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Amenorrhea

Key Diagnostic

 Points:

1. The diagnosis of the disease is characterized by the absence of menstruation.
2. Women at the age of 18 who have never menstruated are considered to have primary amenorrhea; women whose menses have ceased for over three months after the formation of their menstrual cycle are said to have secondary amenorrhea.

Differential Diagnosis:

Deficiency of the Liver and Kidney.
Primary amenorrhea of a patient over 18 years old, or delayed menstrual cycle with scanty menstruation leading gradually to amenorrhea, accompanied with constitutional debility, lassitude in the loins and legs, dizziness, and tinnitus.

Tongue: Red with little coat.
Pulse: Deep and thready

Deficiency of Qi and Blood Gradual delay of menstruation with very little blood which is thin and reddish, ultimately leading to amenorrhea accompanied by dizziness, blurred vision, palpitations, shortness of breath or lusterless hair, emaciation with sallow complexion.

Blood: Scanty, thin and reddish
Tongue: Pale with thin white coat
Pulse: Deep and weak and sometimes languid.

Qi stagnation and blood stasis.
Amenorrhea for several months, accompanied with restlessness and a tendency toward being easily angered, feelings of fullness in the chest and hypochondrium, distending pain in the lower abdomen.

Tongue: Purple spots generally on the edges of the tongue.
Pulse: Deep and choppy

Treatment Principle:

For deficiency of Liver and Kidney:
Tonify the Liver and Kidney to regulate menstruation.

For deficiency of Qi and Blood:
Tonify the Qi and nourish the blood to regulate menstruation.

For Qi stagnation and blood stasis:
Regulate the Qi and activate the blood to induce menstruation.

Point and Technique Prescription:

For deficiency of Liver and Kidney:

UB 18 Liver shu, tonifies Liver
UB 23 Kidney shu, tonifies Kidney
Ren 4 Tonifies Kidney

UB 20 Spleen Shu
St 36 He sea point of Stomach channel
Sp 6 Three Leg Yin crossing point.
Spleen and Stomach are the source for producing Qi and Blood. UB 20, St 36 and Sp 6 all strengthen the function of the Spleen and Stomach which provides the material basis for the acquired constitution. Postnatal Qi and Blood assists the prenatal in the Kidneys.

St 29 for the return of the menstrual cycle.

For deficiency of Qi and Blood:

UB 17 The Influential point of Blood
Ren 6 The "Sea of Qi" for tonifying Qi.
UB 20 Spleen Shu
St 36 He sea point of Stomach channel
Sp 6 Three Leg Yin crossing point.
Spleen/Stomach are the source of producing the Qi and Blood, strengthen the Qi and Blood.

St 29 for the return of the menstrual cycle.

For Qi stagnation and blood stasis:

Ren 3 Regulates the Chong and Ren channels which induce menstruation.
St 29 for the return of the menstrual cycle.
Sp 8 Xi cleft point for removing blood and Qi stagnation. The Qi and Blood are very deep at the Xi cleft points. It is easy for the Qi and blood to become stagnant here, so we choose this point to break up Blood and Qi stagnation
Sp 10 "Sea of Blood", activates blood to induce menstruation.
Sp 6 activates blood
L.I. 4 Yuan source point of L.I. channel regulates Qi
Liv 3 Yuan source point of Liver channel regulates Liver Qi and activates the blood.

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