Premenstrual depression

Depression Premenstrual distress Depression is a common clinical disease in women during the menstrual period and occurs in all age groups. It belongs to the category of mania and depression in traditional Chinese medicine, and also includes the "early menstrual anxiety syndrome" in modern science. In recent years, the author has used the method of soothing the liver and regulating qi to treat 30 cases of premenstrual depression and achieved good results. .

1 Clinical data 1.1 There were 30 cases in the general data group, with a minimum age of 14 and a maximum of 45 years old, including 17 cases aged 14-20 years old, 8 cases aged 21-30 years old, and 5 cases aged 31-45 years old. There were 21 single cases and 9 married cases. The shortest medical history was 3 months and the longest was 5 years. Among them, 25 cases had irritability and 5 cases had depression. 1.2 Clinical symptoms 4 to 5 days before the menstrual period, the patient feels depressed, talks to himself, or swears and cries, feels irritable, feels upset, has pain in both breasts, bloating in the ribs, pain in the waist and lower abdomen, has petechiae on the tongue, and has a deep pulse.

1.3 The diagnosis is based on the presence of depressive symptoms 4 to 5 days before menstruation, such as depression, talking to oneself, stupor or irritability, swearing and screaming, and the symptoms occur regularly every month for more than 3 months, and the central nervous system examination, head X-ray, head CT, EEG and uterine examination are all normal, and the patient is clear of mental disorders.

2 Treatment method: The treatment is to soothe the liver and regulate qi, promote blood circulation and remove blood stasis. The prescription is mainly based on Chaihu Shugan San, and it is interactive according to the symptoms. The prescription: Scutellaria 10g, Red Peony 10g, Notopterygium 10g, Cyperus 10g, Poria 12g, Citrus aurantium 10g, Licorice 6g, Chuanxiong 12g, Toosendan Fructus 10g, Curcuma 10g, Rhizoma Smilacis Glabrae 12g, and Motherwort Granules 15g. For those with qi deficiency, add Scutellaria baicalensis and Codonopsis pilosula; for those with excessive coolness, add cinnamon twig and Evodia rutaecarpa; for those with spleen deficiency, add Atractylodes macrocephala, Poria cocos, Chinese yam, and snow pea; for those with kidney deficiency, add Fenugreek, Curculigo orchioides, and Rhizoma Atractylodis Macrocephalae; for those with breast pain that cannot touch clothes, add Citrus aurantium and Vaccaria segetalis as appropriate. If liver depression turns into fire and liver yang rises, causing headache, bitter taste in the mouth, bad breath, dry mouth and tongue, fever, etc., you can remove the early-stage Notopterygium wilfordii and add Cortex Moutan, Gardenia jasminoides, Semen Cassiae, Herba Prunellae, etc. to soothe the liver, clear away heat and detoxify. Directions: Take 1 dose per day, decocted in water and taken orally in 3 times. Generally, take 2 to 5 doses of the medicine before each menstruation. Menarche occurs and symptoms disappear. The treatment lasted for 6 menstrual cycles. For patients whose menstruation had not come and whose symptoms had not subsided after taking 3 doses of the medicine, we added 5 mg of lutein copper intramuscular injection daily on the basis of Chinese herbal medicine until the menarche.

3 Results 3.1 Efficacy criteria Cure: Symptoms of depression subsided, menarche occurred, and the patient recovered. At the end of the 1-year follow-up, the patient showed no symptoms. The effect is significant: the symptoms of depression are relieved, and the duration of onset is shortened. The symptoms disappear after taking the medicine for 2 to 3 months during the cycle. Reasonable: You need to take medicine before each menstrual cycle to avoid the occurrence of symptoms and to ensure that menstruation comes on time. If you stop taking the medicine, the symptoms will reappear. Ineffectiveness: Symptoms of depression and irritability still occur during every menstrual cycle. 3.2 Treatment results: 16 cases were cured, 8 cases had significant effects, 3 cases had reasonable effects, and 3 cases had ineffective effects. The total efficiency is 90%. Generally, reasonable and significant effects or cure are achieved within 1 to 6 physiological cycles. There were 3 cases in which the treatment was still ineffective after 6 menstrual cycles.

4 Typical STD patient, female, 36 years old, nurse, married, pregnant woman 1, face-to-face consultation on April 28, 2000. In the past five years, every month 4 to 6 days before the period, I began to feel restless, talking to myself, and unable to sleep at night. Sometimes I wanted to quarrel with my family, and sometimes I wanted to cry. Taking stable drugs had little effect. The symptoms disappeared after the menstrual period was over. This happens every month, with symptoms that may be mild or severe. In recent months, the symptoms have worsened, so I sought treatment from traditional Chinese medicine. Current diagnosis: The patient is in a trance, mumbling to himself, confused speech, pain in the chest, flanks and breasts, distension and pain in the waist and lower abdomen, slight edema of the face, petechiae on the tongue, deep pulse, gynecological examination showed normal hair growth, psychiatric examination showed normal, head CT, EEG and other examinations were all normal. Western medicine diagnosed it as anxiety and depression, premenstrual anxiety syndrome, and Chinese medicine diagnosed it as depression and mania. It is caused by liver qi stagnation and blood stasis. The treatment should be to soothe the liver and regulate qi, promote blood circulation and remove blood stasis. The prescription is Chaihu Shugan San mixed with each other. The prescription: 10g each of Scutellaria baicalensis, Notopterygium wilfordii, Leonurus cacao granules, peach kernel, white peony root, Zedoariae rhizome, Corydalis yanhusuo, Safflower, Curcuma aromatica, 6g each of Cyperus rotundus, Curcuma zedoaria, and Trillium.