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1、CLIMACTERIC SYNDROME,（MENOPAUSAL SYNDROME）,I、DEFINATION,Before or after the period of natural cessation of menstruation,women may have some symptoms associated with it,such as menstrual disorder,hectic fever with sweating,dizziness,tinnitus,insomnia,palpitation and lassitude,debilitation.irritabilit
2、y,depression.,This is climacteric syndrome or menopausal syndrome.In TCM,it belongs to the category of“绝经前后诸症(syndromes before or after menopause)”,II PHYSIOLOGY OF MENSTRUATION IN TCM,The production of menstruation is related to the abundance of kidney-qi,as long as the arrival of the Tiangui,and n
3、ormal function of the Chong and Ren Channels.,1.Kidney-qi2.Tiangui3.The Chong Channel and Ren Channel,III ETIOLOGICAL FACTIOR AND PATHOGENESIS,1.Deficiency of kidney-qi.2.Exhaustion of the Tiangui.3.Disturbance of the Chong and Ren Channels,IV、PATHOGENESIS,Fundamental:1.Deficiency of kidney.2.Distur
4、bance of the Chong and Ren Channels.,incidental:1.stasis of liver-qi2.Stagnation of blood3.Phlegm4.Damp-heat,V、DIFFERENTIATION,1.Deficiency of liver-yin and kidney-yin hectic fever with sweating,feverish sensation in the chest,palms and solesdizziness,sore waist and knee,upset,tantrumAdvanced menstr
5、uation,or at irregular intervals,diminished flow.dry mouth,oliguria,constipation red tongue with little coating,wiry thready rapid pulse.,2、Deficiency of kidney-yang and Spleen-yang dizziness,distention of head,memory declineDim complexion,sore waist,cold and swollen limbs Menstruation with light re
6、d,abrupt and heavy flow.Gloom and languid,or lassitudeabdominal distention,belching and sour regurgitation,weak appetite,loose stools,frequent nocturiapuffy tongue with white-slide coating,feeble deep thready pulse,3.Incoordination between the heart and the kidneyPalpitation,emotional lability,vexat
7、ion and dreaminess,insomnia sore waist and knee,dizziness and tinnitushectic fever with sweating,feverish sensation of the chest,palms and solesBitter tastes,red tongue with little coating,thready rapid pulse.,VI、SUMMARY OF CATEGORIES,1、Deficiency of kidney-yin:（1）Hyperactivity of liver-yang（2）Incoo
8、rdination between the heart and the kidney2、Deficiency of kidney-yang:（1）Deficiency of spleen-yang and kidney-yang（2）Declination of fire in the gate of life,3、Associated syndromes:（1）Stasis of liver-qi（2）Retention of phlegm（3）Blood stagnation,VII.THERAPY,1、Therapeutic principle:Invigorating kidney i
9、s the main principle:nourishing the kidney and calm the mindpurging the liver-fire and strengthening the spleen.(restraining yin by supplementing yang)(restraining yang by nourishing yin),肝肾阴虚Deficiency of liver-yin and kidney-yin,(1)Therapeutic principle：Nourishing the kidney and liver,and suppress
10、ing the hyperactive liver-yang(providing water for the growth of wood),(2)Prescription:,肾俞Shenshu(U.B.23)太溪Taixi(K.3)肝俞Gansu(U.B.18)太冲Taichong(Liv.3)行间Xingjian(Liv.2),(3)Selection of acupoints according to symptoms and signs:A、Hectic fever（潮热）涌泉Yongquan(K.1)照海Zhaohai(K.6)列缺Lieque(Lu.7),B、Chest distr
11、ess神门 Shenmen(H.7)大陵Daling(P.7),C、Dizziness(Dizzy vision)百会 Baihui(Du 20)D、Tinnitus听会 Tinghui(G.B.2),*Acupoints for nourishing yin,太溪Taixi(K.3)照海Zhaohai(K.6)复溜 Fuliu(K.7)然谷 Rangu(K.2)三阴交 Sanyinjiao(Sp.6)曲泉 Ququan(Liv.8),*Acupoints for calming the liver and suppressing hyperactivity of the liver-yang
12、:太冲Taichong(Liv.3)行间Xingjian(Liv.2)侠溪 Xiaxi(G.B.43)足临泣 Zulinqi(G.B.41)阳辅 Yangfu(G.B.38)丘墟 Qiuxu(G.B.40),*心肾不交Incoordination between the heart and the kidney A、Therapeutic principal:(1)Nourishing kidney-yin,coordinating the heart and kidney(2)Back-Shu Points mostly selected(3)Reinforcing and reducing
