dose, twice a day.
Originated from stone ink.
(6)
Syndrome differentiation of blood deficiency and kidney deficiency.
Therapeutic methods of nourishing blood and yin, tonifying kidney and replenishing essence.
The name of the party is 425.
Consists of 9g of Angelica sinensis, 3g of Ligusticum Chuanxiong, 9g of Radix Paeoniae Alba, 9g of Radix Rehmanniae Preparata12g, 9g of Ruby, 9g of Semen Cuscutae, 9g of Schisandra chinensis, 9g of Plantago asiatica, 0g of Achyranthes bidentata12g, 5g of Lycium barbarum15g, 9g of Rhizoma Curculiginis and 9g of Epimedium12g.
Usage: decoct with water, 1 dose, twice a day.
The source is Liu's gynecological experience.
(7)
Syndrome Differentiation: Liver and kidney are dry and qi and blood are deficient.
The treatment method can tonify qi and blood and nourish liver and kidney.
Fangming Yiqi Buchong Decoction.
Comprises Radix Codonopsis 15g, Rhizoma Atractylodis Macrocephalae 12g, Poria 12g, Radix Angelicae Sinensis 9g, Radix Rehmanniae Preparata 12g, Radix Astragali 9g, Fructus Lycii 9g, Semen Cuscutae 9g and Radix Glycyrrhizae Preparata 9g.
Usage: decoct with water, 1 dose, twice a day.
Source: Gynecological therapy of traditional Chinese medicine.
(8)
Syndrome differentiation of qi and blood deficiency and stagnation of heart and spleen.
Treat spleen, heart, qi and blood, and clear liver heat.
Self-made Jiawei Guipi Decoction.
It consists of 3 grams of Angelica sinensis, 3 grams of Poria, 3 grams of Atractylodes macrocephala, 3 grams of Radix Astragali preparata, 3 grams of arillus longan, 3 grams of polygala tenuifolia, 3 grams of fried Semen Ziziphi Spinosae, 0.9 grams of Radix Aucklandiae +0.5 grams, 3 grams of fried Radix Glycyrrhizae, 2 grams of Radix Bupleuri and 2 grams of Fructus Gardeniae.
Usage: decoct with water, 1 dose, twice a day.
The source of the book "Essentials of Orthodoxy" is under the volume.
Prevention and nursing of amenorrhea
Doing a good job in family planning and minimizing intrauterine surgery can effectively prevent amenorrhea. Amenorrhea is closely related to internal injuries of seven emotions, so it is appropriate to adjust emotions. Correctly handle the labor process to prevent massive bleeding during and after delivery. In case of massive hemorrhage, blood transfusion should be given in time to prevent Sheehan syndrome and amenorrhea.
Early amenorrhea-a signal of premature ovarian failure
Amenorrhea at the age of 36, did you enter menopause in advance? What causes premature amenorrhea? How to treat it?
Case:
Ms. Wang, 36, is engaged in computer work and full of energy. In recent years, she feels that her energy has dropped. However, due to the stress of work, she dare not relax at all and still often work overtime. One day, she found that her menstruation had not come for two months. She was not pregnant when she went to the hospital for examination, but was diagnosed with premature ovarian failure.
Expert analysis:
Menstruation is controlled by endocrine hormones in the hypothalamus-pituitary-ovary axis, and any problems in this axis will affect the normal menstruation. The function of the axis is influenced by many external factors, such as the change of environment, season and mood, which can obviously cause abnormal menstruation and even amenorrhea.
The menopausal age of normal women is about 50 years old, and it is normal for 3 ~ 5 years before or after menopause. When the menopause age is advanced to 40 years old, it is called premature ovarian failure.
Four causes of premature ovarian failure
1. Immune factors. It accounts for about 20%, and ovarian antibodies can be detected in blood. These patients are often complicated with lupus erythematosus, rheumatoid arthritis and other autoimmune diseases, and they lack an enzyme in their bodies.
2. Cytogenetic factors. Congenital germ cells are few, follicular atresia is accelerated, and X chromosome is abnormal. 10% patients have family history.
3. Physical factors. Such as surgery, chemotherapy, infection, etc., lead to gonadotropin secretion defect or gonadotropin receptor or post-receptor defect.
