Climacteric syndrome is a group of syndromes that occur in men and women as a result of the gradual transition from fertile sexual maturity to old age. The onset of the disease is more common in women around the time of menopause or during menopause, and in men between the ages of 50 and 60. The disease is more common in women. The cause is unknown, but endocrine decline is the most likely cause. Other possible factors include psychological factors, pre-morbid personality traits, and genetics. Most of the patients can remit on their own, but some of them have more serious symptoms that affect their life and work and need treatment. According to the clinical manifestations, this disease can be classified as irregular menstruation, headache, sleeplessness, palpitation, depression, dirty restlessness, deficiency labor, etc. In severe cases, it belongs to the category of “epileptic evidence”.
Understanding of pathogenesis
The current unified view in Chinese medicine is that this disease is caused by kidney deficiency. As the body ages, the function of the internal organs gradually declines, the kidney energy is insufficient, the Chong Ren pulse is deficient, the Tian Yu will be exhausted, the essence and blood are insufficient, and the balance of yin and yang is out of balance, resulting in a deficiency of kidney yin and yang, or a deficiency of kidney yang and loss of warmth of the meridians, resulting in the malfunction of the internal organs. Due to the difference of physical factors, there are different clinical manifestations of kidney yang deficiency, kidney yin deficiency or deficiency of both yin and yang in the kidney, and kidney yin deficiency is the most common. However, based on theories related to the internal organs and clinical practice, it is recognized that kidney deficiency alone is not enough to explain this disease, which is also related to the heart, liver, spleen and qi-blood rushing. The deficiency of kidney yin and the failure of water to contain wood leads to deficiency of liver yin and hyperactivity of liver yang; the deficiency of kidney water and the failure of water and fire to help, and the failure of the heart and kidney to intermingle leads to hyperactivity of heart fire and depletion of qi and blood; the deficiency of kidney yang and the failure of the vital gate fire leads to the failure of spleen yang and the deficiency of spleen and kidney yang; the deficiency of kidney yang and the failure of nourishment of the vital energy leads to the depletion of the vital energy. At the same time, deficiency of essence and blood, and lack of access to the flushing and the Ren are the necessary conditions for the onset of the disease. In recent years, with the in-depth study of the pathogenesis of “kidney deficiency and blood stasis”, it was found that blood stasis as a secondary pathological product is based on the kidney, resulting in the imbalance of qi and blood, the solidity of veins and channels, stagnation and irregularity in the function of the internal organs. In addition, while kidney deficiency is certainly one of the causes of menopausal syndrome, the influence of the eight odd meridians is also a factor that cannot be ignored. The various abnormal manifestations of the disease are mostly related to the odd meridians, so the role of the odd meridians should be noted in both the analysis of the disease mechanism and the diagnosis and treatment.
The disease is mainly seen at the age of the new year, but not necessarily at the age of the month. Most of the cases are due to suspicious nature, depression, heredity, or overuse of the brain, which can easily produce this disease when the kidney qi is deficient.
Identification and treatment
1.Deficiency of kidney yin
Symptoms: dizziness and tinnitus, soreness and weakness of the waist and knees, hot flushes, sweating, irritability of the five hearts, redness of the face and cheekbones, dry mouth and constipation, short and red urine, pre-menstruation or irregular periods, bright red menstruation, more or less volume. Red tongue with little coating and fine pulse.
Treatment: Nourishing kidney yin and slightly submerging yang.
Prescription: Nourishing Yin in the new year.
Radix Rehmanniae 9-12g Yam 6-9g Cornus officinalis 6-9g Fructus Lycii 6-9g Poria 3-4.5g
He Shou Wu 9 to 12 grams tortoise board 9 to 12 grams roasted licorice 3 to 4.5 grams
Explanation: This formula, although the Six Flavors Dihuang Wan, but the removal of Dan Pi, Ze Xie, plus Fructus Lycii, He Shou Wu, tortoise shell, roasted licorice, so the power of nourishing Yin than the Six Flavors Dihuang Wan strong, clearing heat is not obvious, it can be seen that this formula is intended to nourish the kidney yin.
