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menoxenia Composition: Main acupoints: Guanyuan (CV 4) and Sanyinjiao (SP 6) ; for blood heat, Taichong (LR 3) and

Xuehai (SP 10) are added; for qi deficiency, Qihai (CV 6) and Zusanli (ST 36) are added; for qi and blood stasis, Xuehai (SP 10) and Qihai (CV 6) are added. Source: A Handbook of Acupuncture and Mercibustion edited by Jin Rui and Huang Jiexin. Action: Regulating liver and kidney, dredging thoroughfare and conception vessels. Elucidation: Menoxenia is classified into advanced menstruation, delayed menstruation and menstruation at irregular intervals in accordance with its pathogens. Advanced menstruation is mostly caused by depressed liverqi transforming into fire which disturbs blood sea (uterus), or by heat accumulating in thoroughfare and conception vessels due to excessive intake of pungent foods on the basis of constitutional yang hyperactivity. Delayed menstruation results from long-term constitutional weakness and subsequent yin and blood insufficiency, or from diet, overstrain and excessive thought injuring spleen, all of which lead to inadequate qi and blood. Menstruation at irregular intervals is caused by emotional depression unable to disperse qi stasis normally, or by stagnant liver-qi and subsequent blood stasis, or by deficient kidney-qi unabe to store essence and failing to regulate thoroughfare and conception vessels and resultant disorder of blood sea to carry and transport blood. No matter what type of pathogen results in irregular menstruation, it is always concerned with the dysfunction of liver, spleen and kidney zang-organs, and with the disharmony between thorough-fare and conception vessels. Therefore, in this prescription acupoint Guanyuan (CV 4), the crossing point of thoroughfare vessel, conception vessel and three yin meridians of foot, is selected to regulate thoroughfare and conception vessels. Sanyinjiao (SP 6), the crossing point of the three meridians of liver, spleen and kidney, in combination with Guanyuan (CV 4) can regulate liver, spleen and kidney zang-organs and has a good effect on the menoxenia caused by previous pathogens. Acupoint Taichong (LR 3), the shu (stream)-point of foot-jueyin meridian and the yuan ( primary) -point of liver meridian, has the effect to smooth the liver-qi and clear away liver-heat, fit for the excess syndromes of liver meridian. Acupoint Xuehai (SP 10), together with Taichong (LR 3) has better effects on the menstrual disorders caused by the heat in the liver meridian attacking blood sea (uterus). Acupoint Qihai (CV 6) is a common key point for health and strength and acupoint Zusanli (ST 36), the He (sea)-point of stomach meridian, is also a key point for health and strength; the two acupoints together can promote the generation of qi and blood and consequently enrich qi and blood. Xuehai (SP 10) regulates blood and Qihai (CV 6) regulates qi; combination of the two acupoints can promote the flow of qi and blood. Indication: Menoxenia refers to the abnormal changes of menstrual cycle, menstrual colour, menstrual quantity and menstrual quality. Clinical manifestations vary with the causes of diseases. For example, as to menoxenia of blood-heat syndrome, the following symptoms possibly occur: advanced menstruation, profuse menstrual flow with dark-red colour, thick or even foul menstrual blood, flushed cheek and lip, dry mouth, restlessness, abdominal pain, irritability, short and red urine, red tongue and yellowish tongue fur, and rapid pulse; as to menoxenia of qi and blood deficiency, the following symptoms probably appear, delayed menstruation, scanty, light-red and thin menses, pale complexion, weakness of the four limbs, palpitation, vertigo, dizziness, or limp aching lumbus and knees, poor appetite, sloppy stool, whitish tongue and fur, and thready pulse; as to menoxenia of-qi and blood stasis, the following symptoms can arise: menstruation at irregular intervals, dark-red blood with many clots, distending pain in abdomen and chest, dark red tongue with petechia and wiry pulse. Performance: Guanyuan (CV 4) is vertically punctured 1.5 - 2.0 cun in depth and Sanyinjiao (SP 6) is perpendicularly needled 1.0 - 1.5 cun in depth; and reinforcing and/or reducing techniques are performed according to the condition whether the disease is in excess or in deficiency syndrome.

