Speaker: Gu Quzhi, Department of Internal Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guo Yangqing Good evening to all of you! Today I am honored to be invited to share with you the treatment of menopause, that is, the perimenopausal syndrome, by means of prescriptions. Since I am in Guangzhou, and the physique of Guangzhou people, as I have observed, is still mainly Yang deficiency, Mr. Huang’s menopause formula is very useful in treating perimenopausal syndrome. First of all, let me tell you about my experience with Mr. Huang’s Menopause Formula. At the 2012 Nanjing Conference on Menopause, Mr. Shi Xinde talked about his experience in treating menopausal patients with hot flashes and sweating with Gui Zhi Tang plus flavor, and I was very inspired by this because there is an article in the Treatise on Typhoid about Gui Zhi Tang: “A patient who has no other illnesses but has fever at times and sweats spontaneously but does not heal is The patient who has no other illnesses, has fever at the time, sweats out from the body but does not heal, this is the Wei Qi is not in harmony, first its time to sweat is healed, appropriate Gui Zhi Tang.” Ms. Shi’s use of Gui Zhi Tang to treat hot flashes and sweating as well as her experience of using this formula to treat menopause was very inspiring to me, and I thought this was good and worth trying. At that time, I did not have much insight into the use of Ms. Huang’s menopause formula, but after Ms. Shi Xinde’s introduction, I felt that I should use it more often. In early 2012, I met a patient, 52 years old, who had been unable to sleep for half a year, was prone to hot flashes, sweating and early awakening, had stopped menstruating for two months, was very tired, sometimes had panic attacks, had a history of hyperthyroidism, and had a large tongue. She had a history of hyperthyroidism, a fat tongue, a dark red tongue, and a gui Zhi Tongue. She had a history of hyperthyroidism, an enlarged tongue, a dark red tongue, and a Gui Zhi Tongue. At that time, I prescribed Chai Hu plus Dragon Bone and Oyster Soup for her because I saw that she had a Chai Hu constitution and could use Gui Zhi, and added two other herbs, namely, Shu Shu Hui Zi and Magnet. The result was not obvious, still very tired, still waking up early, hot flashes, sweating, and panic. Then I wondered: how to deal with this situation? As a result, I added 15g of Zhi Mu, and after adding Zhi Mu, the patient’s hot flashes improved significantly. After the fourth consultation, that is, after the General Assembly of the menstrual formula, I changed to the formula of the more years, without the Baji Tian, and added Zhi Mu and Cuscuta, the effect is even better, and this formula used up 2 weeks, menstruation again. In other words, the period stopped for more than 3 months and came back, and then she kept looking for me to regulate her period, which continued to be normal for 2 years. This case had a great impact on me, and I think Ms. Huang’s menopause prescription works very well. But I made some changes, added Zhi Mu and Cuscuta, and removed Baji Tian. So why did I think of adding Cuscuta? Because I read some literature and found that many women in their 40s started to have spots, butterfly spots and chloasma, so I checked the literature and found that Cuscuta seeds are very good for pigmentation, so I added Cuscuta seeds to all women with spots. It just so happened that the woman with menopause also had spots, so I added Cuscuta. Later, I looked up the pharmacological description of Cuscuta seeds: Cuscuta seeds can enhance the sensitivity of women to estrogen. I thought this was just the right evidence, so I added Cuscuta. It is also very useful for hot flushes and sweating during menopause, as Mr. Huang said. When it comes to treating menopause, I would also like to introduce the Four Great Warriors of Lingnan, who are well known in the Lingnan area. I like very much the book “Dreaming Back to the Four Vajra of Typhoid” written by Mr. Huang Shipai, which tells a very good story about the thinking of prescriptions and the kind of life that doctors of prescriptions aspire to. This book is about his experience in treating menopause, and he used the two-plus-dragon bone and oyster soup, that is, Gui Zhi plus Dragon Bone and Oyster soup without Gui Zhi, plus Bai Wei and Radix et Rhizoma. So it can be seen that Erjia Longbone and Oyster Soup is very useful in the treatment of menopausal diseases in Lingnan. But the pharmacy did not have Bai Wei. After 2012, I consciously observed the effect of the menopause formula with the addition of Zhi Mu and Cuscuta on the treatment of menopausal women, including my students who also prescribed it to their relatives and friends. Regarding the menopause formula, I think that in the Lingnan area, because Yang deficiency constitution is very common, it can be said that almost 80 to 90 percent of patients can use this formula. I have used it in dozens of cases, and the effect is obvious, even in one case, I said she was artificially menopausal because she herself had breast cancer in her 30s, and after Western medicine injections of estrogen suppressing drugs, she had hot flashes and sweating, that is, she developed menopause because of the injections. This means that she developed menopausal symptoms because of the injection of Western medicine. This kind of person also does well with the Menopause Formula, which can improve her insomnia, hot