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TCM > gyno > Flashcards

gyno Flashcards

1
Q

causes of irregular period

A

liver qi stag
heat in blood
qi xu
cold in uterus
yang xu
blood stag

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2
Q

liver qi stag cycle symptoms

A

period 7 or more days before or after expected period, breast distension, abdominal and hypochondriac distension, irritability, frequent sighing, belching. Pulse wiry, tongue red sides

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3
Q

stress reduced hormone output partially so there is a minimum amount of LH to luteinise a follicle without ovulation occurring

A

liver qi stag

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4
Q

period that comes sooner than 27 days after last period, either excess or xu

A

early cycle

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5
Q

early onset period, sudden onset, often with profuse, heavy flow, red with no purple or clotting, other symptoms

A

heat in the blood

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6
Q

potential causes of early cycle

A

excess internal hear (anxiety, infection)
yin xu with yang excess (false heat)
overconsumption of warm or pungent foods
overuse of warming herbs acting on the uterus
liver qi stag transformed into fire

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7
Q

unable to lift yang and contain blood, thin, light and watery consistency, early onset, sooner than 27 days with no force.may e accompanied by brown spotting almost immediately

A

(spleen) qi xu

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8
Q

causes blood stag, dark and clotted period, abdomen feeling cold with palpation, tongue pale purple, pulse tight and deep

A

cold in the uterus

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9
Q

impedes menstrual flow, BBT needs to rise due to progesterone, if progesterone is xu, yang will not rise, it will take longer for the cycle to function, will feel more fatigued than cold, but prefers warmth and pressure

A

yang xu

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10
Q

develops as a long term consequence of retained cold, retained damp heat or kidney xu, sea of blood will not be filled or empty completely, negatively impacts the function of the heart, since it controls blood circulation, pulse tight and thready, tongue dark purple, history of clotted and/or painful periods

A

blood stag

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11
Q

has the same time period between each menses, controlled consistent flow, asymptomatic, clear and concise start and stop

A

regular menses

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12
Q

if the period starts in the evening or overnight, no matter how heavy the flow is, the next day is counted as

A

day 1

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13
Q

day 1 of menstrual cycle

A

first day of RED bleeding

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14
Q

both oestrogen and progesterone are low to enable the uterine lining to shed, pituitary gland starts to produce FSH and LH to stimulate new follicles growth

A

day 1-5 of menstrual cycle

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15
Q

one of the follicles evolves and starts to produce oestrogen

A

day 7 of menstrual cycle

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16
Q

high levels of oestrogen stimulates the endometrium to thicken and the cervical mucus glands to produce fertile mucus

A

day 7-12 of menstrual cycle

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17
Q

continuing high oestrogen acts on pituitary gland to stimulate it to produce a surge of LH which matures the dominant follicle

A

day 12-13 of menstrual cycle

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18
Q

egg is released from follicle

A

day 14 of menstrual cycle

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19
Q

corpus luteum forms from the empty follicle and produces progesterone

A

day 15-25 of the menstrual cycle

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20
Q

corpus luteum dies causing progesterone and oestrogen levels to drop, causing endometrium to disintegrate and period to start, pituitary gland is stimulated to produce FSH and LH to start the next batch of follicles

A

day 25-28 of the menstrual cycle

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21
Q

regular cycle is considered between

A

27 and 34 days

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22
Q

the luteal phase should be ____ to be considered fertile

A

10-16 days long

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23
Q

BBT

A

basal body temp

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24
Q

kidney yin xu

A

increasingly common. older women, overwork

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25
Q

kidney yang xu

A

constitutional, injury by cold, overwork, longterm yin/qi xu or heart/liver stag

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26
Q

jing xu

A

constitutional, prolonged hormone treatment, prolonged illness

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27
Q

blood stag

A

prolonged cold, damp heat, kidney xu

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28
Q

liver/heart stag

A

sudden shock, prolonged anxiety, historical trauma

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29
Q

phlegm damp accumulation

A

infection, excess rich and sweet diet (obesity), PCOS, often develops secondary to previous symptoms

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30
Q

excessive menstrual flow

A

menorrhagia or flooding

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31
Q

bleeding outside the expected cycle

A

metrorrhagia

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32
Q

factors causing menorrhagia

A

blood heat - profuse, bright red
blood empty heat - less heavy, prolonged spotting at end, red colour
qi xi - spleen yang, kidney yin/yang. flooding at beginning or prolonged spotting, pale red
blood stasis - excess loss during period, possibly loss before the period. dark and clotted

