"Women's metrorrhagia is the most serious disease" (ancient and modern medical system). Xu Chunfu paid attention to metrorrhagia in the Ming Dynasty, which can be seen here. Uterine bleeding is one of the common diseases of women, including metrorrhagia and menstrual bleeding. Chao's "Etiology" said that "women's irregular menstruation, continuous dripping, is called leakage, sudden outbreak, is called collapse." Although there are also dramas that talk about symptoms in order of priority, for example, predecessors thought that "those who leak gradually collapse, those who collapse are very leaky" and "the disease of metrorrhagia depends on one syndrome, and those who are light are called leaks, even those who collapse." In fact, they all belong to abnormal bleeding. Moreover, the two can be transformed into each other, that is, "long-term collapse, qi and blood failure will inevitably lead to diarrhea, long-term diarrhea, and the progress of the disease will also lead to collapse." They are mutually causal, closely related, consuming blood and gas, and have a great influence on women's health.
There are many explanations on the syndrome differentiation and treatment of metrorrhagia and metrorrhagia in the literature. In terms of etiology, it is generally believed that it is caused by qi deficiency, spleen and stomach weakness, liver hyperactivity and blood heat, kidney deficiency, strain, qi stagnation and blood stasis. Generally speaking, it is inseparable from both yin and yang. Chen's Fu Fang holds that "frequent menstrual cramps are caused by the ups and downs of Yin and Yang". "Su Wen. "On Syndrome Differentiation of Yin and Yang" also said: "Yang pulse due to yin deficiency will collapse." Women belong to yin, mainly blood. Due to physiological characteristics such as prenatal delivery, yin and blood are easily consumed, and women are born with liver storing blood, and yang is the body yin. Deficiency of yin and blood is more likely to cause hyperactivity of yang, yin deficiency and hyperactivity of yang, which will force blood to run, and it will be hot because of blood heat, so there are many cases of collapse syndrome. Therefore, distinguishing yin and yang in clinical diagnosis is the key to syndrome differentiation. "Try to judge yin and yang, don't combine rigidity with softness, treat yin with yang disease and treat yang with yin disease." The so-called "governance must seek its roots." This is especially important for functional uterine bleeding and bleeding of uterine bleeding syndrome.
Collapse and leakage can be simply divided into two types: yin collapse and yang collapse. Yin deficiency and cold, Yang deficiency and heat syndrome. Judging from the color quality of bleeding, it is generally black and thin, belonging to yin, red and purple and thick. Therefore, yin collapse refers to negative symptoms and yang collapse refers to positive symptoms. Excess of yang refers to collapse of yang, while excess of yin refers to collapse of yin. Yin collapse is mostly yang deficiency, while Yang collapse is mostly yin deficiency. Therefore, the combination of tongue pulse and systemic symptoms can control the complexity and grasp the essence of the disease, so as to distinguish metrorrhagia from yin syndrome, yang syndrome, cold syndrome and heat syndrome.
There are three steps to treat collapse syndrome in the literature: intercepting, clearing away the source and restoring the old. There is a saying that "stop bleeding first and then stop its flow", which is an emergency measure to avoid excessive blood loss and collapse. For the general collapse syndrome, it really works for a while. However, for patients with uterine functional bleeding, if the cause is not identified, the prescription of hemostasis alone often cannot achieve the expected effect. The course of disease is long and lingering, except for substantive lesions (such as abdominal mass, etc.). It is very necessary to distinguish between yin and yang first, so as to establish the treatment policy and facilitate the use of drugs according to syndromes.
According to the principle that blood heat stops cold, yang collapse is more common in clinic. Qi Zhongfu's Hundred Questions on Gynecology says that "blood heat leads to yang collapse". There are many reasons for yang collapse due to yin deficiency, which are caused by seven emotions. For example, Zhang Jiegu thinks that "there are too many worries, the yang is moving inside, and the true yin deficiency can't keep fire, so the blood collapses." It is a big method to treat collapse syndrome, mainly by nourishing yin and clearing heat, cooling blood and stopping bleeding. Danxi believes that "Yang is often surplus and Yin is often insufficient", so "reinforcing Yin and purging Yang will stop the collapse". But there are also some cases where yang deficiency suddenly collapses or collapses for a long time. For example, Xiao Shenzhai's "Women's Classic" said that "the collapse is due to blood disease and yang deficiency, and blood loss is also lost." Blood is the material basis of qi. Excessive blood loss will lead to blood death and damage to yin, while insufficient yin blood will lead to qi attachment and yang deficiency will lead to collapse. Therefore, the cases of collapse caused by yang deficiency are mostly caused by too long collapse time, except for the element body yang deficiency. Although in clinic, blood collapse caused by yang deficiency is relatively rare, but it is not uncommon, and the symptoms are more serious, which must be paid attention to. Symptoms of metrorrhagia involving yin deficiency or yang deficiency are more common in young and middle-aged women. Generally speaking, when the kidney qi is not suitable for filling or will not decrease, the yin and yang will be more deficient, so the metrorrhagia of deficiency syndrome is equivalent to ovulation or anovulatory dysfunctional uterine bleeding in adolescence and menopause in modern medicine. From the beginning of metrorrhagia and metrorrhagia, it is necessary to distinguish between yin and yang, which will inevitably involve yin and yang in the long run. Therefore, if the treatment of metrorrhagia can be based on syndrome differentiation, the curative effect will be more obvious.
In order to differentiate syndromes and improve curative effect, Fang Yaozhong emphasized "seeking the root, stopping bleeding". Although it is necessary to stop bleeding, blind hemostasis is not advocated. Practice has proved that there are obvious differences between the two effects. This paper gives an example of treating collapse syndrome from yin and yang.