4. Idiopathic premature ovarian failure. The patient has no clear reason, the chromosome is normal, the blood FSH (follicle stimulating hormone) and LH (luteinizing hormone) are increased, the E2 (estrogen) is low, and the PRL (prolactin) is normal. The patient not only lacks estrogen, but also has potential ovarian androgen secretion deficiency, or the adrenal gland has a slight defect in the ability to produce steroid hormones. Laparoscopic examination often shows small ovary or ovarian atrophy.
amenorrhoea
The name of the disease. A "women's quanfang" volume one. Also known as moonless, moonless water, moonless water, menstruation, bloodless, moonless, moonless, moonless, moonless, moonless, moonless, moonless, menstrual, waterless, amenorrhea, menstruation, menstruation, interest-free, menstruation and so on. Refers to women who have reached the age of 18 and still have no menstrual cramps, or who have had menstruation but have been amenorrhea for more than three months. In addition to physiological amenorrhea such as pregnancy and lactation, it is called amenorrhea. Including dark amenorrhea in women. Mostly due to blood deficiency, kidney deficiency, qi stagnation, blood stasis, cold and dampness stagnation and other reasons.
The main causes of amenorrhea
According to the different anatomical sites of the main causes, amenorrhea can be divided into four categories: uterus, ovary, pituitary and hypothalamus.
1. Uterine amenorrhea and its etiology: The so-called uterine amenorrhea refers to amenorrhea caused by endometrial loss caused by uterine diseases. Because there is no endometrium, progesterone and artificial cycle test are negative. The causes of uterine amenorrhea are:
(1) Congenital agenesis or hypoplasia. The uterus is like a nodule. Without vagina, it will cause primary amenorrhea. These patients have normal physical development, but they are often accompanied by skeletal dysplasia, spinal curvature and renal malformation. Ovarian function is normal, ovulation occurs, basal body temperature is bidirectional, and gonadotropin is normal.
(2) Acquired endometrial injury. Amenorrhea can be caused by severe postpartum infection, severe tuberculous endometritis or radiotherapy; Excessive curettage during induced abortion can cause scar or adhesion of uterine cavity and amenorrhea.
(3) Endometrial adverse reactions. Long-term lack of sex hormones caused by long-term breastfeeding or long-term use of contraceptives can cause excessive atrophy of endometrium and amenorrhea.
2. Ovarian amenorrhea and its etiology: Ovarian amenorrhea is amenorrhea caused by insufficient endogenous estrogen due to ovarian reasons. The artificial cycle test was positive, and the level of gonadotropin increased. The main reasons for ovarian amenorrhea are:
(1) Congenital hypoplasia or hypoplasia (rare).
(2) Ovarian destruction. Such as: amenorrhea caused by surgery, radiotherapy, inflammation or tumor destroying ovaries.
(3) Ovarian tumor. Some tumors that can produce androgen cause amenorrhea by inhibiting ovarian function; Ovarian tumors that produce estrogen cause amenorrhea by inhibiting ovulation.
(4) Premature ovarian failure. Menopause is premature ovarian failure before the age of 40. Different degrees of menopausal symptoms can occur.
3. Pituitary amenorrhea and its etiology: seen in pituitary injury; Pituitary tumor, amenorrhea caused by primary pituitary gonadism. Common reasons are:
(1) Pituitary injury. Due to head injury or intracranial surgery, radiation, inflammation and other reasons, pituitary injury causes pituitary dysfunction and ovarian dysfunction, leading to amenorrhea.
(2) Pituitary tumor. It is the most common cause of amenorrhea in organic diseases, and some may have galactorrhea.
(3) Empty sella syndrome. This sign is a congenital disease that causes amenorrhea but does not develop into pituitary failure.
4. Hypothalamic amenorrhea and its causes: Hypothalamic amenorrhea is common in the following factors:
(1) Psycho-neurological factors. Sudden or long-term mental stress, such as mental tension, fear, anxiety and environmental changes, cold stimulation, etc. , can cause neuroendocrine disorders and amenorrhea.
(2) wasting diseases and malnutrition. Such as severe tuberculosis, anemia and anorexia nervosa in young women.
(3) Drug inhibition syndrome. For example, a few women who take long-acting or short-acting contraceptives may have amenorrhea after stopping taking them. Reserpine, chlorpromazine, mianertong, etc. Can also cause amenorrhea.
(4) Dysfunction of adrenal gland, thyroid gland and pancreas can also affect pituitary gland through hypothalamus to cause amenorrhea.
(5) Other diseases. Such as obesity, reproductive dysfunction and malnutrition; Amenorrhea and lactation syndrome; Polycystic ovary syndrome; Diabetes can lead to amenorrhea.