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33
Q

menorrhagia treatment

A

harmonize blood
treat the root cause
astringe
treat qi

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34
Q

how to harmonize blood

A

stop bleeding - sp8 w moxa, r6, du20
eliminate stasis - sp10, stm36, lv8, r4, r6
calm blood - lv2, kd2, sp6, li11
nourish blood - st36, r6, st30, sp6, lv8

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35
Q

sudden flooding, trickling red flow for long after, bright red colour, thirst, red face, agitation, feeling of heat, dark urine, constipation, tongue red with yellow coating, pulse rapid and overflowing

A

blood heat

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36
Q

treatment principle for blood heat

A

clear heat, stop bleeding, cool blood
sp4 and pc6 open sea of blood to control all blood
li11, sp10 to cool blood and stop bleeding
sp8 stops uterine bleeding
kd5 cools uterine blood
sp6 moves and cools blood

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37
Q

sudden flooding outside of expected dates, trickling for many days after expected end, fresh red colour, watery texture, mental restlessness, evening heat, malar flush, scanty dark urine, dry stool, tongue red no coating, pulse floating and empty

A

blood empty heat

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38
Q

treatment principle for empty blood heat

A

clear empty heat, stop bleeding, cool blood, nourish yin
kd2, lv3 cool blood, clear false heat
li11, sp10 cool blood and stop bleeding
sp8 stops uterine bleeding
kd5 coold blood in uterus
sp6 cools and moves blood
r4 nourishes yin

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39
Q

hesitant start and intermittent flow, when it starts again after stopping it floods, trickling flow for a long time after end, premenstrual pain, dark colour and clotted, abdominal distension, dark complexion, tongue purple/red, pulse choppy

A

blood stasis

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40
Q

treatment principle for blood stasis

A

move blood, eliminate stasis, stop bleeding
lv3 free flow of qi to move blood
lv1 moves liver blood, stops bleeding
sp8 stops uterine bleeding
sp4 and pc6 moves blood and subdue rebellious qi
sp6 cools and moves blood
sp10 moves blod, stops bleeding
st30, sp 12 are penetrating vessel, moves blood

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41
Q

menstrual bleeding either scanty or abundant, mid cycle bleeding, sticky blood mixed with significant amounts of mucus, yellow brown discharge premenstrually, no clots, heavy, dragging sensation in lower abdomen, chest oppression, scanty dark urine, burning urination, significant vaginal discharge, coating sticky yellow, pulse slippery

A

damp heat in uterus

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42
Q

treatment principle for damp heat in uterus

A

clear heat, resolve damp, cool blood, stop bleeding
li11 sp10 cool blood, stop bleeding
sp8 stops uterine bleedings
sp4, pc6 open the penetrating vessel to move blood and subdue rebellious qi
sp6 cools and moves blood
sp1 empirical point to stop uterine bleeding
sp9, r3, resolve damp heat in lower jiao
bl22, bl32 promote transformation of fluids, resolve lower jiao damp heat

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43
Q

period comes with a flood, turns to trickle for long time after initial flood, pale colour, watery consistency, pale face, tiredness, slight dizziness, no appetite, loose stool, tongue pale with teethmarks, pulse weak

A

spleen not holding blood

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44
Q

treatment principle spleen not holding blood

A

tonify qi, strengthen spleen, nourish blood to stop bleeding
r6t tonifies qi, stops bleeding by stopping qi sinking
sp6, st36, r12, bl20, bl21 tonify spleen qi
du20 raises qi, stops bleeding from sinking qi

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45
Q

prolonged bleeding, trickle for a long time after proper period, late onset period, late onset period, pale colour, felling cold, sore back, cold limbs, pale complexion, weak knees, pale urine, tongue pale and swollen, pulse deep and weak

A

kidney yang xu

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46
Q

treatment principle for kidney yang xu

A

tonify and warm kidneys, consolidate chong, stop bleeding
r6 tonifies qi, stops bleeding
bl23, r4 (moxa) tonify and warm kidney yang, nourish chong
st30 (moxa) tonifies chong
kd7 tonifies kidney yang
st36, sp6 tonify qi and blood

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47
Q

trickling after regular flow, late onset cycle, fresh red and watery consistency, dizziness, tinnnitus, weak knees, evening heat, night sweats, hot flash, malar flush, mental restlessness, tongue red, no coating, pulse floating and empty

