Etiology of hysteromyoma in the elderly
Estrogen secretion increased (35%);
Estrogen secretion increases, and with the advent of menopause, middle-aged women begin to appear? Estrogen control period? . During this period, women themselves are more prone to depression because of the double pressure of family and work, which promotes the increase of estrogen secretion. In addition, long-term use of contraceptives containing high estrogen, hormone drugs such as weight loss and whitening, and eating foods contaminated with high hormones. These are all important causes of uterine fibroids. This is also an important cause of uterine fibroids.
Early menopause (25%):
The number of primordial follicles in a woman's life is limited, and the ovulation period is about 30 years. During pregnancy and lactation, due to the effect of hormones, ovarian ovulation is suspended until the fourth to sixth month of lactation, which delays ovulation for a certain time, and women with reproductive history will enter menopause later. However, infertile women are prone to hormone-dependent diseases without timely and effective progesterone protection, and hysteromyoma is one of them.
Sexual dysfunction (15%):
Long-term sexual disorder can easily lead to hormone secretion disorder, lead to chronic pelvic congestion, and induce uterine fibroids.
Western medicine treatment of uterine fibroids in the elderly
Treatment must be based on the patient's age, fertility requirements, symptoms, myoma size and so on.
1, follow-up observation
If the fibroids are small and asymptomatic, there is generally no need for treatment, especially for patients close to menopause age, whose estrogen level is low, and the fibroids can naturally shrink or disappear, and they are followed up every 3-6 months; If the myoma is enlarged or the symptoms are obvious during the follow-up, further treatment will be considered.
2. Drug therapy
If the myoma is smaller than the uterus in the second month of pregnancy, the symptoms are not obvious or mild, and it is close to the menopausal age. Under normal circumstances, those who cannot be operated can be given symptomatic treatment with drugs.
(1) Androgen: It can antagonize estrogen, make endometrium contract, directly act on smooth muscle, make it contract and reduce bleeding, and make menopausal patients pass menopause earlier. Commonly used drugs: testosterone propionate 25mg intramuscular injection every 5 days 1 time, and testosterone propionate 25mg intramuscular injection every day 1 time during menstrual cramps, three times in total, with the total amount not exceeding 300mg per month, so as not to cause masculinity.
(2) Luteinizing hormone releasing hormone analogue (LHRH? ): It can inhibit the function of pituitary and ovary, reduce the level of estrogen, and is suitable for the treatment of small fibroids. 2 months pregnant), increased menstrual flow or shortened cycle, menopausal or near menopausal patients. LHRH？ Intramuscular injection 150mg daily for 3 ~ 6 months. After use, the patient's menstrual flow decreased or amenorrhea, anemia was gradually corrected, and fibroids were also reduced, but after stopping taking medicine, they gradually increased and returned to their original size. Side effects are symptoms of perimenopausal syndrome, such as hot flashes, sweating and vaginal dryness. LHRH？ Not suitable for long-term continuous use. Long-term use will lead to estrogen deficiency and osteoporosis.
3. Surgical therapy
If the myoma is larger than the uterus at 2.5 months of pregnancy or the symptoms are obvious, surgery is often needed. The operation method is as follows:
(1) Myomectomy: It is suitable for unmarried or married patients under the age of 35 who want to preserve their reproductive function. More abdominal or laparoscopic myomectomy. Transvaginal or hysteroscopic resection of submucosal myoma protruding from the cervix or vagina, 24 ~ 48 hours later, vascular clamp is taken by pedicle suture or vascular clamp, or directly taken out.
(2) Hysterectomy: If the myoma is large, the symptoms are obvious, and the drug treatment is ineffective, there is no need to preserve reproductive function, or malignant transformation is suspected, subtotal hysterectomy or total hysterectomy is feasible. Under the age of 50, if the ovary looks normal, the ovary can be preserved.
Treatment of senile hysteromyoma with traditional Chinese medicine
First, Chinese medicine treatment
1. According to the characteristics of blood-gas imbalance in hysteromyoma, the treatment should distinguish between qi and blood, new disease or long-term disease. If the disease is caused by qi, it is mainly to regulate qi and relieve depression, supplemented by regulating blood; When the disease is in the blood, it is mainly to promote blood circulation and dissipate blood stasis, supplemented by regulating qi. New diseases are still flourishing, which can be attacked and broken; After a long illness, which is better, attack and repair, attack and cut? Half failed? Don't attack hard, so as not to damage your vitality. If the stone is not strong enough to be cut, it should be lifted by western medicine surgery, and the true evil should be eliminated first, and then it should be made up.
2, the treatment of this disease, can use drugs and non-drug therapy, new diseases, qi deficiency diseases, should be treated by the method of promoting qi and blood circulation; Long-term illness, blood disease or phlegm coagulation, the condition is mild, and the lump is still small, so it is appropriate to treat it with the method of promoting blood circulation and removing blood stasis. The condition is serious, and the mass is large, and the healthy qi gradually decreases. Surgical resection should be adopted to remove the pathogenic factors before adjustment.
Second, treatment based on syndrome differentiation.
1, gas stagnation
Treatment method: promoting qi circulation and stagnation, promoting blood circulation and eliminating symptoms. The user modified Xiangling Pill.
