When talking about the various views of Chinese medicine on the etiology and pathogenesis of premature ovarian failure, it is often necessary to cite a passage from the Huangdi Neijing Suwen Shanggu Tianzhen Lun. Therefore, we will first cite this passage and explain it.
Original text: When a woman is seven years old and her kidney energy is strong, her teeth become longer and her hair grows. At the second seventh year, when the Heavenly Decay arrives, the Ren Pulse is open and the Taichong Pulse is strong, the menstrual period is at the right time, so there are children. In the third seventh year, the kidney energy is even, so the real teeth are born and grow long. In the fourth seventh year, the tendons and bones are firm, the hair is long and strong, and the body is strong. In the fifth year, the Yang Ming pulse declines, the face begins to scorch and the hair begins to fall. Sixth and seventh, the three Yang veins fail on the top, the face is scorched and the hair starts to turn white. In the seventh year, the Ren pulse is deficient, the Taichong pulse is weak, the Tiankui is exhausted, and the earth channel is blocked, so the form is bad and childless.
Translation: When a woman reaches the age of seven, her kidney energy is full, her teeth are replaced, and her hair grows; at the age of fourteen, her Tianjue is mature, her Ren Chakra is open, her Taichong Chakra is strong, and her menstruation is on time, so she can become pregnant and have children; at the age of twenty-one, her kidney energy is full, her wisdom teeth come out, and her growth period is over; at the age of twenty-eight, her body is at its strongest stage, her muscles and bones are strong and sturdy, and her hair grows to the extreme; at the age of thirty-five, her body begins to At the age of thirty-five, the body begins to age, first of all, the Yangming Vessel declines, the face begins to wither, and the hair will fall off; at the age of forty-two, the upper San Yang Vessel declines, the face withers and haggards, and the hair begins to turn white; at the age of seventy-seven and forty-nine, the Ren Vessel is empty, the Tai Chong Vessel declines, the Tian Kui is exhausted, and the menstruation is broken, so the body ages and is no longer fertile.
This sutra, written 2,300 years ago during the Warring States period to the Qin and Han dynasties, is a summary of the physiological characteristics of women throughout their lives.
This sutra gives an accurate and vivid description of the role of the elements of kidney qi, tiankui, and zongren in the physiological process of female growth, development and menstruation, and illustrates that the natural flourishing and declining of a woman’s life is the external manifestation of the natural flourishing and declining of kidney qi. It is the basic starting point of later generations’ views on the etiology and pathogenesis of female reproductive system diseases.
According to Chinese medicine, the kidney collects essence, and the essence transforms into qi, which is the kidney qi, and the kidney qi is the root of female physiological activities. The kidney is the source of heavenly sebum, the origin of punching, the main menstruation, reproduction, and cell ties. The kidney is the place where the essence is stored and administered, and the physiological processes of women are all related to the kidney. Only when the kidney is strong and the yin and yang of the kidney are in balance, can the sebum be secreted, and the two channels of the Qi and the Ren can be open to the public, then the menstrual blood can be injected into the uterus to become menstruation, and the uterus can conceive and nurture a fetus. The natural changes in the physiology of the human body, reflected in the external, is mainly the changes in the strength and weakness of the kidney qi.
The theory of kidney deficiency pathogenesis
This view is that the lack of kidney essence and kidney qi is the most fundamental pathological change of premature ovarian failure. The majority of scholars currently hold this view regarding the Chinese medical etiology of premature ovarian failure. “The theory that the kidney is the master of reproduction is the main basis for this view.
According to Chinese medicine, the conditions for the production of menstruation are the presence of kidney energy, the arrival of heavenly sap, and the presence of any passages and rushes. Under normal physiological conditions, a woman’s reproductive system is mature when she reaches the age of “two-seven”, and her menstrual cycle is “in time”. The woman’s reproductive system develops to maturity at the age of “2.7” and “the menstrual period is under the time”.
The clinical characteristic of premature ovarian failure is that a woman prematurely suffers from “deficiency of the Ren Vessel, decay of the Tai Chong Vessel, and exhaustion of the Tian Kuei” before she reaches the age of “7-7”, i.e. the pathological phenomenon of “premature exhaustion of the Tian Kuei”.
Insufficient kidney yin, deficiency of essence and blood, deficiency of blood, deficiency of blood, loss of moistening of the uterus and gradual interruption of menstrual flow; deficiency of kidney yang, inability to warm the kidney essence to produce heavenly sap, lack of Qi and blood, loss of warming of the uterus and difficulty in arriving at menstrual flow; deficiency of kidney essence, difficulty in filling heavenly sap, loss of smoothness of the ramus, loss of nourishment of the uterus and deficiency of the source of menstruation. The clinical evidence is a deficiency of kidney yin and kidney yang.