A

kidney yin xu

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48
Q

treatment principle kidney yin xu

A

nourish yin, strengthen kidneys, stop bleeding
r6 tonifies qi, stops bleeding
bl23, r4 (no moxa) tonify and warm kidney yang, nourish chong
kd3 tonifies kidney
kd2 clears empty heat from kidney
st36, sp6 tonify qi and blood

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49
Q

xu of menstrual cycle - period that is three days or shorter with extremely light, scanty flow

A

hypomenorrhea

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50
Q

phase of the menstrual cycle from day 1 to ovulation, driven by estrogen, known as the follicular phase

A

yin phase

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51
Q

focus on moving blood, chong vessel starts to empty, ren vessel drives blood downwards, stagnant qi is moved, body temp drops

A

day 1-3

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52
Q

what points for day 1-3 of cycle

A

sp6, sp10, lv3, li4, st28, st30, r4, kd14

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53
Q

rebuilding the endometrium starts on day

A

2-3

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54
Q

day when we switch the treatment focus from moving stagnation and invigorating blood flow, endometrium should be 1-2mm thick and remodelling is complete

A

day 5-6

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55
Q

what points for day 5-6

A

r4, kd3, 4,5,6,8,13, st27,30,36, bl23,32, lv3, pc6, sp4,6,10

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56
Q

what is considered the transition from yin to yang

A

ovulation

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57
Q

treatment principle to invigorate ovulation

A

kd4,5,8,13,14, sp 5,6,8,13, pc5,6, ht5,7, gb26

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58
Q

from ovulation to end of cycle/pregnancy, known as luteal phase because it is driven by the corpus luteum, progesterone elevates BBT and therefore considered yang natured, tonify yang to support progesterone, warm uterus to nourish blood flow, lift and support yang

A

yang phase

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59
Q

emotional stress at the time of ovulation can inhibit egg release, period 7 or more days either before or after expected date, breast distension, abdominal and hypochondriac distension, irritability, frequent sighing, belching, pulse wiry, tongue red on sides

A

liver qi stagnation

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60
Q

defined as a period that comes sooner than 27 days after the last period, typically has two diagnostic patterns, excess or xu, the actual condition of the period will also enable diagnosis along with general health, tongue and pulse

A

early cycle

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61
Q

most common cause of amenorrhea

A

kidney yin xu

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62
Q

infrequent or no periods, no fertile mucus, dizziness, low back pain, 5 palm sweats, night sweats, red tongue, no coating

A

kidney yin xu

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63
Q

prolonged yin xu will lead to

A

yang collapse

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64
Q

treatment principle for kidney yin xu

A

reinforce yin and nourish blood
r4,7, kd3,4,5,6,8,13, st27,30,36, bl23,32, lv3, sp4, pc6, sp6,10, kd12

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65
Q

points for kidney yang xu

A

bl20,23,32, r2,3,4,6,12, st25,36, sp6, kd3

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66
Q

pale complexion, dizziness, fatigue, poor diet, overwork, restless, dreamful sleep, anxiety, cold extremities, abdominal bloating, poor appetite, pale tongue, thready pulse

A

blood xu

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67
Q

blood xu treatment principle

A

nourish blood, nourish spleen qi, support kidneys
r12, st36, bl20, sp6, kd13, st30, ht7

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68
Q

life events causing stopped period

A

heart qi stag affecting hormones via pituitary

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69
Q

amenorrhea, insomnia, dreamful sleep, palpations, anxiety, fear, restlessness, history of trauma, pulse choppy and rapid, tongue red tip

A

heart qi stag

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70
Q

heart qi stag treatment principle

A

p5, 6, ht7, kd3, sp 6, kd19, r4,14

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71
Q

long term breastfeeding can cause

A

liver qi stag

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72
Q

if liver fire rises and invades the stomach channel it may force menstrual blood

A

upwards and appear as (bloody) milk secretion from the nips

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73
Q

irritability, headaches, milk secretions, chest oppression, anorexia, long term use of medication, breast distension, tongue red sides, pulse wiry

A

liver qi stag

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74
Q

liver qi stag treatment principle

A

lv2,8, pc5,7, lv14, st18, sp4

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75
Q

post pill amenorrhea treatment principle

A

lv1,5,8, 11, r3, st30, r1

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76
Q

defined as pain before, during or after menstruation , may be located in abdomen or lumbrosacral region

