The Research Of Clinic Guide Of Delayed Menstruation

Objective:1 Through systematic literature research on delayed menstruation, excavated and collect data of treatment on delayed menstruation , Statistical analysis of the data, provide the literature basis for expert advice.2 Search results based on the literature research design expert advice, Experts using the Delphi method to survey. Through each round of data analysis to understand the definition of delayed menstruation, diagnosis, classification, composition and treatment of syndrome characteristics. To develop treatment guidelines delayed menstruation, Help to improve the diagnosis and treatment delayed menstruation.Methods1 Literature research Access to library collections of ancient Chinese medicine gynecology books, "China Medical Books Dictionary " as a search tool, For hand-inspection, Hebei Medical University Library, International Peace Hospital in Shijiazhuang, Hebei Province, library, Hebei Province People's Hospital since the Tang Dynasty, the existing library of 72 books of literature; Using CJFD, China Doctor Dissertations Full-text databases, full text database of Chinese excellent Master thesis, China and other important meetings to full-text database machine review. Books, documents and reports consolidated results of the study of literature, Expert advice for the development of the late period provide the basis for the questionnaire.2 Expert surveyOn the basis of the literature,experts using the Delphi method to survey.2.1 Preparation of expert consultation questionnaire2.1.1 10 professionals selected to expert advice survey format, Preface , item pool content filtering, recycling methods and other issues questionnaire to listen. Synthesis of the views heard, to revise and improve the expert consultation questionnaire, and then a formal investigation experts.2.1.2 Expert advice in both the closed questions the questionnaire have open questions. The problem is that researchers closed the answer for choice; open question refers to the content of respondents to fill out.2.2 Experts constitutesSelect 23 research centers, each center from 1 to 5 experts, including Chinese medicine experts, an expert in Integrative Medicine and Acupuncture Experts five formal investigations. the selection of experts must have: are senior professional title; in more than 20 years of clinical gynecology; of this disease has done some research.3 Statistical Methods3.1 Literature, statistical methodsThe literature mining and extraction of data entry Excel tables, create the database. Mainly uses the frequency, frequency, proportion and other descriptive statistics.3.2 Statistical method expert consultation questionnaireEach round of questionnaires Excel table of all data entry, create the corresponding database for each round. By SPSS17.0 software, frequency, mean, coefficient of variation, statistical indicators.Results:1 Literature results1.1 Diagnosis of delayed menstruationHistory:After abortion or medical abortion,congenital deficiency conditions fail to materialize then,work pressure or nervous,feeling cold drink cold,lose weight.Clinical manifestations:Delayedmore than 7 days menstrual cycle,or even3 to 5 months and his party;cycle delay 2 Cycles or more consecutive;menstrual normal;with hypomenorrhea. Check:Gynecologicalexamination,B-ultrasound,pregnancytesting,reproductive endocrine hormones,basal body temperature measurement,endometrial biopsy,probe check the uterine cavity.Differential Diagnosis:Fetalspotting,and on months, pregnancy. 1.2 Delayed menstruation syndromeDelayed menstruation syndrome by the late order of frequency were:blood deficiency, excess cold syndrome, Qi stagnation, deficiency cold, phlegm dampness, kidney deficiency.1.3 Distribution of post-menstrual syndrome factorBlood deficiency syndrome: menstruation, pale, pink color, the color dark red, thin quality, quality clear, pale complexion, pale skin, do not run, looking minimalist, dizziness, palpitations, insomnia, palpitation, frail , empty stomach pain, stomach ache rain, abdominal pain, rubbing hi by hi.Excess cold syndrome: menstruation, the dark color, the color dark red, the color dark purple, blood clots, lower abdomen Leng Tong, abdominal cramps, pain refused to press, have reduced heat pain, pale, pale plainer, limb Cold chills, dizziness, abdominal nausea.Qi stagnation syndrome: menstruation after the fault, the line of poor, normal and less color, the color dark red, the color Anhei, a blood clot, even the pain of small abdominal distension, abdominal pain, mental depression, mental depression, breast tenderness Xiong Xie, Chest tightness uncomfortable, like when you sigh, looking dark blue.Deficiency cold syndrome: The little pale, dark color by a small, quality Qingxi, quality thin, pale huang white, pale, abdominal pain, rain, abdominal pain, abdominal Leng Tong, Hei Hei by warm, backache, weakness, lassitude Leng Tong , Dizziness, short breath, dizziness, palpitations, urine long, loose stool.Phlegm dampness syndrome: sticky through to pale, pale and thick, blood mixed with mucus, obesity, vaginal discharge and more,looking huang white,chest tightness,abdominal swelling, abdominal nausea Oue, heart palpitation,shortness of breath,lazy action,mental fatigue,Fu Man loose stools. Kidney deficiency syndrome: delayed menstruation less, the color dark red, the pale dark, thin quality, quality Qingxi, dark complexion dark, dark facial spots, backache, cold extremities, lumbosacral soreness, backache petrified, dizziness Tinnitus, Qingxi vaginal discharge, urinary frequency and color clear, nocturia.1.4 Tongue and pulse period distribution of delayed menstruationBlood deficiency syndrome: pale tongue, pink tongue, no moss, empty pulse small, weak pulse.Excess cold syndrome: normal tongue, dark purple tongue, thin white fur, tight pulse, the pulse was late.Qi stagnation syndrom: Tongue normal, thin yellow tongue coating, thin white fur, pulse