月经不调的中医治疗
Treatment of
menstrual disorders by Traditional Chinese Medicine
月经不调非常复杂,
有月经提前的,推后的,不规则的;有量多的,量少的,时多时少的;或完全闭经的,或淋漓不断的,甚至月经量过大而会导致休克的,等等。治疗上也非常复杂。但是不管怎么说,中医治疗月经不调的效果要比常规医疗方法好的多。我们遵从的是沈绍功先生祖传的,治疗月经不调的中医方法,草药治疗为主。
Menstrual disorders are very
complex. Some women have their menstruation coming earlier, some
later; some have heavy menstrual bleeding, and others have
little menstrual bleeding. For the treatment, conventional
medicine basically does not work well to solve the menstrual
disorders other than using hormones (including to use
contraceptive drugs), or even asking to aggressively remove
ovary or uterus by surgical operation. Generally speaking,
Traditional Chinese medicine (TCM) works well to correct the
menstrual disorders. TCM mostly use herbal therapy and/or
acupuncture. There are also many different ways in TCM to treat
the menstrual disorders. In our clinic, we mostly follow the Dr.
Shen Shao-gong way, which is the hereditary TCM system of Dr.
Shen family.
沈氏调经法对于月经是分期调理的方法,就是说不仅要按照疾病的性质,即寒热虚实来决定用药,还要按照月经前,经期,经后期的不同而分别用药。
The difference between the Dr. Shao’s way and others is that the herbal formula are set up not only
depending on the nature of the disorders (e.g. Cold, Fire,
Sufficient or insufficient condition of the body), but also on
the time during the menstrual circle. This means the herbal
formula are different on the pre-menstruation, during
menstruation and after the menstruation.
(1).
经前期调经
(1). Pre-menstrual period
经前期指的是出现腹痛等月经反应到月经来潮。在此期间的主要问题是经前小腹疼痛,乳房胀满痛,情绪不稳等等。
Pre-menstrual period means the period from the beginning of
menstrual reaction to the beginning of menstrual bleeding.
During this time of period, the disorders are usually abdomen
pain or spasm, anxiety or stressful emotion, tired or sleeping,
bloating feeling in breast of even migraine.
如果病人肝郁-乳胀胁满,少腹引痛,烦怒不安,舌苔薄黄,脉象弦细。为肝郁,用逍遥散或丹栀逍遥散,再加调整内分泌的泽兰、茜草、龟板、鳖甲、川断、女贞子。
If the patient
feels bloating in breasts, spasm in lower abdomen, anxiety or
upset, with thin and yellow tongue covering, and with
thin-string feelings from the pulse, it is a condition of Liver
stagnation. To solve this disorder, we use herbal formula Xiao
Yao San, or Jia Wei Xiao Yao San, with addition of
endocrine-adjusting herbs, such as Ze Lan, Qian Cao, Gui Ban,
Bie Jia, Chuan Duan or Nu Zheng Zi.
如果病人腹凉下坠,引痛筋掣,形寒乏力,苔薄白,舌质淡,脉沉细,为宫寒。用温经汤,再加调整内分泌的枸杞子、蛇床子、菟丝子、仙灵脾、河车粉、鹿角霜、补骨脂。
If the patient feels cold in the lower abdomen, muscle spasm, cold in
the whole body, chronic fatigue, and has pink color in the
tongue and has deep and thin pulse, it is a Cold condition in
the uterus. Use herbal formula Wen Jing Tang, with addition of
endocrine-adjusting herbs, such as Gou Ji Zi, She Chuang Zi, Tu
Si Zi, Xian Ling Pi, Zi He Che, Lu Jiao Shuang, Bu Gu Zhi, etc.
如果病人经前神疲气短,精神不振,少言懒动,经期下腹忍痛,连绵不止,经行色淡量少,纳差便溏,心悸失眠,苔薄白,舌质淡,脉沉细。为营血亏虚,应健脾养血,方用归脾汤化裁,同时加调节内分泌的泽兰,蛇床子,菟丝子。
If the patient feels chronic fatigue, short of breath, no willing to
talk or walk; has continuous pain in the lower abdomen, has poor
appetite, palpitation, poor sleep,
and if the menstrual blood is little amount and the blood
color is pink (not dark red) and the pulse feels deep and thin,
it is the insufficient Yin and Blood condition. Use herbal
formula Gui Pi Tang, with addition of endocrine-adjusting herbs,
such as Ze Lan, She Chuang Zi, or Tu Si Zi.