A

dysmenorrhea

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76
Q

menostaxis

A

prolonged, excessive bleeding outside of the usual cycle, or amenorrhea

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76
Q

causes of dysmenorrhea

A

emotional strain, anger, frustration, resentment, hatred leads to liver qi stag
cold and damp exposure during puberty, exposure of low abdomen/back or ankles, most likely to get cold path after the period
overwork and chronic illness leads to qi and blood xu, specifically affects spleen and stomach, general blood xu results in chong and ren vessels empty, blood xu leads to blood stasis and pain
excess sexual activity/childbirth, both deplete liver and kidney qi

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76
Q

most dominant factor of dysmenorrhea

A

stagnation of qi and/or blood
blood/liver and kidney xu causing blood stag

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77
Q

front menstrual pain is

A

liver

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78
Q

things to consider when diagnosing

A

time of onset, pressure, heat/cold, location of pain, cycle, character of pain

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79
Q

time of pain onset

A

before or during - full condition
after - empty condition

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80
Q

cycle blood type

A

prolonged with dark clotted blood - blood stasis
red blood with small dark clots - cold in uterus
short cycle, heavy flow, bright red - blood heat

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81
Q

character of pain

A

better after passing clots - blood stasis
pronounced feeling of distension - qi stag
burning pain - blood heat
cramping pain - cold in uterus
stabbing pain - blood stasis
pulling pain - blood stasis
bearing down before the start - blood stasis
bearing down after the period - kidney xu

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82
Q

lower abdomen pain either during or a couple days before period, improved by passing clots, breast and abdomen distension, period hesitant to start or typically late, dark flow with clots, premenstrual tension and irritability, tongue purple pulse choppy or wiry

A

qi and blood stagnation

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83
Q

qi and blood stagnation treatment principle

A

move blood and qi eliminate stasis and stop pain
lv3, r6, gb34, sp8, st29, sp10,6, lg7 and kd6, pc6 and sp4

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84
Q

lower abdomen pain before or after the period, pain more central location, relieved by application of heat, menstrual flow scanty, bright red with dark clots, feeling cold, sore low back, tongue pale blue or blue purple, pulse deep, choppy or wiry

A

stagnation of cold

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85
Q

stagnation of cold treatment principle

A

warm uterus, expel cold, move blood
r4,6 with moxa, st29, sp8,6, st36

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86
Q

hypogastric pain before the period and sometimes mid cycle, burning sensation extending through the abdomen to sacrum, general feeling of heat, menstrual flow with red small clots, significant vaginal discharge, yellow colour, scanty dark urine, tongue red, coating sticky and yellow, pulse slippery

A

damp heat

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87
Q

damp heat treatment principle

A

clear heat, resolve dampness, eliminate stasis
sp6 and sp9, lg7 and kd6, r3, st28, bl32,22

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88
Q

dull hypogastric pain towards or at end of menses, dragging sensation in lower abdomen, pain relieved by pressure and massage, scanty menstrual flow, pale complexion, chronic tiredness but worse after menses, slight dizziness, loose stool

A

qi and blood xu

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89
Q

qi and blood xu treatment principle

A

tonify qi, stregthen spleen, nourish blood
r4,6, st36 and sp6, sp8, bl20,17

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90
Q

dull hypogastric pain towards or and end of period, sore lower back, dizziness, worse after period, scanty bleeding, pain relieved by pressure or massage, tinnitus, blurred vision, exhaustion, tongue red, coating peeled, pulse floating, empty

A

kidney and liver yin xu

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91
Q

kidney and liver yin xu treatment principle

A

nourish yin, tonify kidneys, nourish liver
bl23,18, R4, sp6 and kd3 st36

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92
Q

three possible causes of leukorrhea

A

spleen xu, kidney xu, damp heat

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93
Q

excess mucous vaginal discharge

A

leukorrhea

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94
Q

leukorrhea treatment principle

A

tonify spleen, warm middle jiao, remove damp, regulate ren and dai
r6, bl26,30, sp9, st36, tonify all, moxa applicable

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95
Q

profuse and continuous discharge, mucus thin and opaque or transparent, severe lumbar soreness, frequent and excessive urine, loose stool, severe fatigue, cold sensation in lower abdomen, tongue pale, coating thin, pulse deep

A

kidney xu leukorrhea

96
Q

kidney xu leukorrhea treatment principles

A

tonify kidney yang, stabilize and contain ren and dai, resolve leukorrhea
bl23, r4, kd12, bl26

97
Q

infertility phase one - menses

A

open the uterus, encourage smooth and strong downward flow p6, sp4, p5
move blood and regulate chong kd14
cool blood if yin xu heat is evident sp10
remove obstructing blood flow sp8
regulate and move qi in uterus/lower jiao bl25,30,32
moderate descending action r6

