圍絕經(jīng)期綜合癥

圍絕經(jīng)期綜合癥第1頁/共55頁I、DEFINATIONBeforeoraftertheperiodofnaturalcessationofmenstruation,womenmayhavesomesymptomsassociatedwithit,suchasmenstrualdisorder,hecticfeverwithsweating,dizziness,tinnitus,insomnia,palpitationandlassitude,debilitation.irritability,depression.第2頁/共55頁

Thisisclimactericsyndromeormenopausalsyndrome.InTCM,itbelongstothecategoryof“絕經(jīng)前后諸癥(syndromesbeforeoraftermenopause)”第3頁/共55頁IIPHYSIOLOGYOFMENSTRUATIONINTCMTheproductionofmenstruationisrelatedtotheabundanceofkidney-qi,aslongasthearrivaloftheTiangui,andnormalfunctionoftheChongandRenChannels.第4頁/共55頁

1.Kidney-qi2.Tiangui3.TheChongChannelandRenChannel第5頁/共55頁IIIETIOLOGICALFACTIORANDPATHOGENESIS1.Deficiencyofkidney-qi.2.ExhaustionoftheTiangui.3.DisturbanceoftheChongandRenChannels第6頁/共55頁IV、PATHOGENESISFundamental:1.Deficiencyofkidney.2.DisturbanceoftheChongandRenChannels.第7頁/共55頁

incidental:1.stasisofliver-qi2.Stagnationofblood3.Phlegm4.Damp-heat第8頁/共55頁V、DIFFERENTIATION1.Deficiencyofliver-yinandkidney-yin

hecticfeverwithsweating,feverishsensationinthechest,palmsandsolesdizziness,sorewaistandknee,upset,tantrumAdvancedmenstruation,oratirregularintervals,diminishedflow.drymouth,oliguria,constipationredtonguewithlittlecoating,wirythreadyrapidpulse.第9頁/共55頁

2、Deficiencyofkidney-yangandSpleen-yangdizziness,distentionofhead,memorydeclineDimcomplexion,sorewaist,coldandswollenlimbsMenstruationwithlightred,abruptandheavyflow.Gloomandlanguid,orlassitudeabdominaldistention,belchingandsourregurgitation,weakappetite,loosestools,frequentnocturiapuffytonguewithwhite-slidecoating,feebledeepthreadypulse

第10頁/共55頁3.IncoordinationbetweentheheartandthekidneyPalpitation,emotionallability,vexationanddreaminess,insomniasorewaistandknee,dizzinessandtinnitushecticfeverwithsweating,feverishsensationofthechest,palmsandsolesBittertastes,redtonguewithlittlecoating,threadyrapidpulse.

第11頁/共55頁VI、SUMMARYOFCATEGORIES1、Deficiencyofkidney-yin:（1）Hyperactivityofliver-yang（2）Incoordinationbetweentheheartandthekidney2、Deficiencyofkidney-yang:（1）Deficiencyofspleen-yangandkidney-yang（2）Declinationoffireinthegateoflife第12頁/共55頁

3、Associatedsyndromes:（1）Stasisofliver-qi（2）Retentionofphlegm（3）Bloodstagnation第13頁/共55頁VII.THERAPY1、Therapeuticprinciple:Invigoratingkidneyisthemainprinciple:nourishingthekidneyandcalmthemindpurgingtheliver-fireandstrengtheningthespleen.(restrainingyinbysupplementingyang)(restrainingyangbynourishingyin)第14頁/共55頁肝腎陰虛

Deficiencyofliver-yinandkidney-yin(1)Therapeuticprinciple：Nourishingthekidneyandliver,andsuppressingthehyperactiveliver-yang(providingwaterforthegrowthofwood)第15頁/共55頁(2)Prescription:腎俞Shenshu(U.B.23)太溪Taixi(K.3)肝俞Gansu(U.B.18)太沖Taichong(Liv.3)行間Xingjian(Liv.2)第16頁/共55頁

(3)Selectionofacupointsaccordingtosymptomsandsigns:A、Hecticfever（潮熱）涌泉Yongquan(K.1)照海Zhaohai(K.6)列缺Lieque(Lu.7)第17頁/共55頁

B、Chestdistress神門Shenmen(H.7)大陵Daling(P.7)第18頁/共55頁

C、Dizziness(Dizzyvision)百會Baihui(Du20)D、Tinnitus聽會Tinghui(G.B.2)第19頁/共55頁*Acupointsfornourishingyin太溪Taixi(K.3)照海Zhaohai(K.6)復(fù)溜Fuliu(K.7)然谷Rangu(K.2)三陰交Sanyinjiao(Sp.6)曲泉Ququan(Liv.8)第20頁/共55頁

*Acupointsforcalmingtheliverandsuppressinghyperactivityoftheliver-yang:太沖Taichong(Liv.3)行間Xingjian(Liv.2)俠溪Xiaxi(G.B.43)足臨泣Zulinqi(G.B.41)陽輔Yangfu(G.B.38)丘墟Qiuxu(G.B.40)第21頁/共55頁

*心腎不交IncoordinationbetweentheheartandthekidneyA、Therapeuticprincipal:(1)Nourishingkidney-yin,coordinatingtheheartandkidney(2)Back-ShuPointsmostlyselected(3)Reinforcingandreducingmethod第22頁/共55頁B、Prescription心俞Xinshu(U.B.15)腎俞Shenshu(U.B.23)脾俞Pishu(U.B.20)三陰交Sanyinjiao(Sp.6)第23頁/共55頁

