[Objective]To explore the prescription medication rules of medical cases of metrorrhagia and metrostaxis of ancient books in the Ming and Qing Dynasties and the understanding of ancient doctors on the pathogenesis of metrorrhagia and metrostaxis.The clinical efficacy of Ziyin Liangxue Decoction in the treatment of yin deficiency type of metrorrhagia and metrostaxis were retrospectively studied.[Methods]1.Review the literature to determine the search terms related to metrorrhagia and metrostaxis,search the medical cases related to metrorrhagia and metrostaxis in the column of"medical theory and medical cases" in the "Encyclopaedia of Chinese medicine",and screen the medical cases according to the inclusion and exclusion criteria,extract text information from the medical cases that meet the inclusion criteria,establish a database,and standardize the data.The basic information,symptoms,drugs,drug property,flavor,meridian distribution and efficacy were analyzed frequently by Excel table.The Apriori algorithm of SPSS Modeler18.0 software was used to analyze the association rules of high-frequency symptoms and drugs.The cluster analysis of high-frequency drugs was carried out by IBM SPSS Statistics 25.0 software.2.Based on the results of the above literature research,it is determined that yin deficiency is one of the most important pathogenesis of metrorrhagia and metrostaxis,and 56 patients with yin deficiency type metrorrhagia and metrostaxis with complete data from January 2020 to December 2022 were selected for a retrospective study to observe the days of vaginal hemostasis and TCM symptom scores before and after treatment,analyze the clinical efficacy of Ziyin Liangxue Decoction in the treatment of yin deficiency metrorrhagia and metrostaxis.[Results]1.A total of 104 medical cases were included,involving 32 doctors and 36 medical books,a total of 114 symptoms and 203 drugs,including 13 high-frequency symptoms and 22 high-frequency drugs.The drug properties involved three kinds of warm,flat and cold,the drug tastes involved six kinds of sweet,bitter,sour(astringent),pungent,salty and light,and the meridian distribution involved eight items of liver,spleen,kidney,heart,lung,stomach,gallbladder and large intestine.The drug efficacy was divided into five categories:nourishing yin and blood,warming yang and tonifying qi,astringing stop bleeding,clearing heat and cooling blood,regulating qi and harmonizing stomach;from the point of view of the correlation between symptoms and drugs,the drugs associated with the metrorrhagia were atractylodes&astragalus,licorice&angelica,ginseng&angelica,etc.The drugs associated with the metrostaxis were madder&white peony,madder&cuttlebone,madder&donkey-hide glue,etc.The metrorrhagia and metrostaxis drug group was divided into 4 categories:cluster 1:cuttlebone,madder,blood charcoal,palm charcoal,donkey-hide gelatin,eucommia ulmoides;cluster 2:radix rehmanniae,cortex moutan,radix paeoniae alba,radix angelicae sinensis,oyster;cluster 3:radix astragali,rhizoma atractylodis macrocephalae,radix glycyrrhizae preparata,radix ginseng,semen ziziphi spinosae,pericarpium citri reticulatae,fructus Jujubae,poria,radix codonopsis,radix rehmanniae preparata;cluster 4:ophiopogon Japonicus.2.In this study,the recent hemostatic effect was 87.5%,and the improvement effect of TCM symptoms was 89.29%.After treatment,the number of days of vaginal bleeding,vaginal bleeding chromatin,and the effect of reheating sweating,five feverish centres,insomnia and dreaminess,irritability and excitability,dry mouth and constipation,dizziness and tinnitus,lumbar and knee soreness were significantly ameliorated than before,and the difference was statistically significant(P<0.05).The proportion of people who recovered during menstruation after medication was 55.36%,and there was no obvious adverse reaction during medication.[Conclusion]Literature studies have found that the related drugs in the metrorrhagia are mainly warming yang and tonifying qi,and the commonly used drug pairs are atractylodes&astragalus,licorice&angelica,ginseng&angelica,etc;the related drugs in the metrostaxis are mainly nourishing yin and clearing heat,and the common drug pairs are madder&white peony root,madder&cuttlebone,madder&donkey-hide gelatin.The drug group of metrorrhagia and metrostaxis is divided into blood-tonifying and blood-activating drugs,qi-tonifying and yang-rising drugs and yin-nourishing and heat-clearing drugs,which are suitable for kidney deficiency and blood stasis type,spleen deficiency and qi collapse type and yin deficiency and internal heat type.The root cause of the pathogenesis is spleen and kidney deficiency,and the appearance is blood stasis and heat.Clinical studies have found that Ziyin Liangxue Decoction has a significant effect on patients with Yin deficiency metrorrhagia and metrostaxis,and can effectively eliminate symptoms such as reheating sweating,five feverish centres,insomnia and dreaminess,etc,but the recovery of menstrual cycle and menstruation still needs to be further strengthened. |