更年期综合症是指妇女在绝经期或其后，因卵巢功能逐渐衰退或丧失，以致雌激素水平下降所引起的以植物神经功能紊乱代谢障碍为主的一系列症候群。
Menopausal syndrome refers to a series of symptoms mainly caused by autonomic nerve dysfunction and metabolic disorders due to the gradual decline or loss of ovarian function in women during or after menopause, resulting in a drop in estrogen levels.
更年期是每个妇女必然要经历的阶段，但每人所表现的症状轻重不等，时间久暂不一，轻的可以安然无恙，重的可以影响工作和生活，甚至会发展成为更年期疾病。短的几个月，长的可延续几年。更年期综合征虽然表现为许多症状，但它的本质却是妇女在一生中必然要经历的一个内分泌变化的过程。
Menopause is a stage that every woman must go through, but the symptoms vary from person to person and last for different periods of time. The mild ones can be fine, while the severe ones can affect work and life, and even develop into menopausal diseases. It can be as short as a few months or as long as several years. Although menopausal syndrome manifests itself in many symptoms, its essence is a process of endocrine changes that women must experience throughout their lives.
在英国，这种情况通常发生在40岁至60岁之间,平均年龄为51岁(NHS)。但大约百分之一的女性会在40岁之前经历更年期。
Usually, this occurs between the ages of 40 and 60. In the UK the average age is 51 (NHS). But around one in 100 women experience the menopause before 40 years of age.
原因
1.生理上的变化有卵巢功能的衰退，分泌雌激素和排卵逐渐减少并失去周期性，直至停止排卵；垂体分泌促卵泡激素和促黄体素过多。雌激素的靶器官如阴道、子宫、乳房、尿道等的结构和功能改变。从而在围绝经期出现月经不规则、潮热、多汗、心悸、尿频、尿失禁、阴道干燥、性欲减退、睡眠差、骨质疏松及身体发胖等一系列生理现象。随着生理的改变妇女还可出现一些心理上不适反应如情绪不稳定、记忆力下降、多疑、多虑和抑郁等。
Reason
1. Physiological changes include the decline of ovarian function, the secretion of estrogen and ovulation gradually decrease and lose their periodicity until ovulation stops; the pituitary gland secretes too much follicle-stimulating hormone and luteinizing hormone. Structural and functional changes in estrogen’s target organs such as vagina, uterus, breasts, urethra, etc. As a result, a series of physiological phenomena such as irregular menstruation, hot flashes, sweating, heart palpitations, frequent urination, urinary incontinence, vaginal dryness, loss of sexual desire, poor sleep, osteoporosis and body weight appear during perimenopause. Along with physiological changes, women may also experience some psychological discomfort, such as emotional instability, memory loss, suspicion, worry, and depression.
2.在社会关系方面，围绝经期妇女面临一些社会问题如职业困难、离婚、父母疾病或死亡、孩子长大离开身旁等，这一切都给她们带来精神压力，在一定成程度上干扰了围绝经期妇女的生活、工作及其与他人的关系。她们常觉得自已变老了，不喜欢参加公共活动，对家人容易发脾气。出现这些情况，如果得不到社会和家人的理解，很容易导致家庭矛盾，甚至危及妇女的健康。
2. In terms of social relationships, perimenopausal women face some social problems such as career difficulties, divorce, parental illness or death, and children growing up and leaving them, etc. All of these bring mental pressure to them and interfere to a certain extent. It covers the lives, work and relationships of perimenopausal women with others. They often feel that they are getting older, do not like to participate in public activities, and tend to lose their temper with family members. These situations, if not understood by society and family members, can easily lead to family conflicts and even endanger women’s health.
临床表现
1.月经逐渐减少，周期也就是间隔时间延长，经期也就是出血时间缩短，以致逐渐停经。但也有月经量增多，伴有大量血块等情况，然后慢慢停止，生殖能力丧失，生殖器官萎缩。
2.精神和植物神经功能紊乱。病人常感到头颈部一阵阵地潮红，潮热出汗，头晕目眩，头痛耳鸣，腰痛，口干，喉部有烧灼感，思想不易集中，而且紧张激动，情绪复杂多变，性情急躁，失眠键忘，皮肤发麻发痒，有时有蚁走感，即有蚂蚁在身上爬动的感觉等，甚至歇斯底里样发作等。
Clinical manifestations
1. Menstruation gradually decreases, the cycle, that is, the interval time, lengthens, and the menstrual period, that is, the bleeding time, shortens, leading to gradual cessation of menstruation. However, there are also cases where menstrual flow increases, accompanied by large amounts of blood clots, etc., and then slowly stops, with loss of reproductive capacity and atrophy of reproductive organs.