*Selectionoftheacupointsaccordingtothesymptomsandsigns:<1>Insomnia神門Shenmen(H.7)四神聰Sishencong(EX-HN1)<2>Palpitation通里Tongli(H.5)內(nèi)關(guān)Neiguan(P.6)第24頁/共55頁

<3>Feverishsensationoverthepalms,solesandthechest勞宮Laogong(P.8)<4>Disturbanceofconsciousness:人中Renzhong(Du26)大陵Daling(P.7)第25頁/共55頁

（2）脾腎陽虛DeficiencyofSpleen-yangandKidney-yang

<1>Therapeuticprinciple:WarmingthekidneyandactivatingyangTonifyingthekidneyandinvigoratingthespleenBack-ShuPointsmostlyselectedReinforcing,combinedwithmoxibustion第26頁/共55頁

<2>Prescription:腎俞Shenshu(U.B.23)關(guān)元Guanyuan(Ren4)脾俞Pishu(U.B.20)章門Zhangmen(Liv.3)足三里Zusanli(St.36)第27頁/共55頁

*Selectionoftheacupointsaccordingtothesymptomsandsigns:Loosestool天樞Tianshu(St.25)陰陵泉Yinlingquan(Sp.9)太溪Taixi(K.3)第28頁/共55頁（3）Associatedsymptomsandsigns<1>Stasisofliver-qi:A、Therapeuticprinciple:Dispersingthestagnatedliver-qibyinvigoratingtheflowofQi(whichisbasedonnourishingyinandclearingawayheatintheheart)第29頁/共55頁

B、Prescription:太沖Taichong(Liv.3)行間Xingjian(Liv.2)太沖Taichong(Liv.3)合谷Hegu(L.I.4)太沖Taichong(Liv.3)期門Qimen(Liv.14)第30頁/共55頁<2>Accumulationofphlegm:A、Therapeuticprinciple:RegulatingQiandresolvingphlegm第31頁/共55頁

B、Prescription:膻中Shanzhong(Ren17)中脘Zhongwan(Ren12)氣海Qihai(Ren6)足三里Zusanli(St.36)支溝Zhigou(S.J.6)豐隆Fenglong(St.40)第32頁/共55頁

*豐隆(St.40)iscombinedwith內(nèi)關(guān)(P.6),間使(P.5),神門(H.7),太沖(Liv.3),toclearawayphlegm-fireandregulateQitotranquilizethemind.第33頁/共55頁<3>Bloodstasis:A、Therapeuticprinciple:Promotingbloodcirculationandremovingbloodstasis第34頁/共55頁

B、Prescription:膈俞Geshu(U.B.17)血海Xuehai(Sp.10)三陰交Sanyinjiao(Sp.6)第35頁/共55頁*Forthetreatmentofmassesintheabdomen歸來Guilai(St.29)氣沖Qichong(St.30)水道Shuidao(St.28)氣海Qihai(Ren6)中極Zhongji(Ren3)交信Jiaoxin(K.8)陰陵泉Yinlingquan(Sp.9)第36頁/共55頁

*Back-ShuPointsplayanimportantroleintreatingclimactericsyndrome.心俞Xinshu(U.B.15)肝俞Gansu(U.B.18)脾俞Pishu(U.B.20)腎俞Shenshu(U.B.23)膈俞Geshu(U.B.17)第37頁/共55頁VIII.OTHERTHERAPY1、AuricularacupunctureSelectionofpoints:Overy,Endocrine,Uterus,Shenmen,SympatheticNerve,Subcortex,Heart,Liver,Spleen,Kidney.第38頁/共55頁

2、Percussopunctator:ParavertebralpointsTemple第39頁/共55頁

IX、TREATMENTACORDINGTOTHESYMPTOMS1、Lacrimation,dryeyeswithstabbingandburningsensation<1>睛明Jingming(U.B.1)承泣Chengqi(St.1)攢竹Zanzhu(U.B.2)絲竹空Sizhukong(S.J.23)四白Sibai(St.2)第40頁/共55頁

<2>光明Guangming(G.B.37)

臂臑Binao(L.I.33)

養(yǎng)老Yanglao(S.I.6)

肝俞Gansu(U.B.18)

腎俞Shenshu(U.B.23)第41頁/共55頁

2、Chronicpharyngitis:列缺Lieque(Lu.7)照海Zhaohai(K.6)第42頁/共55頁

3、Sweating:合谷Hegu(L.I.4)復(fù)溜Fuliu(K.7)后溪Houxi(S.I.3)陰郗Yinxi(H.6)第43頁/共55頁

4、Pruritusinvulva:（1）Therapeuticprinciple:Clearingdamp-heatNourishingliverandkidneyDredgingcollateralsandstoppingitchiness第44頁/共55頁

（2）Selectionofpoints:中極Zhongji(Ren3)下髎Xialiao(U.B.34)三陰交Sanyinjiao(Sp.6)血海Xuehai(Sp.10)蠡溝Ligou(Liv.5)第45頁/共55頁

5、Chroniceczema（1）Therapeuticalprinciple:Moisturizingdrynessbynourishingblood第46頁/共55頁（2）Prescription

足三里Zusanli(St.36)三陰交Sanyinjiao(Sp.6)大都Dadu(Sp.2)郗門Ximen(P.4)曲池Quchi(L.I.11)大椎Dazhui(Du14)陶道Taodao(Du13)肺俞Feis