98
Q

infertility phase two - kidney yin and blood

A

this is the most crucial phase to building a fertile cycle
treatments must be as precise as possible to influence production of a new endometrium and allow the egg to mature to its fullest potential
the endometrium should be min 8mm thick at the end of this phase
also determines how well an embryo can implant
start building yin and blood at day 4
if menses is short start at day 3
assessing cervical secretions is the most reliable way to measure yin
address kidney jing xu

99
Q

infertility patterns in phase 1 and 2

A

kidney yin xu
kidney yang xu
kidney jing xu
heart and liver qi stag
blood stag
phlegm damp obstruction

100
Q

nourish kidney jing points

A

kd12 and st27

101
Q

balance ren and chong vessels

A

r7, kd5,8,13

102
Q

lower back pain accompanied by abdomen pain and

A

cant feel pulse, labour starting within 12-24 hrs

103
Q

development of fetal meridians

A

week 1-4 liver
week 4-8 gall bladder
week 8-12 pericardium
week 12-16 san jiao
week 16-20 spleen
week 20-24 stomach
week 24-28 lung
week 28-32 large intestine
week 32-36 kidney
week 36-40 bladder
can needle if needed, avoid for general pregnancy treatment

104
Q

avoid strong stimulation during pregnancy (especially first trimester) unless

A

inducing labour
threatened miscarriage from spleen qi sinking

104
Q

points to avoid

A

li4 and sp6 used to induce labour
gb21 strong downward action, makes qi sink (for induction)
bl32,bl32 used to induce labour
bl67 only needle to induce labour - moxa daily to turn breech baby
abdominal points

104
Q

3 organs most commonly affected by change in qi circulation

A

spleen, liver, kidney

104
Q

questions for morning sickness

A

time of day
any pain or dull ache
how does eating affect
how does activity affect
presentation of morning sickness
what is content of vomit
any thirst
any taste in the mouth

105
Q

stimulate chong vessel

A

sp4, st30

106
Q

emphasize kidney yin development

A

kd3,5,6, sp6, bl23, r4

106
Q

encourage blood production

A

st36, lv3, sp10

106
Q

resolve phlegm damp

A

r9, sp9, sp5, gb26

107
Q

move liver qi stag

A

lv3,5

107
Q

harmonize the shen

A

ht5,7, pc6

108
Q

infertility phase three - ovulation

A

at the end of phase two begin to build yang (when yin grows it will consume yang)
ovulation is the transition from yin to yang
to ensure ovulation is successful we must boost yang quickly and effectively for ~4-5 days
if yang is very xu you should begin to nourish during the follicular phase while also nourishing kidney yin
when yin foundation is strong we can switch the focus to drastically move qi and blood
it is crucial that heart and liver remain clear and calm, choose points to maintain flow

109
Q

cool heart/liver fire if necessary

A

ht5,8, pc7, lv2

110
Q

mid cycle bleeding

A

can be caused by dramatic peaks and falls of estrogen
most likely to occur is endometrium structure and quality has not been firmly established in follicular phase
tcm-chong vessel not fortified due to yin and blood xu
may also signify heat in the blood - pc4

111
Q

infertility phase four - post ovulation

A

implantation depends on the embryo quality, so nourishing kidney jing to enhance gamete quality should always be done
by the time of phase 4 nothing can be done to change the quality of the embryo
now we focus on the environment for the embryo to finish
maintain kidney yang
inadequate progesterone - kd yang xu

112
Q

methods to boost yang

A

boost kidney yang by tonifying kidney yin
boost kidney yang by promoting qi
boost kidney yang by nourishing blood

113
Q

boost kidney yang by tonifying kidney yin

A

reinforce and invigorate kidney yin and yang r2,4, kd3,6, bl23
regulate qi in uterus r5
regulate activity of chong and ren r7
calm the mind r15

114
Q

boost kidney yang by promoting qi

A

invigorate spleen and stomach qi r12,6, st36,25, bl20, sp6
support development of kidney yang r4, kd3, bl23
regulate qi in ren channel r5

115
Q

boost kidney yang by nourishing blood

A

directly influence blood formation bl17, sp10
enhance blood formation though kidney yang kd5, st36, r12, sp6
support kidney yin and yang r4
invigorate qi and blood of all zang bl17, r17, lv8

