Transcript Document

Dysmenorrhea
痛经，Tong Jing
Concept
Dysmenorrhea or painful menstruation is
characterized by continual pain or even acute
pain in the lower abdomen and lumbar region
before,during or after menstruation,usually
accompanied with pallor,profuse cold sweat
on the head,cold limbs,nausea and
vomiting.A light distending pain or discomfort
in the lower abdomen or lumbar region is a
frequent occurrence and is not diagnosed as
dysmenorrhea.
Etiology and Pathogenesis
1.cold Dampness Obstruction
Prolonged residence in damp housing
conditions or getting wet and being exposed
to cold during the menstrual period may
produce cold dampness which impairs the
Lower Jiao and stagnates in the
uterus,thereby congealing the blood and
obstructing the menstrual flow causing pain.
2.Liver Qi Stagnation
Stasis of
menstrual
blood in
the uterus
Liver and kidney Yin
deficiency,depletion of
essence and deficiency of
blood
Under
nourishme
nt of the
uterus
Dysmenorrhea
Cold dampness obstruction in
the uterus,liver qi
stagnation,impairment of the
Chong and Ren meridians
3.Liver and Kidney Yin Deficiency
A liver and kidney Yin deficiency,weak
constitution or excessive sexual activity
leads to liver and kidney Yin
deficiency,depletion of essence,deficiency
of blood,and insufficient blood supply in
the Chong and Ren meridians.After
menstruation,the sea of blood is totally
depleted and is even less able to nourish
the uterus,causing deficiency pain in the
lower abdomen.
Differentiation
1.cold Dampness Obstruction
Main manifestations:Cold pain occurs in the
lower abdomen before or during
menstruation,the pain is aggravated when
pressure is applied,and may radiate to the
back,but it may be alleviated when heat is
applied.In acute cases,the pain radiates to
the lower back.
Accompanying symptoms and Signs:Scanty
menstruation with dark menses,often with
clots
Tongue and Pulse :A thin and white tongue
coating,a deep and tense pulse
2.Liver Qi Stagnation
Main Manifestations:distending pain in the
lower abdomen before or during
menstruation,the feeling of distention being
predominant to the pain,obstructed menstrual
flow
Accompanying Symptoms and Signs:Scanty
periods often with clottedblood,accompanied
by distending pain in the
chest,hypochondrium and breasts
Tongue and pulse:A dark tongue with
ecchymosis,a thin and white coating,a deep
and wiry pulse
3. Liver and Kidney Yin
Deficiency
Main Manifestation:Dull pain in the lower abdomen
during or after menstruation,alleviated by pressure
Accompanying Symptoms and Signs:Pink,clear and
thin menstrual blood,soreness of the lowerback,
dizziness,tinnitus,pale complexion, mental fatigue
Tongue and pulse:A pale tongue,a deep and
thread pulse.
Treatment
1. cold Dampness Obstruction
Treatment Principle:Dispersing cold and
dampness,inducing menstruation to relieve
pain,mainly selecting joints from the Ren and the
Foot Taiyin meridians
Acupoint
Selection:Zhongji(RN3),Shuidao(ST28),Diji(SP8)
Method:All points are punctured perpendicularly to
a depth of 1.0-1.5 cun with the reducing
method,needles are retained for 20
minutes.Alternatively,moxibustion may be applied.
2.Liver Qi Stagnation
Treatment Principle:Dispersing the
stagnated liver qi for regulating the
circlation of qi to promote menstrual flow
Acupoint
Selection:Qihai(RN6),Taichong(LR3),Sanyi
njiao(SP6)
Method:Puncture Qihai perpendicularly
1.0-1.5 cun and Taichong and Sanyinjiao
1.0 cun.Use reducing or even method.
3.Liver and Kidney Yin
Deficiency
Treatment Principle:Nourishing the liver and
kidney Yin,regulating and reinforcing the chong
and Ren meridians
Acupoint
Selection:Ganshu(BL18),Shenshu(BL23),Guanyua
n(RN4),Zusanli(ST36),Zhaohai(KI6).
Method:Ganshu and Shenshu are punctured
obliquely towards the spine to a depth of 1.5
cun.Guanyuan and Zusanli are punctured
perpendicularly 1.5 cun.Zhaohai is punctured
perpendicularly 1.0 cun.All the points are
punctured with the reinforcing methed by
lifting and thrusting while twirling the
needles.Moxibustion may also be applied.
Other Therapies
Ear Acupuncture
Otopoint :Uterus ,Endocrine,Sympathesi
s,kidney
Method:Select 2-3 points each time,give
mild stimulation,retain the needles for
15-20 minutes.
Differentiation Treatment principle
Acupoint selection
Cold
dampness
obstruction
Dispersing cold and
dampness,inducing
menstruation to
relieve pain
Liver qi
stagnation
Soothing the liver
and regulating
qi ,promoting
menstrual flow to
stop pain
Tonifying the liver
and
kidney,regulating
the Chong and Ren
meridians
RN3,ST28,SP8
For acute pain, adding
BL32,ST29
For abdominal pain
radiating to the lower back,
adding DU4,BL23
RN6,LR3,SP6
Deficiency of
the liver and
kidney
BL18,BL23,KI6,RN4,ST36