如果寒热都不好判断,体质较强壮,特别是常有项背部僵紧不适,或前额痛的病人,可直接用葛根汤,加大葛根剂量,同时加调节内分泌的泽兰,蛇床子,菟丝子。
If it is hard to diagnose whether the condition is Fire or Cold, and if
the body constitution is strong, especially if the person
usually has tightness and sore on the neck and upper back or on
the front head, we can directly use herbal formula Ge Gen Tang
with higher dose of the herb Ge Gen in it, and also with
addition of endocrine-adjusting herbs, such as Ze Lan, She
Chuang Zi, or Tu Si Zi.
(2).
经期调节
(2). Menstrual correction during the period
经期指的是月经来潮到结束这几天。用药要考虑经血多少和体质的寒热属性。
During period means the time from the beginning of the menstrual
bleeding to the cessation of the bleeding. During this time, it
is needed to consider the amount of menstrual blood, and the
nature of disorder, e.g. if the condition belongs to Fire, Cold,
sufficient, or insufficient condition.
量少腹凉,用八珍汤。
If the menstrual blood is little in amount and the patient feels cold in
the lower abdomen, we use herbal formula Ba Zhen Tang.
量多腹凉,月经量很多,肚子凉的,用胶艾四物汤。
If the menstrual blood is heavy in amount and the patient also feels
cold in the lower abdomen, we use Jiao Ai Si Wu Tang.
量少腹不凉,用桃红四物汤。
If the menstrual blood is little in amount and the patient does not feel
cold in the lower abdomen, use Tao Hong Si Wu Tang.
量多腹热,就是月经量很多,少腹不凉,甚至腹部烫的,用栀芩四物汤。
If the menstrual blood is heavy and the patient feels hot in the lower
abdomen, use Zhi Qin Si Wu Tang.
在以上四个基本方证基础上要随证加减,就是经期有5个症状进行加减。
The four formula
above is the basic formula for the menstrual disorders used
during the menstrual period. These formula need to be completed
with additional herbs according to accompanying symptoms, such
as stomach pain, diarrhea, swelling, sour in the lower back, or
infertility, etc.
1)腹痛,加川楝子、元胡、郁金、益母草、地龙、五灵脂、蚕砂还有三七粉。或者加用芍药甘草汤。三七粉用于月经量多的时候加三七粉止痛;量少的时候三七粉少用,用了以后经量会更少。
1)If the patient has
abdomen pain during the menstruation, add herb Chuan Lian Zi,
Yuan Hu, Yu Yin, Yi Mu Cao, Di Long, Wu Ling Zhi, Can Sha, and
San Qi powder. Or, we can use the herbal formula Shao Yao Gan
Cao Tang together. The herb San Qi is used when the amount of
blood is heavy.
2)便溏,用山药、煨葛根、金樱子、生龙牡、炒白术、补骨脂、五倍子。
2)If the patient has diarrhea, add herb Shan Yao,
Wei Ge Gen, Jin Yin Zi, Long Gu, Mu Li, Chao Bai Zhu, Bu Gu Zhi,
or Wu Bei Zi.
3)浮肿,经期浮肿特别多,用防己、泽泻、桑白皮、车前草、生黄芪、冬瓜仁和云苓。
3)If the patient has swelling, which is common in
women during the menstruation, add herb Fang Ji, Ze Xie, Sang
Bai Pi, Che Qian Cao, Huang Qi, Dong Gua Ren, and Fu Ling.
4)腰酸,经期腰酸用鸡血藤、老鹳草、金毛狗脊、川断、桑寄生。
4)For sour in lower
back, add herb Ji Xue Teng, Lao Guan Cao, Jin Mo Gou Ji, Chuan
Duan, and San Ji Sheng.