115
Q

heart liver qi stag treatment

A

regulate liver qi lv3,5,11,13,14, gb34
regulate liver fire (anger) lv2
nourish liver blood (to temper qi stag) lv8
regulate qi in uterus lv5,8,11, kd5, ht7
resolve emotional tension lv5
calm the mind and shen pc5,6,7, ht5,7
regulate qi in ren and liver channels r3

116
Q

blood stasis treatment goals

A

regulate qi and blood st28,29
assist embryo passage down fallopian tubes r6, st36
resolve blood stasis to assist implantation sp10, lv3
regulate blood in uterus lv5,8, kd14, sp6,8, r3
regulate kidney and ren channels kd5,9

117
Q

phlegm damp accumulation treatment goals

A

transform and distribute fluids r9
resolve damp by increasing kidney yang r3,6
resolve phlegm from fallopian tubes gb26,27,28
regulate fluids in lower jiao bl22,28,32
support spleen action of transforming fluids sp9,6

118
Q

IUI

A

inter uterine insemination - used as an aid to natural conception, sperm is collected, washed, and treated with a protein drink and inseminated during natural ovulation cycle

118
Q

IVF short protocol

A

exactly the same as long protocol but without 3 weeks downregulating meds
does not consume yin in the same way as long term
not used as often

118
Q

ART

A

assisted reproductive techniques
includes medications, interventions, and donor gametes

118
Q

blood heat miscarriage

A

bright red, profuse bleeding, sudden onset, accompanied with febrile symptoms if due to infection, anxiety is a big trigger - causes heat in the heart which disturbs the uterus via the bao mai vessel, extreme anger - liver fire, restless and agitated, thirst, dark urine, constipation, pulse rapid

118
Q

kidney qi xu miscarriage

A

spotting, low back pain, ache or soreness, sore legs, fatigue, frequent urination, low progesterone, tongue pale, pulse weak and soft
kidney pulse should be firm, solid and slightly slippery in a healthy pregnancy

118
Q

IVF - long protocol

A

woman is given downregulating drugs to switch off her natural hormone cycle, putting her into ‘false menopause’
symptoms can vary in severity but are all yin xu symptoms
IVF affects kd, ht, lv, st yin, create ht and lv blood xu, LQS and shen disturbance

118
Q

ICSI

A

intracytoplasmic sperm injection - if sperm are unable to fertilize egg effectively or at all, during IVF the sperm will be chosen and directly injected into the egg

119
Q

post miscarriage treatment

A

move qi and blood, sink qi
if possible treat while the person is actively bleeding

119
Q

threatened miscarriage

A

presents with pink, red or brown spotting following positive pregnancy test
lower back ache, lower abdominal cramps, heavy PMS pain
bleeding may be functional, indicating new growth phase

119
Q

blood xu miscarriage

A

scanty, watery bleeding, fatigue, palpitations, small fetus for dates, anemia, pale complexion, tongue pale

119
Q

causes of miscarriage

A

embryo DNA failure
multiple fertilizations of 1 egg
kidney jing and yin xu (age)
difficult implantation due to endometrial abnorm
excess phlegm/damp obstructing implantation
cold womb - yang xu - typically low progesterone
blood and yin xu- thin dry uterine lining

119
Q

causes of blood heat miscarriage

A

yin xu heat
prolonged IVF patients whose yin has been consumed by meds
infection of the endometrium, a UTI or flu
treat with low dose Tylenol

119
Q

spleen qi sinking miscarriage

A

abdominal distension and heaviness, bearing down or sagging sensation, spotting, fatigue, nausea worse for exertion, cervix may be slightly open, pulse weak

120
Q

blood stasis miscarriage

A

IVF procedures cause stasis, should be addressed after embryo transfer so not interfering with implantation, fibroids and endometriosis, physical traumas, terminations, previous miscarriages, traumatic births, blood clotting disorders, sharp, stabbing or cramping abdominal pain, dark bleeding with clots, tongue purple, pulse choppy

121
Q

inevitable miscarriage

A

if the fetus has stoped growing and deceased in the first trimester TCM can be used to expel the products of pregnancy, instead of surgical intervention D&C

122
Q

post miscarriage

A

invigorate blood without causing haemorrhaging, sp10, lv1, r6, sp8 can regulate blood and qi to stop excessive bleeding, post miscarriage is it vital to recover qi and blood and strengthen kidney, spleen and heart yang
st36, sp3,6, lv13, r12, bl20, r6, kd3,6, lg7, pc6&sp4, sp10

