The treatment of gynecological hemorrhage with medication precautions: 1, fixing the collapse and stopping the bleeding Gynecological hemorrhage is no more than the collapse and leakage, and no more dangerous than the violent collapse. In the case of violent bleeding, the first treatment task is to stop the bleeding, and the combination of Chinese and Western medicine is essential to stop the bleeding. According to Prof. You Zhaoling, the pathogenesis is based on three aspects: Qi deficiency, blood heat and stasis [1]. Chinese medicine treatment is based on the principle of benefiting qi and nourishing yin, resolving blood stasis and stopping bleeding. Since qi can take in blood, it is important to benefit qi to stop bleeding, and to benefit qi first; besides, the tangible blood cannot be produced quickly, and the invisible qi should be fixed urgently. The essence, blood and fluids all belong to Yin, blood loss will hurt Yin, Yin deficiency will give rise to internal heat, heat disturbing the flush will force the blood to travel, so at this time to nourish Yin has the meaning of nourishing the blood. The goal of “stopping the flow” is to stop bleeding without leaving stasis, so the choice of charcoal medicine is based on resolving stasis and stopping bleeding. Professor You’s commonly used clinical formula is “Gongbao Ningfang”, which consists of Dang Ginseng, Astragalus, Roasted Turtle Board, Radix et Rhizoma, Wu Mei charcoal, Agaricus, Chen Pi and Licorice, taken frequently in a thick decoction, with yam added for diarrhea. In this formula, Astragalus is the ruler, which is a powerful measure to benefit qi and stop bleeding, while Radix et Rhizoma Ginseng is the minister, which strengthens the spleen and enhances qi. Aconite is sweet and mild in nature, enters the liver and kidney meridian, can nourish Yin and moisten the lungs, nourish blood and stop bleeding, used for a variety of bleeding evidence, good hemostatic effect, and is a good blood tonic, especially suitable for bleeding and also see blood and Yin deficiency; tortoise version is salty and sweet, slightly cold in nature, has nourished Yin and submerged Yang, nourish blood and nourish the heart. The Shennong Ben Cao Jing cloud turtle plate: “…… main treatment under the leakage of red and white, ……”; Ume plum sour, astringent, flat nature, with the production of Jin astringent use, the production of Jin is to help Yin blood, astringent is solid blood, Ume plum The fried charcoal is good for stopping bleeding; Chen Pi regulates the qi and strengthens the spleen, so that the medicines are not greasy; Xie Cao charcoal clears heat and cools the blood, resolves blood stasis and stops bleeding, has the function of stopping bleeding without leaving stasis. The above herbs are complemented by Ginseng and Astragalus to nourish Yin, clear heat, resolve blood stasis and stop bleeding. Glycyrrhiza glabra harmonizes all the herbs as an ambassador. Throughout the formula, it benefits Qi to regulate blood, nourishes Yin and clears heat to nourish blood, and resolves blood stasis to stop bleeding without leaving stasis, which is well formulated and cleverly conceived! In addition to prolonged leakage, abnormal vaginal bleeding also includes heavy menstruation, prolonged menstruation, intermenstrual bleeding, premenstrual bleeding, etc. Clinical treatment requires dialectical treatment to regulate menstruation and stop bleeding. 2.1 prolonged menstruation and excessive menstruation Based on the principle of “prolonged leakage and prolonged collapse, clearing and clearing are appropriate”, for prolonged leakage, excessive menstruation and prolonged menstruation, it is generally not advisable to stop the bleeding but to regulate the blood, so that the blood stasis can be dispersed, the meridians can be unblocked, and the blood can return to the meridians before the bleeding can be stopped. On the basis of the formula of Gongblood Ning, the bleeding volume is more than that of Blood Yu Charcoal, Rhubarb Charcoal, Fried Pu Huang, White Peony, Large and Small Thistle; Xian He Cao, Thornbush Charcoal, Guan Zong Charcoal, Large and Small Thistle. Those with stasis mostly show purple and dark lumps in the menstrual blood and a purple tongue. Because of the long leakage will be stasis, blood stasis does not go, the new blood can not return to the menstrual, the bleeding will not stop, appropriate adjuvant to remove blood stasis and blood products, there is a general purpose, not