Introduction
Perimenopausal syndrome refers to a series of symptoms related to the dysfunction of automatic nerve before and after menopause. The clinical manifestations are menstrual disorder, tidal fever, irritability and susceptibility to rage, vertigo and tinnitus, amnesia and suspicion and abnormal sensation due to hypofunction of ovary, hyperthyroidism and hyperadrenalism as well as endocrine disorder. This syndrome is similar to the conceptions of “syndromes before and after menopause” and "visceral irritability" in TCM due to decline of kidney qi, exhaustion of reproductive essence, insufficiency of essence and blood, asthenia of the thoroughfare and conception vessels, imbalance between kidney yin and yang as well as dysfunction of the viscera.
Syndrome Differentiation
1. Asthenia of Liver and Kidney Yin
Dizziness and tinnitus, flushed complexion, night sweating and fever, aching pain in loins and knees, irregular menstruation with fresh red color and profuse or scanty menorrhea, reddish tongue with scanty coating, thin and rapid pulse.
2. Asthenia of Spleen and Kidney Yang
Pale complexion, dispiritedness, cold body and limbs, edema of lower limbs, thin and profuse leukorrhea, loose stool and dyspepsia, frequent urination in the night, deep and weak pulse.
3. Imbalance Between the Heart and Kidney
Palpitation and insomnia, restlessness, dreaminess and susceptibility to fright, bitter taste in the mouth and dry throat, reddish tongue with scanty coating, thin and rapid pulse.
4. Stagnation of Phlegm and Qi
Obesity, chest oppression and profuse phlegm, epigastric and abdominal distension and fullness, belching and acid regurgitation, edema and loose stool, greasy tongue coating and slippery pulse.
Treatment
1. Body Acupuncture
Prescription:
Sanyinjiao (SP 6), Qihai (CV 6), Shenmen (HT 7) and Baihui (GV 20).
Modification:
For asthenia of the liver and kidney, Taixi (KI 3), Taichong (LR 3) and Ganshu (BL 18) are added; for asthenia of spleen and kidney yang, Pishu (BL 20) , Zusanli (ST 36), Yinlingquan (SP 9) and Zhongwan (CV 12) are added; for imbalance between the heart and the kidney, Tongli (HT 5), Xinshu (BL 15), Shenshu (BL 23) and Zhishi (BL 52) are added; for stagnation of phlegm and qi, Fenglong (ST 40) and Tanzhong (CV 17) are added.
Performance:
Each time 5 - 6 acupoints are selected according to the pathological conditions. Sanyinjiao (SP 6), Qihai (CV 6) and Shenmen (HT 7) are needled with reinforcing technique; while Fengchi (GB 20) and Baihui (GV 20) are needled with reducing technique. For the treatment of asthenia of liver and kidney yin, Taixi (KI 3) and Ganshu (BL 18) are needled with reinforcing technique, while Taichong (LR 3) is needled with reducing technique; for the treatment of asthenia syndrome of spleen and kidney yang, reinforcing needling technique is used and needle-warming moxiubstion or moxa-roll moxibustion is used; for the treatment of imbalance between the heart and the kidney, Tongli (HT 5) is needled with reducing technique and the rest acupoints are needled with reinforcing technique; for the treatment of stagnation of phlegm and qi, reducing needling technique is used.
2. Ear Acupuncture
Prescription:
Endocrine (CO18), Internal genitalia (TF2), Sympathetic Nerve (AH6a), Subcortex (AT4), Kidney (CO10) and Liver (CO12).
Performance:
Each time 2 - 3 acupoints on one side are selected to seal with Wangbuliuxingzi (Semen Vaccariae). The patient is advised to press the sealed seeds on the selected ear acupoints 3 times a day. The sealed seeds are changed once every 3 - 4 days. Five to ten days make up one course of treatment.