If you also see irritability, hypochondriacal pain and bitterness, insomnia and dreams, red tongue with thin and dry coating, and thin and stringent pulse, you can add or subtract on the basis of the original formula. If the headache and dizziness are heavy, add white peony, Xia Gu Cao, stone cassia, white chrysanthemum; if insomnia, add sour date palm, acacia flower, nightshade vine; if palpitations, add cypress seeds and salvia; if liver depression is uncomfortable, add fried bupleurum in vinegar; if mouth bitterness is heavy, add scutellaria; if crying and laughing are unstable, add huai wheat and jujube.
2.Deficiency of kidney yang
Main symptoms: mental depression, cold body and limbs, soreness and coldness of the waist and knees, dullness and bloating, loose stools, or menstruation with high volume and light color, swelling of the face and limbs, frequent nocturnal urination or incontinence. Pale tongue or fat and tender tongue with tooth marks on the side, thin white moss, and sunken and weak pulse.
Treatment: Warming the kidney yang.
Prescription: Warming the yang of the kidney in the new year.
Radix Rehmanniae Praeparata 18～24 grams Atractylodes Macrocephala 9～12 grams Cornus Officinalis 9～12 grams Fructus Lycii 9～12 grams Antler Gum 9～12 grams (melted)
Radix Angelicae Sinensis 9-12 grams, cinnamon 6-9 grams, Radix Aconiti 6-9 grams
Explanation: Deficiency of kidney yang, loss of nourishment of the vital essence, then the spirit of atrophy and other symptoms can be seen. Therefore, the treatment of non-warm kidney yang can not revitalize its vitality. This formula is mainly composed of kidney warming medicine, and supplemented with qi and brain strengthening medicine, kidney yang is abundant, the spleen and stomach yang rely on warming, the latter has to rely on the transformation, not only the deficiency of kidney yang can be removed, the spleen yang disorders also disappeared.
3. Kidney Yin and Yang deficiency
Main symptoms: lumbar soreness and knee weakness, dizziness and distress, or depression, fatigue and weakness, fear of cold, sometimes baking and sweating. Thin white tongue coating and thin pulse.
Treatment: Nourishing the kidneys and supporting Yang, tonifying and benefiting the flushing.
Prescription: Double tonic soup for menopause.
Xianmao 12-15 grams Epimedium 12-15 grams Baji Tian 9-12 grams Radix Angelicae Sinensis 9-12 grams Phellodendron 3-4.5 grams
Zhi Mu 6～9 grams Eucommia 9～12 grams cinnamon heart 3～4.5 grams rehmannia 6～9 grams
Explanation: This formula is composed of one for warming kidney yang, such as Xianmao and Epimedium; one for clearing liver fire to protect kidney yin, such as Zhi and Pai. The main pathogenesis of this disease is the deficiency of both kidney yin and kidney yang, resulting in the loss of nourishment of the flush and the concurrent evidence of hyperactivity of deficiency yang. Therefore, the clinical see baking heat and sweating, and the use of heat-clearing and fire-removing drugs, should be distinguished from the main priorities, to regulate the main, supplemented by bitter drainage. It is very important to grasp the main symptoms, pay attention to clearing heat should not be too bitter cold, cold should not be too pungent heat, and not to use the gram.
Key points of treatment
1, the disease is mostly deficiency, so the identification of evidence is focused on distinguishing kidney Yin deficiency or kidney Yang deficiency, or kidney Yin and Yang deficiency.
2, this disease may appear “Yang” symptoms, but can not be thought of as actual evidence, and the use of aggressive products; generally are Yin deficiency caused by the “deficiency Yang” symptoms. As Yin deficiency is treated, the so-called “Yang” symptoms can disappear. If you need to use clearing and eliminating medicines, you have to use them a little bit, not to take away the main focus.
3. Although this disease is caused by the decay of kidney energy and the imbalance of yin and yang in the body, most of the patients have mental factors or some special personalities, so psychotherapy is also an important element in the diagnosis and treatment. There are many psychological treatment methods in TCM, so you can choose the best one.
4, the disease must be treated early, because if the delay is not treated, it is likely to gradually become more serious depression or epilepsy, the prognosis is not good.