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PROLONGED MENSTRUATION

GENERAL

Clinical Manifestations	Bleeding for more than 7 days
Treatment Principle
Herb Formulas
Points

SPLEEN QI DEFICIENCY - SPLEEN NOT GOVERNING BLOOD

Clinical Manifestations	Sallow or pale complexion Anorexia Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Dizziness Palpitations Sallow complexion Fatigue Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even, forceless and Deficiency
Treatment Principle	Nourish Qi Stop Bleeding
Herb Formulas	Gui Pi Tang Bu Zhong Yi Qi Tang modified Gui Pi Tang + Jiao Ai Tang Ju Yuan Jian modified
Points	DU-20, LI-11, REN-4, SP-1, SP-3, SP-4, SP-10, ST-36, UB-1, UB-20 DU-20, KI-3, REN-6, SP-1, SP-6, SP-8, ST-36, Tituo, UB-20

YIN DEFICIENCY HEAT IN THE BLOOD

Clinical Manifestations	Early menstrual period (short cycle) Discharge of a small amount of thick, bright red Blood Heavy flow Mid cycle bleeding (spotting) Bloody vaginal discharge Discharge begins with scant light-colored Blood Dizziness Blurred vision Hectic fever Flushed cheeks Sore throat Tinnitus Heartburn Thirst Five sole Heat Night sweats Lack of skin luster Weak and sore lower back and knees Weakness and atrophy of the legs Dry, parched mouth and throat Dizziness Blurred vision Insomnia Dream disturbed sleep Prematurely gray hair Premature hair loss A bitter taste in the mouth Hypermenorrhea T: Red or Crimson or Red and dry C: Little or None P: Thready and rapid or Deep, small and weak
Treatment Principle	Nourish Yin Clear Heat Stop bleeding
Herb Formulas	Liang Di Tang + Er Zhi Wan
Points	KI-3, KI- 6, REN-3, SP-8, SP-10 With hot flashes: + HT-6, KI-7 WIth Dampness: + SP-9, ST-40

BLOOD STAGNATION WITH BLOOD DEFICIENCY

Clinical Manifestations	Copious bleeding of dark purple blood The blood is sticky during menstruation May or may not have clots Menstrual cycle is shortened (early menstruation) Palpitations Dizziness Blurred vision Pale, lusterless complexion Pale nails Abdominal pain Irregular menstruation with little flow Fixed lower abdominal pain Vertigo Tinnitus Pale lips May be amenorrhea Insomnia Menstruation may also be accompanied by distention and pain T: Pale C: Normal P: Thin and weak or Thin and choppy
Treatment Principle	Tonify and Invigorate the Blood Regulate Blood Circulation Break up Stagnation Eliminate Blood Stagnation Regulate menstruation Alleviate pain
Herb Formulas	Tao Hong Si Wu Tang Zong Pu San WIth abdominal pain: + Shi Xiao San
Points	LIV-3, LIV-13, LIV-14, SP-6, UB-17 REN-3, SP-6, SP-10, ST-29, Zigong

BLOOD HEAT DUE TO HEAT IN THE CHONG AND REN

Clinical Manifestations	Continuous menstruation or Uterine bleeding that alternates between spotting and gushing The Blood is very red, thick and sticky and may contain dark-purple clots A sensation of Heat and irritability in the chest Menstruation may be delayed Dry mouth Leukorrhea Dysuria Abdominal pain Dark urine Red urine Red face Difficulty defecating T: Red C: Normal or Yellow P: Wiry or Wiry and rapid or Tight and rapid or Slippery and rapid
Treatment Principle	Enrich Yin Clear Heat Clear Deficiency Heat Stop bleeding Stabilize the menses
Herb Formulas	Gu Jing Wan
Points

DAMP-HEAT WITH HEAT IN THE BLOOD

Clinical Manifestations	Pain in low back and knees Weakness or atrophy of lower extremities Scanty yellow urine Red, hot, swollen and painful feet or knees Edema in lower legs Eczema Painful and swollen feet Pain and swelling of the joints Leukorrhea (thick, yellow and foul-smelling) Sores on lower extremities due to Damp Severe numbness and weakness in lower extremities T: Normal C: Yellow and greasy P: Soft and rapid
Treatment Principle	Eliminates Heat Resolves Dampness Cool the Blood
Herb Formulas	Si Miao Wan modified
Points	KI-3, KI- 6, REN-3, SP-8, SP-9, SP-10, ST-40 With hot flashes: + HT-6, KI-7