flashes and sweating, and improve her quality of life. In addition to the menopause formula, I would also like to introduce the Gan Mai Da Zao Tang from the Jin Kui Yao. Ganmai Dazao Tang is a treatment for dirty agitation, “happy sadness and desire to cry, as if made by the gods”. This person always wants to cry, inexplicably want to cry, sad, this kind of I also see there, women in their 40s, menopausal women, a lot of this kind of look. In this case, I would combine Gan Mai Da Zao Tang with the menopause formula. After taking this formula for a week or so, some patients will tell me, “Dr. Gu, after taking this medicine, I feel much better, I am not so sad anymore”. There is also a kind of woman with ephedra, who is very strong, with large pores and a puffy face, and some of these women tell me privately: “Doctor, I seem to have poor sexual function, that is, female sexual indifference, no desire. Then this kind of women, I combined with Ephedra with seeds and fine pungent soup on the basis of the formula of more years, because Mr. Huang said that Ephedra with seeds and fine pungent soup for male impotence, premature ejaculation, male sexual dysfunction, used in women with ephedra body, the same effect is very good. I remember a woman of about 45 years old from Sichuan who was afraid of cold, had hot flashes, sweating, was cold and uninterested in sex, and also felt fatigued and in need of TCM treatment. I then used the more years formula combined with hemp and pungent, and after a week of use, she felt something. Later, she continued to come to me for prescriptions, and she felt that the effect was good, the medicine tasted less, and it was also very cheap, and the patient was very satisfied. There is another kind of body type, emaciated women, like Gui Zhi body type of menopause, emaciated very much, the skin is very dry and loose, sometimes I will use the menopause formula, and sometimes also intermittently use the Wen Jing Tang. It is very good for emaciated women and very good for “dry roses” because it is a natural estrogen, as Mr. Huang also said. Some women with low estrogen during menopause will have less moisturized skin, dry skin, flaking, and even atrophy of sexual organs such as the vagina, difficulty in sexual life, and even urinary frequency and urgency, all of which are problems that arise from the decline of systemic functions after estrogen is lowered. This is most often seen in old women with emaciated Gui Zhi bodies, who can have improvement in their skin problems and sexual discomfort after using Wen Jing Tang. I saw a patient with menopause cum stomach problems, also very interesting, with a very uncomfortable stomach and a lot of cracks in the skin of the palms, that is, very dry palms with cracking. I used the warming of the meridian soup at that time, not for the localized consideration of the stomach disease, I think she is more suitable for the warming of the meridian soup, after using it for 2 weeks, the stomach disease is much better, and the roughness and cracking of the palms are almost gone, the effect is quickly seen. At that time, I also saw a post by Ms. Huang about menopausal women’s stomach problems, and the use of Wen Jing Tang was also very effective. Some patients may also use Chai Gui Tang, because Chai Hu’s body, edema, and “yellow rose with yellow face” are also very effective. . The above are some of my small experiences in the Lingnan area, and I would like for you to come together to discuss them. All of you are masters of sutra prescriptions from all over the world and have your own experiences, so you might as well share them. Next, please discuss together. Groupmate A: I have used Gan Mai Da Zao Tang before to treat children’s sadness and joyful crying, as if it was done by the gods, and it worked very well. Groupmate C: Please tell us about your experience in treating premature ovarian failure (premature menopause) with the Sutra formula. Yes, the problem of premature ovarian failure is indeed very common. Nowadays, the pace of life is also very fast, and the pressure of work is also very high, so this kind of women is entering menopause early. Group D: Please teach Mr. Gu about the specific medications and ideas of the warm and subtle method. The main medicines used in the treatment of insomnia in this method of warming and submerging are the Radix et Rhizoma, Dragon Bone and Oyster. In fact, this more year formula actually contains one of the most common treatment method of the Vulcan school ——. I think it works very well in this area of Lingnan, where the Vulcan school is very hot, and there is a certain reason for it. And my colleagues in Lingnan, some of them are from the Vulcan school, they usually use some of the formulae for treating insomnia with the Four Reverse Soup plus or minus. I found that they used it very well, and then I also absorbed their experience and treated insomnia with the warm and subtle method, which I feel is good for some patients with fatigue syndrome who have deficiency insomnia and deficiency cold insomnia. This Yang deficiency insomnia is based on the syllabus evidence of Shao-Yin disease in the “Treatise on Typhoid,” which is a Shao-Yin disease, and the word “but want to sleep” means that you want to sleep but can’t. In this case, you have to warm Yang, but more often you use the warming method. In this case, we need to warm Yang, but more often we use the method of warming the subtle.