2. Mental and autonomic nervous system disorders. Patients often experience bursts of flushing in the head and neck, sweating, dizziness, headache, tinnitus, low back pain, dry mouth, burning sensation in the throat, difficulty concentrating, nervousness, complex emotions, irritable temper, and insomnia. Forget it, the skin is numb and itchy, and sometimes there is a feeling of ants crawling on the body, or even a hysterical attack.
3.心悸、血压增高、肥胖、下肢浮肿、关节疼痛、骨质疏松等。凡45~50岁的妇女，如有上述症状，经医生检查排除了其他疾病后，使可诊断为更年期综合征。
3. Heart palpitations, increased blood pressure, obesity, lower limb edema, joint pain, osteoporosis, etc. Women aged 45 to 50 who have the above symptoms can be diagnosed with menopausal syndrome after a doctor has ruled out other diseases.
预测指标
女性更年期的先兆或早期症状比较明显，可通过下述指标预测更年期。
通过家族遗传进行预测：由于进入更年期的年龄与遗传因素有一定关系，所以，祖母、母亲、同胞姐姐出现更年期的年龄可以作为孙女、女儿、妹妹进入更年期年龄的预测指标。但此指标并不是绝对的，易受后天生活条件、环境、气候、社会因素、药物、疾病等因素的影响，使更年期提前或推迟。
从初潮年龄预测更年期年龄：多数人观察确认，月经初潮年龄与更年期年龄是负相关，即初潮年龄愈早，更年期(绝经)年龄愈晚；相反，初潮年龄愈晚，更年期年龄则愈早。
Predictive indicators
The precursors or early symptoms of menopause in women are relatively obvious, and menopause can be predicted through the following indicators.
Prediction through family inheritance: Since the age of entering menopause has a certain relationship with genetic factors, the age of grandmother, mother, and sibling sister can be used as a predictor of the age of granddaughter, daughter, and sister entering menopause. However, this indicator is not absolute and is easily affected by acquired living conditions, environment, climate, social factors, drugs, diseases and other factors, which can lead to early or delayed menopause.
Predicting the age of menopause from the age of menarche: Most people have observed that there is a negative correlation between the age of menarche and the age of menopause, that is, the earlier the age of menarche, the later the age of menopause ; on the contrary, the later the age of menarche, the earlier the age of menopause.
月经紊乱现象：月经紊乱为最终绝经前的月经表现形式。月经改变的表现大致分为三种类型：一是月经间隔时间长，行经时间短，经量减少，然后慢慢停经；二是月经不规则，有人行经时间长，经量多，甚至表现为阴道大出血；也有人表现为淋漓不断，然后逐渐减少直至停经；三是突然停经。绝经是进入更年期的重要指标之一。
Menstrual disorders: Menstrual disorders are the manifestation of menstruation before final menopause. The manifestations of menstrual changes can be roughly divided into three types: one is long menstrual intervals, short menstrual time, reduced menstrual flow, and then slowly stops menstruation; second, irregular menstruation, some people have long menstrual time, heavy menstrual flow, and even vaginal symptoms. Heavy bleeding; some people show continuous bleeding, and then gradually decrease until menopause; the third is sudden menopause. The syndrome is one of the important indicators of entering menopause.
