I. Diagnosis
Women of childbearing age who have been married for more than 1 year, living together as a couple, with normal reproductive function of the spouse, who have failed to conceive without contraception, or who have conceived without contraception for more than 1 year without pregnancy. The former is called total failure to conceive, and the latter is called broken Og. To exclude congenital physical defects and malformations of the reproductive system
(1) Low or no ovulation.
(2) Clinical or biochemical hyperandrogenic manifestations.
(3) Ultrasonographic visualization of ovarian volume >10 ml with ≥12 follicles of 2 ~9 mm in diameter visible.
Excluding congenital adrenocortical hyperplasia, Cushing’s syndrome, ovarian or adrenal tumors. The presence of 2 of the 3 items listed above will be established.
II. Chinese medical understanding
The pathogenesis of polycystic ovary syndrome is mostly due to internal dysfunction of the kidney, liver and spleen, and external invasion of phlegm and dampness, blood stasis and other pathological products, both of which act as cause and effect on the body, causing disorders of the kidney-tengui-rheum-utero axis, so clinical evidence of mixed deficiency and reality is common. Kidney deficiency is the basic pathogenesis of this disease, while liver depression, phlegm-dampness and blood stasis are its main pathogenesis.
Identification and treatment
1. Spleen deficiency and phlegm-dampness: Infertility after marriage, obesity, late menstruation, or even amenorrhea. The amount of the band is large, white and sticky without odor. Dizziness and palpitations, chest tightness, generalized evil, face is weak and floating or s white. Pale fat tongue with teeth marks, white greasy moss, sunken and slippery pulse.
Treatment: Strengthening the spleen, resolving phlegm, regulating Qi and regulating menstruation
Remedy: Cang Fu Gui Phlegm Tang (Ye’s Women’s Medicine) plus or minus.
2.Yang deficiency of spleen and kidney: infertility after marriage, late menstruation, low menstruation or even amenorrhea, hirsutism, acne, obesity, soreness of waist and legs, dizziness and tinnitus, tiredness and fatigue, nocturnal urination, cold and loose stools, cold and clear, dark red tongue, white fur, sunken and thin pulse.
Treatment: Strengthening the spleen, tonifying the kidney, nourishing blood and regulating menstruation.
Remedies: Right Return Pill and Bajhen Tang plus or minus.
3. Yin deficiency of liver and kidney: infertility after marriage, late menstruation with low volume or even amenorrhea, hirsutism, or acne, accompanied by fever in the heart, dizziness and tinnitus, dry eyes, lumbar acidity and knee weakness, low or no amount of hypochondrium, vaginal dryness and pain, or breast swelling and pain, or small amount of overflowing milk, preference for coolness and heat, dry mouth and drink, red tongue with little coating and thin pulse.
Treatment: Nourishing the liver and kidney, regulating menstruation and promoting pregnancy.
Remedy: Zuo Gui Wan plus or minus.
4. Qi stagnation and blood stasis: infertility, menstrual disorders, obesity, hirsutism, acne. Dull red tongue with stasis points on the edge of the tongue, with a thin string pulse.
Treatment: Diversify the liver and regulate Qi, invigorate blood and regulate menstruation.
Treatment: Dredge the liver and regulate the blood to regulate menstruation.
5, deficiency of qi and blood: marriage for a long time infertility, late menstruation, low volume or even amenorrhea, light color, thin texture, or menopause and menstrual dripping alternately, accompanied by fatigue, dizziness, palpitations, shortness of breath, face withered, light tongue, thin coating, weak pulse.
Treatment: Benefit Qi and nourish Blood, tonify kidney and regulate menstruation.
Remedy: Ten whole tonic soup with reduction.
IV. Manual cycle therapy of Chinese medicine to regulate menstruation and promote pregnancy
On the basis of the above dialectical treatment, for patients with late menstruation or amenorrhea, herbal artificial cycle therapy is performed to promote follicle development and restore ovulation.
Menstrual period: Benefit Qi and nourish Blood, harmonize Blood and regulate menstruation. Stop using other drugs during this period and take Angelica Blood Pills. Measure basal body temperature.
Follicular phase: Nourishing Blood and tonifying Kidney to promote follicular development. This formula is based on the formula of Yi Kidney Ovulation Promotion Tang (experienced formula of the department) with addition and reduction. Monitor vaginal secretions and follicle size by ultrasound to guide clinical treatment. Measure basal body temperature.
During ovulation: tonifying the kidney and invigorating blood, tonifying yin and yang to promote follicle discharge. Ultrasound to monitor ovulation. Measure basal body temperature.
Luteal phase: Strengthening the spleen and tonifying the kidney, tonifying the liver and regulating menstruation to promote luteal function. The formula is supplemented with Tongluo Fu Menstruation Tang (a formula based on the department’s experience). Measure basal body temperature.
V. Adjunctive therapy
1.Exercise therapy: aerobic exercise (jogging, swimming, cycling, taijiquan, etc.) for 30-60 minutes each time, more than 5 times a week.
2. Diet control: adopt low-calorie diet therapy, limiting the daily calorie intake to 2500~5000J (600~1200 calories), with protein accounting for 25%, sugar 20% and fat 20%.