to stop the blood and the blood from the wonderful. Commonly used to invigorate blood circulation and resolve blood stasis are: Cyperus rotundus, squid bone, palm charcoal, Cyperus rotundus. The face is gray and white, the tongue is light and fat, the evidence is deficient cold, with red stone fat, Yu Yu Rong. Menstrual blood with fishy odor, dark red tongue and yellowish greasy moss is less adjuvant with heat-clearing and blood-cooling drugs, which can be used to clear heat and stop bleeding, commonly used Bai Shao, Tsubaki root with white peel, Dan Pi, Huang Lian and Yin Chen. For those with hot hands and feet, red and thin tongue, the evidence is yin deficiency, with nourishing yin and clearing heat of moxibustion turtle version, yellow cypress, dry lotus grass, raw earth, white peony. The small amount of dripping, it is appropriate to use astringent medicine to stop bleeding, can be selected with cynthia, ground elm, white foxglove, palm charcoal, five times. 2.2 Premenstrual leakage red Premenstrual leakage red, that is, premenstrual menstrual bleeding in small amounts intermittently, lasting 1-2 days, before the formal onset of menstruation, mostly seen in luteal insufficiency, endometritis and endometrium ovarian ectopic. The disease is prone to recurrent attacks and is not easily treated. The clinical treatment is mostly divided into two types. In cases with heart and liver fire, dampness and blood stasis, the menstrual blood is dark red, the heart is troubled and the mouth is bitter, the tongue is dark and the coating is yellow and greasy. The treatment should not be too astringent, too warm drugs. Add lotus heart, dendrobium, helianthus bark, dried lotus grass, deer’s head, artemisia, thornbush, zedoary, pelargonium on the basis of the situation to promote the discharge of menstrual blood. The face swollen and gray, cold form and cold limbs, fat tongue for Yang deficiency lesions, treatment should be beneficial to help Yang, choose party ginseng, Atractylodes, Poria, yam, parasiticus, cuscuta, deer horn cream, locking Yang. Only the blood can be selected for those who clip the blood, Sheng Di Yu, Xian He Cao, Thornbush. 2.3 Intermenstrual bleeding: Intermenstrual bleeding is ovulatory bleeding. The intermenstrual period is a dense condition of qi and blood running more active stage, the cell egg needs to break the membrane and out, so qi and blood should move rather than static. If the movement is a little too much, there will be bleeding; if it is static, the egg cannot be discharged. Most intermenstrual bleeding is due to damp-heat in the liver meridian. It is advisable to disperse the damp-heat and avoid the use of astringent and sour products. Commonly used drugs are Xianhecao, Jingchuosi, Phellodendron, Shengdiyu, Daji, Xiaoxi, Shengdi, Bai Shao. When there is stasis abdominal pain, menstrual blood with stasis clots and debris, purple tongue, drugs with vervain grass, deer artichoke, cedar grass, purple pearl grass, thorny mustard spike to clear heat and eliminate stasis to stop bleeding. In case of heavy bleeding, use vervain, deer’s tongue, dry lotus grass and celandine grass to clear heat and stop bleeding. 2.4 Bleeding from the uterine ring The cause and mechanism of bleeding from the uterine ring is special, because the “gold blade foreign body” directly injures the uterine vessels and channels, and stasis of the meridians (i.e. blood stasis) is the key pathogenesis of bleeding from the uterine ring. Therefore, this disease also has its own special characteristics in the treatment method. It cannot be treated by eliminating the causes, and the clinical evidence is often divided into liver stagnation and blood stasis, yin deficiency and blood stasis, and qi deficiency and blood stasis, while blood stasis in the uterus is the essence of this disease, and removing blood stasis and stopping bleeding is the effective treatment method throughout all the methods[2] . On the basis of resolving blood stasis and stopping bleeding, the treatment is divided into stages. On days 1-3 of menstruation, the method of activating blood circulation and removing stasis is used to promote the flow of qi and blood, promote contraction of the uterus, accelerate the shedding of the endometrium and the discharge of stagnant blood, thus achieving the removal of stasis and cessation of bleeding, with the use of Di Jin Cao, Lu Han Cao, Jing Zhi Zhi and Xi Cao. Cuscuta sinensis, Chuan Cao, Xian He Cao; after the menstrual purification, mainly to regulate the flushing, Qi and Blood, sickness for a long time too much blood loss, with Aconite, Angelica nourishing Blood and replenishing Blood. Astragalus, Shengma, Puhuang and Citrus aurantium have the effect of promoting uterine contraction; Amaranthus has an ergot-like shrinking effect on the uterus to stop bleeding; the strong contraction of the uterus increases the feedback stimulation of the endometrium by the birth control ring, so it should not be used heavily in the non-menstrual treatment of this disease. 