更年期的先兆：妇女进入更年期之前一般都有某些症状。如患者感到胸部、颈部及脸部突然有一阵热浪向上扩展的感觉，同时上述部位的皮肤发红，并往往伴有出汗。又如平时月经较准，经前也无特殊不适，而突然在某次月经前发生乳房胀痛、情绪不稳定、失眠多梦、头痛、腹胀、肢体浮肿等经前期紧张症候群；另外，出现烦躁、焦虑、多疑等情绪精神方面的改变，也是步入更年期的先兆。
通过以上预测方法和自己身心的具体感受，大多数妇女可以知道自己是否已进入了更年期。
Signs of menopause: Women generally have certain symptoms before they enter menopause. For example, the patient feels a sudden heat wave extending upward on the chest, neck and face, and at the same time, the skin in the above areas becomes red, often accompanied by sweating. Another example is that menstruation is usually accurate and there is no special discomfort before menstruation, but suddenly before a certain menstruation, breast tenderness, emotional instability, insomnia and dreaminess, headache, abdominal distension, limb edema and other premenstrual stress syndrome occur; in addition, irritability occurs. Emotional and mental changes such as depression, anxiety, and suspicion are also precursors to menopause.
Through the above prediction methods and the specific feelings of their own body and mind, most women can know whether they have entered menopause.
精神症状
据统计，约75%的更年期妇女会出现一系列的神经精神症状，主要表现是抑郁、情绪不稳、记忆力减退、注意力不集中，绝经后往往比绝经前更为明显，这些症状的发生除了与雌激素下降有关外，还与受教育程度、个人精神状态和精神创伤史，经济情况等社会、心理因素密切相关。神经精神症状的出现，常使妇女更容易紧张，发生焦虑，悲观等心理异常，症状的长期维持，药物治疗的效果不佳又加重了上述心理负担。某些妇女因此转辗门诊各个临床科室要求确诊，要求作特殊化验和检查。一些妇女的这些症状又会受到气候、情绪、不良刺激和其它疾病的影响而阵发性加重。
Psychiatric symptoms
According to statistics, about 75% of menopausal women will experience a series of neuropsychiatric symptoms. The main manifestations are depression, emotional instability, memory loss, and inattention. Postmenopausal women are often more obvious than premenopausal women. In addition to the occurrence of these symptoms, In addition to the decline in estrogen, it is also closely related to social and psychological factors such as education level, personal mental state and trauma history, and economic status. The emergence of neuropsychiatric symptoms often makes women more prone to stress, anxiety, pessimism and other psychological abnormalities. The long-term maintenance of symptoms and the poor effect of drug treatment increase the above-mentioned psychological burden. As a result, some women were transferred to various clinical departments in the outpatient clinic for confirmation and special tests and examinations. These symptoms in some women will be affected by climate, emotions, adverse stimuli and other diseases and worsen intermittently.
心理状态
最多见的症状是多疑，一些妇女在年轻时的个性特点并非如此，但到了更年期却会逐渐出现。妇女的多疑心态严重地影响了人际关系。为此，这些妇女也很苦恼，周围的人也难以理解和接受。
多疑心态的表现多种多样，在不同文化层次和不同工作岗位上的人表现也不完全一样，大体有以下几种情况：
1.感知觉过敏。过份的敏感，把发生在周围的一些不愉快事件强行与自己联系，听了风就是雨。听说同龄妇女生癌死亡，马上会联想到自己可能也会有同样的下场；在家里，孩子放学后晚归，会联想起路上是否发生车祸；有女同志往家里挂电话或爱人晚归，联想是否有第三者。
Mental state
The most common symptom is paranoia, which is not the personality trait of some women when they are young, but will gradually appear during menopause. Women’s suspicious mentality seriously affects interpersonal relationships. For this reason, these women are also very distressed, and it is difficult for people around them to understand and accept them.
There are various manifestations of a suspicious mentality, and people at different cultural levels and in different positions do not behave exactly the same. Generally speaking, there are the following situations:
1. Sensory hypersensitivity. Being overly sensitive, you force yourself to associate some unpleasant events that happen around you with yourself, and listen to the wind and it becomes the rain. When I hear that a woman of the same age has died of cancer, I immediately think that I may have the same fate; at home, if my children come home late after school, I will think of whether there was a car accident on the road; if a lesbian hangs up the phone at home or her lover comes home late, I will think of it. Does Lenovo have a third party?