Radix Aucklandiae, Flos Caryophylli, Rhizoma Sparganii, Fructus Aurantii, Rhizoma Curcumae, Pericarpium Citri Reticulatae Viride, Fructus Toosendan and Fructus Foeniculi can be decocted in water, or made into watered pills for oral administration. Radix Salviae Miltiorrhizae and Rhizoma Cyperi are added for irregular menstruation. Poria, Coicis Semen and Radix Angelicae Dahuricae are added into leucorrhea; Severe abdominal pain plus Rhizoma Corydalis and Radix Notoginseng.
2. Blood stasis
Treatment: promoting blood circulation to remove blood stasis, eliminating symptoms and resolving hard mass. Add and subtract Guiji Fuling Pill.
Prescription cassia twig, tuckahoe, peony bark, peony and peach kernel. It can be decocted in water, or made into fine powder and watered pill for oral administration. For menorrhagia or metrorrhagia, Pollen Typhae and Oletum Trogopterori are added; Adding too much Coicis Semen and Radix Angelicae Dahuricae in leucorrhea; Rhizoma Corydalis, Olibanum and Myrrha are added for severe abdominal pain; Achyranthes bidentata and Eupatorium adenophorum were added to patients with less menstrual flow or amenorrhea, and the lump was obvious. If it is pushing, you can add drugs for removing blood stasis and resolving stagnation, leeches and stingers.
3. Phlegm dampness
Treatment of qi, phlegm and symptoms. Season with Chen Er soup.
The prescription is prepared from Pinellia ternata, Pericarpium Citri Tangerinae, Poria, Pericarpium Citri Reticulatae Viride, Rhizoma Cyperi, Rhizoma Chuanxiong, Rhizoma Sparganii, Rhizoma Curcumae, Radix Aucklandiae, Rhizoma Atractylodis and Radix Glycyrrhizae. Codonopsis pilosula and Atractylodes macrocephala are added for patients with spleen deficiency; Remove rhizoma Cyperi, rhizoma Atractylodis, herba Patriniae and caulis Sargentodoxae.
Chinese patent medicine
(1) Guiji Fuling Pill: Promote blood circulation to remove blood stasis and relieve symptoms. Indications: A female has a mass in her lower abdomen, which causes pain and abdominal cramps. Or abdominal distension and pain caused by amenorrhea and leucorrhea. It has a good therapeutic effect on hysteromyoma. 6g honey pills, 1 time 1 pill, daily 1 time, taken orally. Drink warm water.
(2) Dahuangchong Pill: It has the effects of promoting blood circulation, removing blood stasis, dredging channels and collaterals, reducing swelling and clearing heat. Indications: blood stasis, abdominal mass, onychomycosis and abdominal mass. Take 3 grams of honey pills orally, each time 1 ~ 2 capsules, l ~ 2 times a day, and take them with warm water.
Thirdly, acupuncture.
The treatment method is mainly qi stagnation, the pain has no fixed place and the mass can move. Body acupuncture therapy is used to promote qi and blood circulation, remove blood stasis and relieve pain.
Take Zhongyu, Sanyinjiao, Neiting and Guanyuan. Needle needling, purgation, twisting and inserting, needle retention for 20 minutes, 1 time a day,1time as a course of treatment.
Fourth, family self-treatment.
1, massage
The patient lies on his back, with the performer standing beside him, and rubs Shenque, Qihai, Guanyuan, Shu Tian, Hayes, Huilai, Uterus, Qichong, Xue Hai and Sanyinjiao with his thumb for 1 min, then rubs with his palm, then puts his abdomen, rubs it clockwise for 36 times, and then rubs it counterclockwise for 36 times, and finally uses it.
2. Application method
(1) roll the garden balsam stem, pubescent angelica root, angelica dahurica 1, turtle shell, rhizoma sparganii, zedoary, salvia miltiorrhiza, safflower, radix paeoniae rubra and * * * into coarse powder, put them in a cloth bag, steam them and warm iron the lower abdomen, once a day 1 ~ 2 times, 20 ~ 30 minutes each time, and each bag can be used continuously for 5 ~ 7 minutes.
② Dry dung beetles and clematis chinensis respectively and grind them into powder, then apply appropriate amount of yellow wine to navel and apply plaster, 65438 0 times a day, each time for about 65438 0 hours, and stop using during menstruation.
③ Grind Rhizoma Arisaematis, Semen Sinapis Albae, Cortex Magnolia Officinalis, Rhizoma Pinelliae, Fructus Aurantii, Radix Angelicae Dahuricae, Folium Artemisiae Argyi, Bulbus Allii Cepae, and * * * into coarse powder, put it in a cloth bag, spray water, steam for half an hour, and iron under the umbilicus while it is hot for 20 minutes each time. Each dose can be used continuously for 5 to 7 days, and 10 times is 65433.
(4) Mud Pinellia ternata, scallion and * *, apply it on the umbilicus, and cover it with Shangshi ointment, with a daily change of 1, with 5 days as a course of treatment 1.
3. Family therapy
(65,438+0) Uterine fibroid powder was taken orally three times a day, 65,438+0.5g each time, and the curative effect was observed for three months.
(2) Take Semen Vaccariae, Prunellae Spica, Raw Oyster and Perillae, decoct in water, and take 1 dose every day or every other day, with 30 doses as a course of treatment.
Did you get a look at him? The treatment method of hysteromyoma in the elderly? People still see:
1. Symptoms and treatment of hysteromyoma
2. The harm and treatment of hysteromyoma
3. Treatment of small uterine fibroids
4. Treatment of hysteromyoma with traditional Chinese medicine