1. Four kinds of diagnosis

(1) Consultation (essentials of diagnosis and treatment, the first clinical task)

Content: Age (first question), chief complaint, present medical history, menstrual history, leucorrhea history, marriage and childbearing history, postpartum, past history, family history, etc.

Example:

(2) Observation: spirit shape, complexion, body shape, tongue picture, menstruation, leucorrhea, lochia, vulva and vagina, milk, etc.

Menstruation:

Excessive menstrual flow, light color and thin quality? Qi deficiency; Less menstruation, pale face and thin body? Deficiency of kidney yang;

Less menstrual flow, reddish color and thin quality? Blood deficiency; A lot of menstruation, dark red in color and thick in quality? Hyperhematic fever;

Less menstrual flow, bright red color and thick texture? Excessive blood heat due to yin deficiency; Menstruation is short in duration and dark purple in color. Blood stasis and qi stagnation.

Take off:

Is the color white and the quality thin? Spleen deficiency and kidney deficiency; Yellow, thick? Damp heat; Red or mixed color? heat toxin

lochia

Large quantity, light color and thin quality? Qi deficiency; Bright red or purple, sticky? Blood heat; Do you have purple and black ones? Blood stasis

(3) Listen to the diagnosis

It is very important to listen to sounds, fetal heart rate (120- 160/ min) and smell (the smell of menstruation, leucorrhea and lochia). )

(4) Pulse diagnosis: pulse cutting, abdomen cutting and skin cutting.

feel/take sb's pulse

The moon of meridians, slippery benefits are vulgar; The pregnant pulse is smooth, and the ruler pulse is pressed endlessly; During labor, the pulse (far from the meridians) is large and slippery, and the ulnar pulse turns sharply. The pulse from the middle finger to the tail of the finger should be sharp; Postpartum pulse is weak, slow and peaceful.

2. Key points of syndrome differentiation

The main points of syndrome differentiation of pregnancy diseases are as follows: first, it is necessary to distinguish between fetal disease and maternal disease; Secondly, we should distinguish between safe and unsafe fetuses; Finally, syndrome differentiation is carried out by combining viscera, qi and blood.

Postpartum disease? Third trial? First, check the mild abdominal pain and indolence to determine lochia stagnation; Second, check whether the stool passes to test the rise and fall of body fluids; Re-examine the line and decline of milk, the amount of diet, and the strength of stomach qi. Syndrome differentiation combined with viscera and qi and blood.

3. The combination of TCM disease differentiation and syndrome differentiation refers to the differentiation of TCM diseases first and TCM syndromes later.

Treatment of gynecological diseases

According to the characteristics of female blood deficiency and qi exuberance, attention should be paid to protecting seminal blood during treatment.

Treatment principles: regulating viscera, regulating qi and blood, regulating strange meridians, and periodic therapy.

1. Internal treatment:

I tonify viscera:

(1) Nourishing kidney and tonifying kidney

① Nourish kidney qi? Shoutai Pill and Shenqi Pill

② Warming and tonifying kidney yang? Gui You pills, Gui You drinks and warm cell drinks.

3 Bushen Yiqin? Zuogui Pill and Liuwei Dihuang Pill

(2) Soothing and nourishing the liver

1 Shugan Jieyu? Chaihu Shugan decoction, Sini powder, Xiaoyao powder

2 Shugan Qingre? Danzhi Xiaoyao Powder, Qinggan Jingying Decoction

3 nourishing blood and softening the liver? Yangjing Zhiyu Decoction, Qiju Dihuang Pill, Sanjia Fumai Decoction, Jiao Ling Gouteng Decoction.

(3) Strengthening the spleen and regulating the stomach

① Jianpi method

Strengthening spleen and nourishing blood? Bazhen Decoction, Ginseng Yang Rong Pill.

Spleen and dehumidification? Atractylodes macrocephala powder and Wandai decoction

Buqi and blood? Guben Zhibeng Decoction, Anchong Decoction and Guipi Decoction

Strengthening spleen and rising yang? Buzhong Yiqi Decoction and Juyuan Decoction

② stomach-harmonizing method

And a stomach drop? Xiangsha Liujunzi Decoction, Xiaobanxia Fuling Decoction

Clearing stomach and descending adverse flow? Dried tangerine peel and bamboo shavings, Suye Huanglian decoction

Ⅱ regulating qi and blood:

(1) regulating qi method

Regulate qi and relieve depression? Jinlingzi Powder and Jiawei Wuyao Decoction

Butch, lifting? Sijunzi Soup, Shen Du Soup and Orange Garden Soup.

Regulating qi and descending adverse flow

(2) regulating blood

1 blood? Siwu Decoction, Danggui Buxue Decoction, Ginseng Yang Rong Decoction.

② Clearing heat and cooling blood? Jing Qing Powder, Yin Bao Decoction, Liangdi Decoction, Baizhi Dihuang Pill.

3 clearing away heat and detoxifying? Wuwei Xiaodu Yin and Yinjia Pill

④ Warming meridians to dispel cold? Liang Fang Wenjing Decoction, Aifu Wengong Pill, Jingui Wenjing Decoction.

⑤ Promoting blood circulation and removing blood stasis (promoting blood circulation, promoting blood circulation and breaking blood)? Wang Qingren's Zhuyu Decoction, Shenghua Decoction and Shixiao Powder

ⅲ diuretic expectoration? Baizhu Powder, Jiangu Decoction, Ditan Decoction, Cangfu Daotan Pill

Fourth, adjust the Chong Ren Du Dai

ⅴ regulating the uterus: warming the meridians and warming the uterus, purging heat and clearing the uterus, nourishing and benefiting the uterus, removing blood stasis and invigorating the uterus.

ⅵ Regulating the Reproductive Axis of Kidney-Tiangui-Chongren-Uterus: Circulation Therapy and Acupuncture Therapy

Traditional Chinese medicine artificial cycle therapy

Late menstruation? Nourishing kidney yin and nourishing essence and blood

Intermenstrual period? Bushen Huoxue

Premenstrual period? Tonifying kidney and nourishing yin

Menstruation? Regulating qi, promoting blood circulation and regulating menstruation

2. Extraterritorial jurisdiction:

Vulva fumigation and washing (sitz bath), vaginal washing, vaginal medication, intrauterine injection, anal introduction, external hot ironing, drug iontophoresis, interventional therapy and surgical treatment.