Professor Kang Youwen's Experience in Differentiated Treatment of Perimenopausal Syndrome
Professor Kang Youwen believes that the pathogenesis of perimenopausal syndrome(PMS)primarily involves kidney essence deficiency,with kidney yin deficiency being particularly common in clinical cases,often affecting the heart,liver,and spleen.Professor Kang asserts that the imbalance of kidney yin and yang and the deficiency of kidney essence are the fundamental causes of PMS.There-fore,the treatment should focus on nourishing the kidney,replenishing essence,nourishing yin,benefiting the kidneys,fostering yin,subdu-ing yang,and balancing yin and yang.Prolonged kidney yin deficiency can lead to kidney essence depletion;hence,while nourishing kidney yin,it is also necessary to replenish kidney essence,calm the heart,and nourish blood to relieve dryness.Commonly used drugs include Shudihuang(Radix Rehmanniae Praeparata),Yinyanghuo(Herba Epimedii),Heshouwu(Radix Polygoni Multiflori),Danggui(Radix Angelicae Sinensis),Shanyurou(Fructus Corni),Tusizi(Semen Cuscutae),Gouqizi(Fructus Lycii),Guibanjiao(Colla Testudinis Plas-tri),Duzhong(Cortex Eucommiae),Xuanshen(Radix Scrophulariae),Mudanpi(Cortex Moutan),Baiziren(Semen Platycladi),Fushen(Sclerotium Poriae Pararadicis),Huainiuxi(Radix Achyranthis Bidentatae),Mohanlian(Herba Ecliptae),Nvzhenzi(Fructus Ligustri Lu-cidi),etc.For those with night sweating due to yin deficiency,Digupi(Cortex Lycii),Qinghao(Herba Artemisiae Annuae),Biejia(Cara-pax Trionycis),Muli(Concha Ostreae),Fuxiaomai(Fructus Tritici Levis),etc.are added to nourish yin,subdue yang,and arresting swea-ting.For those with dry mouth and throat,Maidong(Radix Ophiopogonis),Shashen(Radix Adenophorae seu Glehniae),Yuzhu(Rhizoma Polygonati Odorati),Zhimu(Rhizoma Anemarrhenae),and Baiwei(Radix et Rhizoma Cynanchi Atrati)are added to nourish yin and re-lieve dryness.For those with difficulty in sleeping and frequent waking,Yejiaoteng(Caulis Polygoni Multiflori),Longyanrou(Arillus Lon-gan),Suanzaoren(Semen Ziziphi Spinosae),etc.are added to nourish the heart and calm the mind.For those with sore lower back and knees,Shudihuang(Radix Rehmanniae Praeparata),Nvzhenzi(Fructus Ligustri Lucidi),Mohanlian(Herba Ecliptae),Duzhong(Cortex Eucommiae),Mudanpi(Cortex Moutan),Tusizi(Semen Cuscutae),Xianmao(Rhizoma Curculiginis),Guibanjiao(Colla Testudinis Plas-tri),Danshen(Radix Salviae Miltiorrhizae),Mudanpi(Cortex Moutan),etc.are added.For those with vexing heat in the chest,palms and soles,Digupi(Cortex Lycii),Shengdihuang(Radix Rehmanniae),Mudanpi(Cortex Moutan)are added.As women approach menopause,the inability of kidney yin to nourish heart yin can lead to symptoms such as irritability,insomnia,and vivid dreams due to the overactivity of heart fire.The treatment for these symptoms in menopausal women should focus on nourishing kidney yin and clearing the heart to calm the mind,using commonly prescribed drugs such as Gouteng(Ramulus Uncariae Cum Uncis),Lianzixin(Plumula Nelumbinis),Zhenzhu-mu(Concha Margaritiferae Usta),Huanglian(Rhizoma Coptidis),Muli(Concha Ostreae),Baihe(Bulbus Lilii),Yujin(Radix Curcum-ae),Hupo(Succinum),etc.to clear the heart,subdue yang,and calm the mind.For palpitations,Fushen(Sclerotium Poriae Pararadicis)and Yuanzhi(Radix Polygalae)are added.For insomnia and vivid dreams,Yejiaoteng(Caulis Polygoni Multiflori),Longyanrou(Arillus Longan),Suanzaoren(Semen Ziziphi Spinosae),etc.are added are added.When liver and spleen functions are imbalanced,menopausal women are prone to symptoms such as tidal fever,night sweating,palpitations,and insomnia due to kidney essence deficiency and liver blood deficiency.Treatment should focus on regulating and tonifying the liver and spleen to restore physiological functions,with commonly used drugs including Dangshen(Radix Codonopsis),Huangqi(Radix Scutellariae),Banxia(Rhizoma Pinelliae),Chenpi(Pericarpium Citri Reticulatae),Huaishanyao(Rhizoma Dioscoreae),Baizhu(Rhizoma Atractylodis Macrocephalae),Fuling(Poria)and Baishaoyao(Radix Paeoniae Alba).Additionally,it is essential for menopausal women to manage their emotions,maintain a joyful state of mind,en-gage in social activities,exercise appropriately,and maintain a healthy diet to promote physical recovery.Kidney yin deficiency is often ac-companied by liver yin and blood deficiency,leading to a failure of yin to anchor yang and resulting in hyperactive liver yang.While re-plenishing kidney essence,it is also important to nourish blood,soften the liver,soothe the liver,and relieve depression.Commonly used drugs include Chaihu(Radix Bupleuri),Jingjiesui(Spica Schizonepetae),Danggui(Radix Angelicae Sinensis),Shaoyao(Radix Paeoniae Alba seu Rubra),Hehuanpi(Cortex Albiziae),Yujin(Radix Curcumae),Xiangfu(Rhizoma Cyperi),Cijili(Fructus Tribuli),Zhiqiao(Fructus Aurantii),Xuduan(Radix Dipsaci),Tusizi(Semen Cuscutae),Shanyurou(Fructus Corni),Nvzhenzi(Fructus Ligustri Lucidi),Huangbai(Cortex Phellodendri Chinensis)and Zhimu(Rhizoma Anemarrhenae).Furthermore,Professor Kang often integrates various ap-proaches to help patients calmly face the natural state of life,ensuring a smooth transition through menopause.Through appropriate medica-tion and patient self-regulation,patients can better cope with the challenges posed by PMS,regaining health and confidence.
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