3.Anti-fetus and stop bleeding According to Prof. You Zhaoling, the kidney collects essence and is the main reproducer. Punch is the sea of blood and Ren is the master of twins. If the kidney energy is damaged, then the ramus is not fixed and cannot fix the fetus, which leads to fetal movement, fetal leakage and even slippage. If the kidney essence is abundant, and the ramus can be nourished, the fetal element will be solidified. Although fetal leakage, fetal movement and abnormal fetus are different from kidney deficiency, Qi and blood deficiency, blood heat, fall and pounding injury, and Y obstruction to fetus, in clinical antifetus, the treatment should be based on treating kidney first and benefiting essence[3] . The kidney is the precursor and the spleen is the posterior. The spleen is the source of Qi and blood biochemistry, and it can produce and regulate blood. If the spleen is weak, the qi and blood will not be able to transport and transform, and the fetus will lose its nourishment and blood will lose its solidity, resulting in fetal leakage and miscarriage, just as the former people said, “the spleen and stomach are responsible for nourishing the fetus, like a bell hanging from a beam. Therefore, it is also the basic method to treat the spleen and kidney together in cases of fetal leakage and bleeding due to pre-eclampsia. Although the spleen and kidney are the most important factors in stopping bleeding, it is also necessary to regulate the liver. If liver qi is depressed, liver stagnation turns into fire, which causes heat to tickle the ramus and uterus, then fetal leakage and fetal movement will occur due to lack of solidity of the fetus. The liver and kidney need to be regulated together, and the kidney can be tonified on the basis of draining heat from the liver or softening the liver to relieve pain to calm the fetus, and de-stressing the qi is also an important rule in the treatment of pregnancy. However, the medication should be gentle, such as adding Chai Hu, Bai Shao and Scutellaria. It is said that “to relax one point of qi, to nourish one point of fetus”. The basic drugs include Xidan, Astragalus, Fructus, Cornu Cervi Pantotrichum, Rhizoma Atractylodis Macrocephalae, Pericarpium Citri Reticulatae, Jujube, Ramie root, etc. If bleeding is accompanied by lumbar pain, kidney deficiency is not able to fix the fetus, so we can use dog’s spine, cuscuta, Chuanjian, parasite, date skin, ramie root and jinzhuzi to nourish the kidney to tie the fetus. Bleeding with abdominal distension must be added to the formula for tonifying the kidneys, the implication is not in strengthening the spleen, but in replenishing the qi, “to sparing a point of qi, nourishing a point of fetus”, can be used to replenish the qi to carry the fetus, replenish the qi to ingest blood, such as ginseng, astragalus, atractylodes, yam. Bleeding with heartburn, bitter mouth, dry mouth, restless sleep at night for the heart and kidney, can be used hooked vine, date palm, Fu Shen, dragon tooth and other drugs to tranquilize the heart and fetus, this and the modern medical sedation and tranquilization treatment intentions are similar. If the bleeding is accompanied by red tongue and dry mouth, it is advisable to clear heat and calm the fetus, using the “sacred medicine for fetus” Scutellaria baicalensis and Atractylodes macrocephala; with back pain and constipation, use the “wonderful medicine for fetus” Semen Cuscutae and Cornu Cervi Pantotrichum to nourish the kidney and astringent essence and benefit Yin and fix Yang. If you have lumbago, constipation and dry mouth, you can use “three sons of the fetus” (Cuscuta sinensis, Lycium barbarum and Mulberry), which are complementary but not greasy, not warm and not dry, and can be used for both Yin and Yang deficiency. In addition, remember that it is forbidden to use cold, hot, nourishing, greasy and lightly permeated products to stop bleeding.