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.irritability,
2、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 norma
3、l function of the Chong and Ren Channels.1.Kidney-qi 2.Tiangui 3.The Chong Channel and Ren ChannelIII ETIOLOGICAL FACTIOR AND PATHOGENESIS 1.Deficiency of kidney-qi.2.Exhaustion of the Tiangui.3.Disturbance of the Chong and Ren ChannelsIV、PATHOGENESIS Fundamental:1.Deficiency of kidney.2.Disturbance
4、 of the Chong and Ren Channels.incidental:1.stasis of liver-qi 2.Stagnation of blood 3.Phlegm 4.Damp-heatV、DIFFERENTIATION 1.Deficiency of liver-yin and kidney-yin hectic fever with sweating,feverish sensation in the chest,palms and soles dizziness,sore waist and knee,upset,tantrum Advanced menstrua
5、tion,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 red,a
6、brupt 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,vexation
7、 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 CATEGORIES1、Deficiency of kidney-yin:（1）Hyperactivity of liver-yang（2）Incoordina
8、tion 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 life3、Associated syndromes:（1）Stasis of liver-qi（2）Retention of phlegm（3）Blood stagnationVII.THERAPY1、Therapeutic principle:Invigorating kidney is the ma
9、in 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 suppressing the hy
10、peractive 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）（潮热）涌泉涌泉Yongquan(K.1)照海照海Zhaohai(K.6)列缺列缺Lieque(Lu.7)B、Chest distress神
11、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:太
12、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 m
13、ethodB、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）脾肾阳虚 Deficiency of Spleen-yang and Kidney-yang Therapeutic principle:Warming the kidney and activating yang Tonifying the kidney and invigorating the spleen Back-Shu Points mostly selected Reinforcing,combined with mo
15、xibustion 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、Therapeut
16、ic principle: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 pri
17、nciple:Regulating Qi and resolving phlegmB、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 stasi
18、s:A、Therapeutic principle:Promoting blood circulation and removing blood stasisB、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 Yinlingq
19、uan(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 THERAPY1、Auricular acupuncture Selection of points:Overy,Endocrine,Uterus,Shenmen,Sympathetic Nerve,Subcortex,Heart,Liver,Sp
20、leen,Kidney.2、Percussopunctator:Para vertebral pointsTempleIX、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)肝俞Gansu
21、(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 points:中极
22、 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(Du 13)肺俞 Fei
23、shu(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(1)Therapeutic pr
24、inciple: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)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)
