Treatment of menopausal functional uterine bleeding based on TCM classification

Menopausal functional uterine bleeding is generally believed to be caused by liver, spleen and kidney deficiency, Chong and Ren meridians are not solid, and deficiency, heat and stasis are combined. The clinical condition is complicated. "The kidney is the foundation of the innate, receiving and storing the essence of the five internal organs and six bowels", so kidney deficiency is the root cause. In the treatment of menopausal functional uterine bleeding, the principle of "treating the symptoms in an emergency and treating the root cause in a slow manner" is followed. During the bleeding period, the bleeding should be blocked, and treatment should be carried out according to clinical symptoms. "Blocking the flow", "clearing the source" and "restoring the original state" are the three major principles for treating functional uterine bleeding.

(1) Liver and kidney yin deficiency: This type of patient has continuous menstruation at first, followed by sudden heavy menstruation, bright red blood without odor, no abdominal distension or pain, soreness of waist and knees, dry mouth and throat, red cheeks, night sweats, fever in the five parts of the body, tinnitus, forgetfulness, red tongue without coating, and weak pulse. The prescription is Zuogui Pills combined with Erzhi Pills and Guchong Decoction with modifications.

(2) Spleen and Kidney Yang Deficiency: This type of patient has continuous bleeding, scanty menstruation with blood clots, or only a small amount of blood in the leucorrhea, cold body and limbs, cold pain in the abdomen, likes warmth and pressure, sore waist and weak legs, pale complexion or dark complexion, shortness of breath and laziness, fatigue, loss of appetite, loose stools or diarrhea at dawn, or puffy face and limbs, pale and enlarged tongue or with blood stasis, slippery white tongue coating, and deep and weak pulse. The prescription is Guben Zhibeng Decoction combined with Yougui Pills and Siwuzei Bone and Qiancao Pills with modifications.

(3) Liver depression and kidney deficiency: This type of patient has continuous menstruation, sometimes more and sometimes less, dark purple blood, or sudden heavy menstruation, abdominal distension and refusal to press, flank distension, frequent sighing, depression, or irritability, intestinal rumbling and loss of breath, soreness of waist and knees, and stringy pulse. The prescription is Pinggan Kaiyu Zhixue Decoction combined with Siwujigu Yiqiancao Pill with modifications.

(4) Deficiency of both Qi and Yin of the spleen and kidney: This type of patient has continuous menstruation, fatigue, sweating, shortness of breath, dry mouth and sore throat, dizziness, hot flashes in the afternoon, hot hands and soles, sore waist and tinnitus, oliguria and constipation, red tongue, little coating, and weak and thready pulse. The prescription is Buzhong Yiqi Decoction combined with Maiwei Dihuang Decoction combined with Siwuzeigu and Qiancao Pills with modifications.

(5) Disharmony between the heart and kidney: This type of patient has continuous menstruation, insomnia, paroxysmal palpitations, irritability, dry mouth and lack of saliva, flushing of the cheekbones, dizziness, tinnitus, backache, spermatorrhea, constipation and yellow urine, bright red tongue with little coating, and weak pulse. The prescription is Jiaotai Pills combined with Baizi Yangxin Pills combined with Siwuzei Bone and Qiancao Pills with modifications.