13、 method,B、Prescription,心俞 Xinshu(U.B.15)肾俞 Shenshu(U.B.23)脾俞 Pishu(U.B.20)三阴交 Sanyinjiao(Sp.6),*Selection of the acupoints according to the symptoms and signs:Insomnia神门 Shenmen(H.7)四神聪 Sishencong(EX-HN 1)Palpitation通里 Tongli(H.5)内关 Neiguan(P.6),Feverish sensation over the palms,soles and the chest劳
14、宫 Laogong(P.8)Disturbance of consciousness:人中 Renzhong(Du 26)大陵 Daling(P.7),（2）脾肾阳虚Deficiency of Spleen-yang and Kidney-yang Therapeutic principle:Warming the kidney and activating yangTonifying the kidney and invigorating the spleenBack-Shu Points mostly selectedReinforcing,combined with moxibustio
15、n,Prescription:肾俞 Shenshu(U.B.23)关元 Guanyuan(Ren 4)脾俞 Pishu(U.B.20)章门Zhangmen(Liv.3)足三里 Zusanli(St.36),*Selection of the acupoints according to the symptoms and signs:Loose stool天枢 Tianshu(St.25)阴陵泉 Yinlingquan(Sp.9)太溪 Taixi(K.3),（3）Associated symptoms and signs,Stasis of liver-qi:A、Therapeutic prin
16、ciple:Dispersing the stagnated liver-qi by invigorating the flow of Qi(which is based on nourishing yin and clearing away heat in the heart),B、Prescription:太冲Taichong(Liv.3)行间Xingjian(Liv.2)太冲Taichong(Liv.3)合谷 Hegu(L.I.4)太冲Taichong(Liv.3)期门 Qimen(Liv.14),Accumulation of phlegm:,A、Therapeutic princip
17、le:Regulating Qi and resolving phlegm,B、Prescription:膻中 Shanzhong(Ren 17)中脘 Zhongwan(Ren 12)气海 Qihai(Ren 6)足三里 Zusanli(St.36)支沟 Zhigou(S.J.6)丰隆 Fenglong(St.40),*丰隆(St.40)is combined with 内关(P.6),间使(P.5),神门(H.7),太冲(Liv.3),to clear away phlegm-fire and regulate Qi to tranquilize the mind.,Blood stasis
18、:,A、Therapeutic principle:Promoting blood circulation and removing blood stasis,B、Prescription:膈俞 Geshu(U.B.17)血海 Xuehai(Sp.10)三阴交 Sanyinjiao(Sp.6),*For the treatment of masses in the abdomen,归来 Guilai(St.29)气冲 Qichong(St.30)水道 Shuidao(St.28)气海 Qihai(Ren 6)中极 Zhongji(Ren 3)交信 Jiaoxin(K.8)阴陵泉 Yinling
19、quan(Sp.9),*Back-Shu Points play an important role in treating climacteric syndrome.心俞 Xinshu(U.B.15)肝俞Gansu(U.B.18)脾俞 Pishu(U.B.20)肾俞 Shenshu(U.B.23)膈俞 Geshu(U.B.17),VIII.OTHER THERAPY,1、Auricular acupuncture Selection of points:Overy,Endocrine,Uterus,Shenmen,Sympathetic Nerve,Subcortex,Heart,Liver
20、,Spleen,Kidney.,2、Percussopunctator:Para vertebral pointsTemple,IX、TREATMENT ACORDING TO THE SYMPTOMS1、Lacrimation,dry eyes with stabbing and burning sensation 睛明 Jingming(U.B.1)承泣 Chengqi(St.1)攒竹 Zanzhu(U.B.2)丝竹空 Sizhukong(S.J.23)四白 Sibai(St.2),光明 Guangming(G.B.37)臂臑 Binao(L.I.33)养老 Yanglao(S.I.6)肝
21、俞Gansu(U.B.18)肾俞 Shenshu(U.B.23),2、Chronic pharyngitis:列缺Lieque(Lu.7)照海Zhaohai(K.6),3、Sweating:合谷 Hegu(L.I.4)复溜 Fuliu(K.7)后溪 Houxi(S.I.3)阴郗 Yinxi(H.6),4、Pruritus in vulva:（1）Therapeutic principle:Clearing damp-heatNourishing liver and kidneyDredging collaterals and stopping itchiness,（2）Selection of
22、 points:中极 Zhongji(Ren 3)下髎 Xialiao(U.B.34)三阴交 Sanyinjiao(Sp.6)血海 Xuehai(Sp.10)蠡沟 Ligou(Liv.5),5、Chronic eczema（1）Therapeutical principle:Moisturizing dryness by nourishing blood,（2）Prescription,足三里 Zusanli(St.36)三阴交 Sanyinjiao(Sp.6)大都 Dadu(Sp.2)郗门 Ximen(P.4)曲池 Quchi(L.I.11)大椎 Dazhui(Du 14)陶道 Taodao
23、(Du 13)肺俞 Feishu(U.B.13)神门 Shenmen(H.7),6、Frequent micturition（1）Therapeutical principle:Tonifying kidney,（2）Prescription,提托穴 Tituoxue(4 cun lateral to the point Ren 4)中极 Zhongji(Ren 3)关元 Guanyuan(Ren 4)百会 Baihui(Du 20)足三里 Zusanli(St.36)三阴交 Sanyinjiao(Sp.6)阴陵泉 Yinlingquan(Sp.9),7、Pains in the limbs(
24、1)Therapeutic principle:Tonifying kidney（2）Treatment is the same as that of Bi syndrome.,8、Headache and dizziness,Points selected:百会 Baihui(Du 20)风池 Fengchi(G.B.20)印堂 Yintang(EX_HN 2)头维 Touwei(St.8)列缺 Lieque(Lu.7)合谷 Hegu(L.I.4),9、Poor memory百会 Baihui(Du 20)风池 Fengchi(G.B.20)大椎 Dazhui(Du 14)心俞 Xinshu(U.B.15)肾俞 Shenshu(U.B.23)四神聪 Sishencong(EX-HN 1),THANK YOU!,2、Differentiation and treatment of common syndromes（1）Deficiency of yin leads to hyperactivity of yang(deficiency of kidney-yin leads to hyperactivity of liver-yang),