123
Q

spleen and stomach xu morning sickness

A

pre existing xu allows qi and blood to accumulate in chong and counterflow upward - nausea
spleen xu - inability to T&T food to produce enough blood to meet the increased demand from fetus
spleen and stomach disharmony nausea, vomiting, poor appetite, abdominal distension and fatigue
spleen and stomach xu - weakness, lethargy, slow movements, feeling better after eating and resting, sickness worse in the morning, tongue pale, coating white, pulse loose and slippery

124
Q

liver and stomach disharmony

A

LQS is partly necessary to prevent energy from moving freely and negatively affecting the fetus, liver stores blood, governs smooth flow of qi of all meridians, liver qi helps spleen transform food and qi of all meridians, liver qi helps spleen transform food and qi and ascend, helps stomach digest food and descend

125
Q

liver and gallbladder disharmony

A

presents similarly to liver and stomach disharmony, with more pronounced nausea and bile regurge, may present as depression, irritability, fullness or heaviness in chest of hypochondruim

126
Q

points review

A

p6 relaxes chest and diaphragm, moves qi stag in upper and middle jiao, relieves nausea
st36 helps treat xu patterns and rebellious stomach qi works with p6 and r12
r10 food retention in stomach p6
r12 calms rebellious qi, xu based nausea
r14 helps qi descend
st19,20 moves epigastric fullness, helps nausea better for vomiting
st21 combined with st44 for stomach heat
st34 used for excess conditions, p6
st40 pairs with p6 to resolve phlegm
kd21 pairs with st19 and r12 for patient cant stop vomiting emergency
sp4 and p6 strong treatment so only use if patient has persistent condition that isint responding to other points

127
Q

PRIMARY CAUSE OF PCOS

A

dampness

128
Q

endocrine imbalance

A

spleen qi xu

129
Q

hirituism is

A

disharmony between chong, qi and blood, blood xu in uterus leads to excessive chong at skin level leading to facial hair

130
Q

ovarian cysts

A

abdominal masses as a result of damp phlegm accumulating

131
Q

PCOS patterns

A

there is always damp phlegm
there is always kidney xu, typically kidney yang xu
may be blood stasis, blood xu or damp heat in liver (based on symptoms)

132
Q

treatment of PCOS

A

use extraordinary vessels to clear damp phlegm from uterus and tonify kidneys
SJ to balance the flow of water passages with sj4
harmonize water with st28, r9, du26
clear fluids from ren r17, r9, r5
gb 26
ren mai - lg7 (left) and kd6 (right)
chong mai - pc6 (left) and sp4 (right)
du mai - si3 (right) and bl62(left)

133
Q

spleen and kidney yang xu PCOS

A

kidney yang fails to warm spleen yang- unable to transport fluids - damp
scanty or no periods (spleen not producing .blood)
irregular bleeding (spleen not containing blood)
underdeveloped breasts (kidney essence xu)
cold back ache (kidney yang xu)
tiredness (spleen yang not producing daily energy)
dizziness (spleen not making blood to nourish marrow)
poor appetite ( spleen unable to process food) tongue ale, wet, pulse weak, axc.

134
Q

excess patterns of PCOSq

A

damp phlegm obstructing uterus
accumulation of damp/heat
blood stasis
liver fire with damp heat

135
Q

xu patterns of PCOS

A

spleen and kidney yang xu
blood xu

136
Q

damp phlegm obstructing uterus PCOS

A

scanty or no periods (clogged uterus lining)
obesity (damp phlegm)
excessive hair (phlegm obstructing uterus disturbs hormone balance)
chest oppression (damp interferes with lung dispersing fluid)
abdominal masses (phlegm accumulation)
excessive vaginal discharge (damp in lower jiao)
tongue swollen, coating sticky, pulse slippery

137
Q

damp heat

A

abdominal heaviness and fullness (spleen not able to transport fluids from middle jiao)
overweight (spleen not able to transform food into qi and transport it around the body)
acne (accumulation of damp when yellow pus indicates heat)
excessive yellow or odoured vaginal discharge (damp heat in lower jiao)
mid cycle pain and heaviness (damp obstructing ovulation)
pulse slippery, rapid, coating sticky, yellow

138
Q

liver fire and damp heat PCOS

A

the least frequent pattern of PCOS
amenorrhea or irregular bleeding liver (fire consuming blood)
excessive hair growth hormonal imbalance = liver not freely moving qi
large red spots on buttocks yellow pus filled (damp heat)
headaches on top of head as liver fire rises or distending, muxxy pressure with damp
breast distension (liver not freely moving qi)
yellow vaginal discharge (damp heat in lower jiao)
tongue red sides, coating sticky, yellow, pulse wiry, rapid