5)不孕,月经不调和不孕有直接关系,加用调节内分泌的药物:蛇床子、菟丝子、金樱子、黄柏、泽兰、龟板、肉苁蓉、川楝子。
5)If the patient has strong desire to have
pregnancy, we need to add some endocrine-adjusting herbs to the
formula above. Such herbs are, for example, She Chuang Zi, Tu Si
Zi, Jin Yin Zi, Huang Bo, Ze Lan, Gui Ban, Rou Chong Rong and
Chuan Lian Zi.
(3).
经后期,月经干净以后到下次来月经开始有症状,这个阶段叫经后期。
(3).
Post menstrual period. It is the time from the
cessation of the menstrual bleeding to the early menstrual
reaction (such as lower abdomen pain or anxiety).
经后要调肾,调肾就吃丸药,一直吃到下一次月经前期。
In this
post-menstrual period, herbal therapy is to nourish the Kidney
system of the body. The herbal therapy should be continued until
the beginning of the next pro-menstrual period.
偏寒的选艾附暖宫丸,女金丹;偏热的选加味逍遥丸或者德生丹。如果寒热难以判断,八珍益母丸、白通丸、杞菊地黄丸任选一个;
If the body
condition belongs to Cold, use herbal pill Ai Fu Nuan Gong Wan,
or Nu Jin Dan. If it belongs to Fire, use Jia Wei Xiao Yao Wan
or De Sheng Dan. If it is hard to tell whether the body
condition belongs to Cold or Fire, use Ba Zhen Yi Mu Wan, Bai
Tong Wan, or use Qi Ju Di Huang Wan.
针灸也常用于月经不调的治疗,取决于病情的寒热虚实性质,针灸的穴位选择和行针手法也不同。一般需要每周针灸两到三次,连续两个月。月经不调的治疗是以月为单位的,不是象治疗普通痛症那样是以天为单位的。这是需要知道的。
Acupuncture can also be used for the treatment of menstrual
disorders. The acupuncture points and the ways to handle the
needles depend on the nature of the disorder (Fire, or Cold;
Sufficient or insufficient condition, etc.). Acupuncture is
needed once every two to three days for one to two months. You
can notice the healing effect of such treatment month after
month, unlike for the treatment of pain, that is day after day.
许多年轻女性靠服用避孕药来避孕或调整月经。往往是,服药时月经正常,但是一停药,月经照样紊乱。
所以靠服避孕药来调整月经并不是一个理想的方法。而服避孕药本身也会导致月经紊乱,所以,服用避孕药的妇女有月经紊乱,首先要考虑停用避孕药,这样中医治疗的效果才会更好。
Many women take the contraceptive drugs for contraception or for
correction of menstrual disorders. Usually, when you take the
contraceptive drugs, your menstruation appears normal, but once
you stop it, the disorder remains the same. Therefore, it is not
at all an ideal therapy for menstrual disorders. In addition, it
is also possible that the contraceptive drug can also bring out
a disorder of menstruation. To correct the menstrual disorder,
we recommend you to stop the take of any contraceptive medicine
for a while, so that the Chinese medicine can work much fast and
much better for you.
艾灸和拔罐也常用于月经不调的治疗,无论对于肝郁还是寒凝都有效。二者也常和针灸草药疗法结合使用。对于寒凝的患者,也不妨用红糖水加生姜片当茶饮,或常喝老姜茶,对于预防经前腹痛,改善症状都有好处,但是,一定要先咨询中医医生,知道自己的体质到底是否适合这种温热疗法。
Moxibustion and cupping therapy are also commonly used for the
treatment of menstrual disorders. They work for both Liver
stagnation and Cold accumulation conditions. They are also
commonly used in addition to the acupuncture or herbal therapy.
For those of patients with Cold body constitution, they can try
to drink brown sugar water with a piece of fresh ginger in it.
Drink it as regular green tea. They can also drink Old-ginger
tea. The sugar-ginger tea works to release abdomen pain.
However, it is recommended to consult with TCM doctor first, to
see if your body constitution is really suitable to such Warm
therapy.
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