string Shibuya, pulse string. .Deficiency cold syndrome: pale tongue, thin white fur, white fur, the pulse delay, weakness, weak pulse weak.Phlegm dampness syndrome: pale tongue, greasy moss, thick and greasy fur, slippery pulse, slippery pulse string.Kidney deficiency syndrome: dark pale tongue, pale tongue, thin white fur, thin pulse, the pulse was late.1.5 Prescription and therapies of delayed menstruation Blood deficiency syndromeGoverning Law: Blood-based, accompanied by help gas; blood support battalion, accompanied by Qi; nourishing spleen menstruation.Prescription: Ginseng Yang Rong Tang, Zi blood ginseng soup, Bazhen Decoction.Excess cold syndromeGoverning Law: The line of stagnation temperature; warmthrough the cold-dispelling menstruation; warm through the cold, promoting blood circulation to regulate menstruation.Prescription: Wenjing Tang, Evodia soup, turmeric soup. Qi stagnation syndromGoverning Law: On Yu Qi, promoting blood circulation to regulate menstruation; qi and blood circulation; liver qi stagnation, nourishing menstruation.Prescription: Modified Wu Yao Tang, the system Cyperus rotundus seven pills, CHSGS, Xiaoyaosan.Deficiency cold syndromeGoverning Law: nourishing and warm through, Fu Yang and cold; blood temperature by Fu Yang.Prescription: Camp fry and warm soup, warm house with Viagra pills. Phlegm dampness syndromeGoverning Law: phlegm dampness, promoting blood circulation to regulate menstruation; spleen dampness, Ditan meridians.Prescription: Xionggui Erchen, Dao Tan Cang with Pill, Six Gentlemen Decoction, Qi Gong pill.2Kidney deficiency syndromeGoverning Law: kidney nourishing menstruation; kidney Qi, nourishing menstruation; Kidney Yang Jing menstruation.Prescription: Shen Qi Wan, Rehmannia Decoction Angelica, addition and subtraction BREE dodder pills.2 Expert consultation questionnaire results2.1 Diagnosis of delayed menstruationHistory: deficiencies;-pressure or psychological stress; abortion or medical abortion after; weight loss; sense of cold drinks cold.Clinical manifestations: delayed menstrual cycle, more than 7 days, or even 3 to 5 months and his party, the cycle delay of 2 cycles of continuous, with hypomenorrhea.Check: gynecological examination, B-ultrasound, reproductive endocrine hormones, basal body temperature measurement, a pregnancy test.Differential diagnosis: fetal spotting, and on months ,pregnancy.2.2 Delayed menstruation syndrome according to the frequency from high in the end the following order: Kidney deficiency syndrome, Blood deficiency syndrome, Blood cold syndrome (Deficiency cold syndrome, Excess cold syndrome), Phlegm dampness syndrome, qi stagnation syndrome.2.3 Distribution of delayed menstruation syndrome2.3.1 Kidney deficiency syndromeMain syndromes: delayed menstrual cycle, less, the pale dark, quality Qingxi; looking dark dark or dark spots, dizziness, tinnitus, weak waist, nocturia; dark pale tongue, thin white fur pulse Fine. Governing Law: kidney Qi, nourishing menstruation.Prescription: Angelica Di Huang Yin.2.3.2 Blood Deficiency syndromeMain syndromes: delayed menstrual cycle, less color, pink, quality thin; pale or sallow complexion, dizziness, palpitations, insomnia, stomach ache rain; tongue is pink, thin fur, thready and weak pulse. Governing Law: in nutritional blood, Qi menstruation.Prescription: Ginseng Yang Rong Tang.2.3.3 Blood cold syndrome 2.3.3.1 Deficiency cold syndromeMain syndromes: delayed menstrual cycle, less, light incolor, quality Qingxi; abdominal Leng Tong, Hei Hei by warm, backache, weakness, urine long, loose stools thin; pale tongue, white coating, weak pulse delay. Governing Law: The Fu Wen Yang, nourishing menstruation.Prescription: Wenjing Tang ("Golden Chamber")).2.3.3.2 Excess cold syndromeMain syndromes: delayed menstrual cycle, less color Anhei, there are the blood clots; abdominal Leng Tong refused to press, aversion to cold; dark tongue, white coating, pulse tight.Governing Law: warm through the cold, promoting blood circulation to regulate menstruation.Prescription: Wenjing Tang ("Woman Daquan recipe").2.3.4 Phlegm dampness syndrome Main syndromes: delayed menstrual cycle, less, blood mixed with mucus, quality of adhesion; usually taken off the volume, body fat, abdominal nausea Oue, Fu Man loose stools; tongue pale, greasy fur, slippery pulse.Governing Law: phlegm dampness, promoting blood circulation to regulate menstruation. Prescription: Dao Tan Cang with pills.2.3.5 Qi stagnation syndromeMain syndromes: delayed menstrual cycle, less color, dark red, or small; abdominal pain, breast tenderness or Xiong Xie; tongue as normal, pulse string.Governing Law: qi stagnation line, promoting blood circulation to regulate menstruation. Prescription: Wu Yao Tang.Conclusion:The subject of the use of evidence-based medicine philosophy, literature review and expert survey using the method of combining the definition of the late period, diagnostic, syndrome, syndrome composition and treatment (the dialectical therapy, Chinese medicine treatment and external treatment) study, the conclusion as follows:1 By comparing before and after the founding of the founding of the literature post-menstrual syndrome can be found after the founding of an increase in kidney deficiency syndrome, depression Syndrome, renal deficiency, blood deficiency, spleen, kidney deficiency, kidney deficiency syndrome, cold coagulation stagnation, and to increase the number of syndromes and treatment elements of the syndrome.2 After two rounds of expert investigations, experts on the definition of the late period, diagnostic, syndrome, syndrome composition and treatment (the dialectical therapy, Chinese medicine treatment and external treatment) reached a consensus to develop a draft guide to diagnosis and treatment of the late period of the menstrual regulate the initial diagnosis and treatment of the late, late diagnosis and treatment for menstruation development of guidelines laid a solid foundation.