138
Q

blood stasis PCOS

A

imbalanced chong, ren and uterus, phlegm obstructs blood circulation
painful, dark, clotted periods (blood not flowing smoothly)
irregular periods (blood not fulling chong regularly)
abdominal pain (sharp, stabbing nature a blood stagnated)
tongue purple all over or at sides, pulse wiry, choppy

139
Q

spleen and kidney yang xu PCOS

A

kidney fails to warm spleen yang - spleen yang unable to transport fluids = damp - spleen unable to transform food into qi
scanty or no periods (spleen not producing blood)
irregular bleeding (spleen not containing blood in vessels)
underdeveloped breasts (kidney essence xu)
cold backache (kidney yang xu)
tiredness (spleen yang not producing daily energy)
dizziness (spleen not making blood to nourish marrow)
poor appetite (spleen unable to process food)
tongue pale, wet, pulse weak, deep

140
Q

endometriosis symptoms

A

dysmenorrhea, pelvic pain, lower back pain radiating down anterior thigh, heavy periods, irregular bleeding, pain on deification, rectal pressure, tender ovaries, infertility, painful intercourse

141
Q

triggers for blood stasis in uterus (endometriosis)

A

cold invading uterus, tampons, emotional stress, damp accumulation, intercourse during puberty

emotional stress causes liver qi to stagnate which prevents blood from flowing smoothly

142
Q

xu endometriosis patterns

A

spleen qi xu, kidney yin xu, kidney yang xu, blood xu
if spleen is too weak to make blood liver will also become xu - spleen qi xu will lead to kidney yang xu

143
Q

non consensual sexual activity results in

A

liver qi stag

144
Q

the root of endometriosis is

A

always kidney xu - typically yang but may be yin or yang

145
Q

patterns of endometriosis

A

liver blood stasis
cold stag
damp accumulation
damp phlegm in the uterus
kidney yang xu
kidney yin xu
blood xu
spleen qi xu

146
Q

general treatment endometriosis

A

phase one - invigorate blood
phase two - tonify kidney, nourish blood and yin
phase three (ovulation) - tonify kidney and spleen, resolve dampness
phase four - invigorate blood, tonify yang to expel cold, resolve damp

147
Q

liver blood stasis endo

A

intense stabbing pain before or during period (liver unable to regulate smooth flow when fullest)
pain is relieved for passing clots (excess blood stasis)
dark blood with large clots (qi not circulating blood)
irritability (liver not governing smooth flow)
mental restlessness (liver not governing smooth flow, not controlling blood to fill heart volume)
tongue purple, pulse wiry or choppy

148
Q

cold accumulation endo

A

painful period better for heat (cold contracts qi and blood flow)
pain is central lower abdomen (uterus location)
scanty red menstrual flow with small dark flecks of clots (cold obstructing blood flow to endometrium)
feeling cold, especially during period (internal cold retnetion)
tongue pale blue/purple, pulse deep, tight

149
Q

kidney yun xu menopause

A

dizziness, low pitch tinnitus, hot flashes, night sweats, 5 palm sweats, lower back ache, dry mouth, skin, hair, constipaiton, tongue red if empty heat - not necessarily, coating peeled, pulse fine and rapid

150
Q

damp accumulation endo

A

hypogastric pain before period and mid cycle (damp obstructing blood flow around ovaries and uterus)
menstrual flow red with small clots and clear mucus (stagnation not caused by blood stasis)
vaginal discharge (damp in lower jiao)
scanty dark urine (damp obstructing flow of water passages)
abdominal fullness and heaviness (spleen not transporting fluids)
tongue swollen, coating sticky, pulse slippery
may be combined with heat = burning pain though sacrum, heat thirst tongue red

151
Q

kidney yang xu

A

hot flushes with cold hands and feet, night sweats in early morning when yang begins to rise, pale face, depression, chilliness, backache, ankle oedema, tongue pale, pulse weak, deep

152
Q

kidney yin and yang xu

A

hot flushes with cold extremities, night sweats, frequent pale urination, flushed around neck when talking, mild agitation, chilliness, dry throat, dizziness, tinnitus, lower back ache, pounding, throbbing, top of head headache, tongue peeled, red with false heat, pulse wiry on middle right

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TCM (11 decks)

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