The kidney contains essence and is the master of reproduction. The strength and weakness of the kidney essence is directly related to the functional state of the “kidney – tiankui – zongren – uterus reproductive axis”, which governs the root of fertility. Therefore, in the “Medical Journal”, there is a cloud: “The moon water all depends on the kidney water, and the lack of kidney water will dry up the essence water day by day.”
The theory of the pathogenesis of the depletion of heavenly sebum
Some scholars believe that the basic pathogenesis of premature ovarian failure is the depletion of natural sap.
The production of menstruation is mainly a result of the integration of the Kidney-Tian Kuei-rheumato-uterine reproductive axis, and must occur after the Kidney Qi is in full bloom, the Tian Kuei has arrived, and the Rheumato-rheumato is in full bloom. The scriptures in Suwen Shanggu Tianzhen Lun, already fully explained that when a woman is seven years old, the kidney qi is already in full bloom, but the menstrual flow is not yet due to the immaturity of the heavenly sebum, and when the heavenly sebum is mature at the age of two or seven, it acts on the rushing and the uterus to make the blood of the rushing vein flourish and the qi of the Ren vein pass, and the menstrual flow will be in time. Only the maturation of the spermatozoa or its function affects menstruation and conception, and the tide and termination of menstruation are closely related to the maturation, secretion and decline of the spermatozoa, and the spermatozoa and menstruation are always the same.
This view is supported by the clinical symptoms of patients with premature ovarian failure. In other words, if premature ovarian failure is caused by kidney deficiency, why are the other internal organs not affected by it, but only the menstruation is not tidal; the symptoms of premature ovarian failure are not the most common symptoms of kidney deficiency, such as dizziness and tinnitus, lumbar acidity and knee weakness, but the symptoms of yin and yang imbalance, such as hot flashes, sweating, anxiety, insomnia and dreaminess.
Emotional and moral factors cause the disease
The so-called emotional and mental factors are the seven emotions of happiness, anger, sadness, thought, grief, fear and fright.
The emergence of professional women is one of the characteristics of the progress of civilization in modern society. The intense pace and mental pressure that women are subjected to in modern society are not comparable to those of the ancient times. Mental tension, emotional anxiety, depression and other emotional fluctuations, resulting in emotional discomfort, liver loss of drainage, qi stagnation, depression for a long time into fire, dark depletion of qi and blood, insufficient qi and blood, can not glory kidney fill essence, nourish the ramus, down to nourish the uterus and the uterus; and the liver is not in line, affecting the middle jiao lifting and lowering the function of transport, the grain transport function is low, the essence is not born, deficiency of qi and blood, Tiankui lack of source, the ramus blood exhausted, the qi of the ramus fails, the uterus and the uterus lose nourishment, kidney – The normal function of the Kidney – Tian Kuei – Chong Ren – Uterus cannot be coordinated and maintained, resulting in the absence of menstrual blood, the sea of blood is empty and menstruation stops early. As described in the “Chen Suan Gynecology Supplementary Interpretation – Menstruation is not available in the seven emotions of depression formula”: “Women …… sex more obstinate, worry, anger and pity, …… a depression, the menstrual injuries, starting or first or after, or more or less, long is closed The “six sexes” cause disease.
The “six sexes” pathogenic factors
The “six obscene” that is “wind, cold, heat, humidity, dryness, fire”, in ancient times refers to the climate, the region and the environment of human habitation. Although the “six obscene” seasonal toxins are not the determinants of premature ovarian failure, they can promote the occurrence of the disease.
In modern society, the scope of the ancient concept of the “six sexes” has become more extensive with changes in the environment and lifestyle, covering a wide range of modern factors such as biological (bacteria, viruses, etc.), physical (radiation, sound, light, electricity), chemical (food, drugs, chemical agents), trauma (surgery), etc. that are difficult for the human immune function to resist. environmental factors. These factors have been proven by modern medical research to have different degrees of adverse effects on the immune function of the human body, thus inducing, prompting and leading to the occurrence of diseases. When the six evil spirits invade the body, they can attack the uterus through the uterine vein and damage the ramus, interfering with the overflow of menstrual blood in the uterus, so that the menstrual flow does not stop when it arrives or when it arrives; or when the infection is poisonous, the poisonous evil damages the uterine vein and damages the ramus, making it difficult for the qi of the uterine vein to pass and the essence and blood of the ramus to flourish, so that the kidney-tiankui-ramus-uterus axis cannot establish a normal regulatory feedback function and the production of menstrual blood is obstructed and the menstrual flow stops early. Chen Su-an gynecology supplement explanation – regulating the menstruation door – women’s diseases from the menstrual water does not regulate the theory” said: “more beginning due to the six lewd attack, and by the seven feelings of depression, internal and external injury, diet, muscle gradually fade, yellow face hair fall, and even hot flashes bone steam, menstrual water through the years and months, called blood withering”.