For blood heat, Taichong (LR 3) is vertically punctured or obliquely punctured 0.5 - 1.0 cun with the needle tip upward; Xuehai (SP 10) is perpendicularly needled 1.0- 1.5 cun with reducing manipulations. For qi and blood deficiency, Qihai (CV 6 ) is vertically punctured 1.0 - 2.0 cun; Zusanli (ST 36) is vertically needled 1.0 -1.5 cun; and reinforcing manipulations are given and moxibustion can be performed on the acupeints in accordance with the specific conditions. For qi and blood stasis, Xuehai (SP 10) is vertically punctured 1.0 - 1.5 cure Qihai (CV 6) is perpendicularly needled 1.5 - 2.0 cure and reinforcing manipulations are performed. All the needles in the acupoints are retained for 20 -30 minutes and manipulated 1 or 2 times on the basis of the disease. The acupuncture treatment is given once a day. Clinical material: Ji Ping et al treated 65 cases with menoxenia, whose ages ranged from 22 - 39 years old and courses of disease from 0.5 - 4 years, which was chiefly manifested by menstrual suppression, scanty menstrual blood, shorter menstrual period, longer menstrual cycle, galactorrhea and sterility, etc. Acupoints Zhongji (CV 3), Guanyuan (CV 4), Sanyinjiao (SP 6), Dahe (KI 12), Zigong (EX- CA 1), Zusanli (ST 36), Huatuo Jiaji (EX- B 2) of T4 T12 were selected as the principal points in the treatment of menoxenia. For liver-qi depression, Tai- chong (LR 3) and Ganshu (BL 18) were added; for kid- ney-yang deficiency, Shenshu (BL 23) and Mingmen (GV 4) were added; for liver-yin deficiency, Ganshu (BL 18) and Taixi (KI 3) were added; for spleen hypofunction and phlegm-dampness, Pishu (BL 20), Fenglong (ST 40) and Gongsun (SP 4) were added. Stainless filiform needles of No. 30 in size were inserted into acupoint by flicking the needles. For deficiency syndromes, reinforcing manipulation (for inducing a hot sensation) and 30-minute warm needling with moxibustion were given. For excess syndromes, reducing manipulation (for inducing cold sensation) was given. After manipulations, the needles were electrified with continous wave for 30 minutes, one treatment a day and 15 treatments making up one course. There is a 5-day interval between two courses and at most 5 courses were given. Results. 59 cases were cured (regular menstruation, becoming pregnant, clinical manifestations disappearing and experimental indexes restoring to normal); 2 cases were obviously improved (clinical presentations disappearing and related indexes approaching the normal); 3 cases were improved (clinical findings disappearing and a part of indexes turning to normal) ; 1 case failed (clinical manifestations and related indexes not changing significantly). [ Journal of Chinese Acupuncture and Moxibustion, 1997, (8) : 453] Shen Qigen treated 18 cases with menoxenia and profuse menstrual flow. Their ages ranged from 20 to 40 years old; the duration of sickness was within 1 year in 13 cases, over 1 year in 5 cases. All the 18 cases were cured. Treatment methods: Acupoints Xuehai (SP 10), Sanyinjiao (SP 6), Guanyuan (CV 4), Taichong (LR 3), Yinlingquan (SP 9), Zusanli (ST 36) and Shenshu (BL23), as the main points, were punctured. For dizziness and weakness, Sishenchong was added; for poor appetite, Neiguan (PC 6) and Shenmen (HT 7) were added; for hemicrania, Taiyang (EX - HN 5) was added. Chinese herbs Six-ingredient Rehmannia Decoction combining with Ingredient-altered AstragalusTangkuei Decoction were administered. [ Practical Journal of Combination of Chinese and Western Medicine, 1992, (7) : 419] Typical case: A Qiu, female patient, 21, unmarried, was initially seen in Sep. in 1993. Her menarche came on when she was at the age of 17. Her menstruation was usually irregular with scanty and light purple blood. Two months ago, when she was in menstrual period she suffered from a cold pathogen by having cold drink. Till now the menstruation did not come yet, accompanied by limp aching lumbus and knees, pain in the bilateral lower abdomen, pale tongue with thin fur, and deep, thready

and weak pulse. This was caused by insufficienct yin-blood due to congenitally deficient kidneyessence and inadequate tiangui, and accidently she was invaded by the cold drink which led to menstrual blood stasis and delayed menstruation. The treatment principle was to warm the meridian and disperse the cold, activate the blood and smooth the menstruation. The acupoints selected were Sanyinjiao (SP 6) (puncture), Hegu (LI 4) (puncture) and Guanyuan (CV 4) (moxibustion). Daily treatment was given. Till the third treatment, the menstruation came. Afterwards, Sanyinjiao (SP 6) and Shenshu (BL23) were needled with reinforcing techniques for 2 months to nourish liver and kidney, and enrich essence so as to consolidate the effects. She was told to have recovered in the next 1-month survey. [ Journal of Chinese Acupuncture and Moxibustion 1997, (9) : 554]

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