Perimenopausal syndrome is a group of syndromes that occur in women before and after natural menopause due to fluctuations or decreases in estrogen levels, mainly due to dysfunction of the vegetative nervous system and accompanied by neuropsychological symptoms. The incidence of perimenopausal syndrome is as high as 85%, and 10%-15% of women have serious symptoms that affect their work and life. Therefore, the prevention and treatment of perimenopausal syndrome has become a hot topic of concern in the medical field and has very important social significance. At present, Chinese medicine has achieved better clinical efficacy through evidence-based treatment. 1, the pathogenesis – from the kidney Chinese medicine ancient books do not have “perimenopausal syndrome” as a disease name, because of its performance will be classified as “before and after menopause evidence”, “before and after menopause evidence”. It is classified as “symptoms before and after menopause”, “dirty agitation”, “depression”, “lily disease”, etc. The Nei Jing cloud: “women seven years old, kidney qi Sheng, teeth more hair long …… seven seven Ren vein deficiency, Tai Chong vein decay less, heavenly sebum exhaustion, the earth channel is not accessible, so the form is bad and childless also.” From this, it is easy to see that the strength of the kidney is the material basis for determining the reproduction of women. If the kidney energy is strong, the heavenly sap will arrive, menstruation will come and the reproductive function will mature; if the kidney energy is weak, the heavenly sap will be exhausted, the woman will go through menopause and the reproductive function will gradually fail. According to the characteristics of “kidney” in Chinese medicine, which is the reservoir of sperm, the main reproductive organ, and the internal linkage between the function of punching and endocrine reproduction, kidney deficiency is the root cause of perimenopausal syndrome. Following the classical theory of TCM and summarizing the theories and practical research of contemporary physicians, I suggest that the cause of this disease is mainly kidney deficiency. The deficiency of kidney yin, kidney yang, or both kidney yin and yang affects the heart, liver and spleen, leading to various pathological changes. Women over 40 years of age Yin Qi since half, seven seven days of sebum exhaustion, before the ground pass, kidney Qi gradually decline, Yin essence deficiency less, imbalance of Yin and Yang. Kidney yin deficiency water does not contain wood, liver fire is vigorous, water does not control fire, heart fire on inflammation, heart and kidney do not intersect heart and kidney intersect then both water and fire, kidney yin deficiency. The heart fire is hyperactive or the heart fire is hyperactive on the top and cannot cross over to the kidney, the heart and kidney yin and yang water and fire lose the coordination of both help then a series of symptoms appear. In the treatment of perimenopausal syndrome of the heart-kidney non-interaction type, the combination of each drug should be appropriate. In the clinical evidence, we mainly focus on nourishing water, concealing wood, nourishing the heart and tranquilizing the mind, and then we make clinical evidence-based prescriptions; we also combine the Chinese medicine evidence score with Kupperman Index to evaluate the efficacy, so that the efficacy evaluation is more credible. In the clinical practice, the self-formulated formula of Baihe Qiyong Drink was used to treat patients with perimenopausal syndrome in which the heart and kidney are not intertwined, and good results were obtained. In this formula, Radix Rehmanniae nourishes kidney essence and strengthens kidney water; Fructus Lycii nourishes essence and blood and can control fire as the monarch; Lily benefits qi and nourishes the heart, calms the mind and stabilizes the body; Sour date palm is sweet and acidic, its sweetness can nourish the heart and blood, and sourness can astringent the heart qi to make the mind calm; Yuan Zhi is good at happy qi to calm the heart and mind, pass the kidney qi to strengthen the will and not forget, and has the long of communicating the heart and kidney as the minister; Cistanches nourishes kidney yang, benefits essence and blood, warm but not dry; Angelicae and Bai Shao nourish liver and blood; Lotus heart can clear the heart fire. They are used as adjuvant medicines. The whole formula is based on tonifying the kidneys, emphasizing the heart and kidneys, and treating the liver and wood at the same time, thus nourishing the kidneys and nourishing the liver, nourishing the heart and calming the mind. For dizziness, add green calyx plum and chrysanthemum to calm the liver and clear the head; for palpitations and insomnia, add helianthus bark and spirit magnet; for hot flashes and night sweats, use Yu Ping Feng San, in which dang ginseng, forbidden wind and atractylodes, or ground bark and floating wheat nourish yin and clear heat and regulate sweating. 3.Example of a case A female, 60 years old, married, was first diagnosed on August 20, 2006. She complained of menopause for two years, and in the past six months, she has been suffering from sleeplessness, palpitations and forgetfulness, dry throat, soreness and weakness of the waist and knees, hot flashes and sweating, heat in the hands and feet, red tongue, thin yellow fur, and fine pulse. The sex six tests showed that the FSH value was elevated and the E2 value was decreased. The tongue is pale, the fur is thin and white, and the pulse is sunken and thin. The evidence indicates that there is a lack of kidney essence and the heart and kidneys are not cooperating. Prescription: Radix Rehmanniae 15g, Radix Angelicae Sinensis 12g, Radix et Rhizoma lotus 12g, Radix Lily 15g, Radix Ziziphiopogonis 15g, Radix Paeoniae Alba 15g, Radix et Rhizoma Yam 15g, Radix Salviae Miltiorrhizae 15g, Radix et Rhizoma Hopi 15g. 7 doses in water, 1 dose daily, warm in the morning and evening. The symptoms were slightly relieved, but the leucorrhoea was yellowish. The above formula is supplemented with 15g of Phellodendron Bark, 28 doses, decoction in water, 1 dose daily, warm in the morning and evening. After the medicine, all the symptoms were obviously reduced, still keep the above. Every two weeks to review the subtlety, adjust the formula, continued for 3 months, the symptoms significantly alleviated. Comment: kidney for the innate essence, kidney essence to produce yuan yin yuan yang qi, so the kidney “hide true yin, in yuan yang”, for “water fire house”. Jing Yue Quan Shu – Chuan Zhong Lu” cloud: “Life Gate is the root of Yuan Qi, the house of water and fire. The yin of the five viscera and six bowels can not be nourished, the yang of the five viscera and six bowels can not be developed.” The pathology of other organs yin and yang deficiency, can gradually consume the essence of the kidney yin and yang, that is, “long-term disease and kidney”; if the kidney in the yin and yang deficiency and easy disease and other organs, such as the heart and kidney do not intersect. The author’s treatment of perimenopausal syndrome is based on the “kidney” theory of treatment, the treatment of the kidney is the main focus on the transportation of the heart and kidney, and also treat the liver wood, thus receiving the effect of nourishing the kidney and nourishing the liver, nourishing the heart and calming the mind, so that many patients with perimenopausal syndrome have been relieved of their problems, improve the quality of life, and reduce psychological pressure. This case provides a reference for the treatment of perimenopausal syndrome, and the specific medication and mechanism of action have yet to be confirmed by experimental studies and clinical practice.