2.特别关注流言蜚语。在一些单位里，总有一些人喜欢传播小道消息，或是流言蜚语，某些更年期妇女就是这些传播的积极参与者和受害者。当流言蜚语被夸大，失实时，造成人际关系的紧张，对更年期妇女来说，又是一种恶性刺激。
3.行为动作关系。即对别人的某些行为和动作，作盲目联系。有时别的几个人在一起轻轻的议论某件事，正巧某位更年期妇女走过，他们停止了议论或突然发笑。尽管这些人议论这事与她毫无关系，这位妇女马上会敏感地把它联系他们背后议论我。心中的不平衡马上膨胀，情绪立即会激昂起来。
2. Pay special attention to rumors. In some units, there are always some people who like to spread gossip or rumors, and some menopausal women are active participants and victims of these spreads. When rumors are exaggerated or inaccurate, it causes tension in interpersonal relationships, which is another vicious stimulus for menopausal women.
3. Behavioral action relationship. That is, making blind connections with certain behaviors and actions of others. Sometimes several other people were quietly discussing something together, and when a menopausal woman happened to walk by, they stopped talking or suddenly laughed. Even though these people talking about it had nothing to do with her, this woman immediately sensitively linked it to them talking about me behind my back. The imbalance in the heart will immediately expand, and the emotions will immediately become excited.
4.盲目怀疑。尤其对一些涉及到其本身利益的事无端地盲目怀疑，如晋级、加薪、分房中的一些决策没有满足其本人的愿望时，她就会盲目怀疑，既可以怀疑领导班子，人事部门中有什么人在背后作怪，甚至板着手指将这些领导干部逐个“排队“也可能怀疑同一部门的人员，是否在背后打过小报告，“搅掉了我的好事“，一旦认定，愤恨之心就会急剧上升。
4. Blind doubt. Especially when she has unreasonable and blind doubts about things that involve her own interests, such as promotions, salary increases, and housing assignments. When some decisions do not meet her own wishes, she will blindly doubt. She can doubt the leadership team, the personnel department, etc. Someone is causing trouble behind the scenes. Even if you “line up” these leading cadres one by one with a straight finger, you may also suspect whether people in the same department have made a small report behind the scenes and “ruined my good things.” Once confirmed, resentment will will rise sharply.
性行为改变
更年期是妇女生殖能力逐渐停止的过程。绝经则是生殖能力终止的信号，但这并不表明妇女的性要求与性反应能力终止。相反，当妇女意识到自己即将进入绝经期或已绝经后，由于不再担心怀孕的问题，可能会出现性欲增强。当然存在明显的个体差异。由于更年期是一个较长的时间过程，处于不同时期的妇女对性的要求可稍有不同。绝经前期，还要考虑避孕的问题，还存在担心怀孕丢人的紧张情绪。有些月经过多、出血时间延长的妇女，可能影响丈夫的性要求和情趣。
Changes in sexual behavior
Menopause is the gradual cessation of a woman’s reproductive capacity. Menopause is a signal of the termination of reproductive capacity, but it does not indicate the termination of women’s sexual requirements and sexual responsiveness. Conversely, women may experience an increase in sexual desire when they realize they are approaching menopause or have gone through menopause because they no longer have to worry about pregnancy. Of course there are obvious individual differences. Since menopause is a long process, women at different stages may have slightly different sexual requirements. In the premenopausal period, you also have to consider the issue of contraception, and there is also the nervousness of worrying about the shame of pregnancy. Some women with excessive menstruation and prolonged bleeding may affect their husband’s sexual requirements and interest.
绝经后可因阴道皱襞及分泌物减少出现性交痛。有的妇女会主动向医生要求治疗以满足夫妻双方的性要求和性和谐，但也有部分妇女因此而拒绝男方的性要求，成为绝经期吵架、感情不和的一个重要原因。由于传统的影响，中国妇女尤其羞于向外人谈及个人的性生活问题，即使遇到了麻烦，也只好自己忍了。许多男人无性知识，对女性的性要求和性反应缺乏了解，甚至存在大男子主义，性生活中只求满足个人的私欲，对女方不观察、不了解、不体贴。长期性抑制和无满足的性生活使中年妇女出现了厌倦性生活的现象。
After menopause, dyspareunia may occur due to reduced vaginal folds and secretions. Some women will take the initiative to ask doctors for treatment to meet the sexual requirements and sexual harmony of the couple. However, some women refuse the sexual requirements of their men because of this, which becomes an important reason for quarrels and emotional discord during menopause. Due to the influence of tradition, Chinese women are particularly shy about talking about their personal sexual life problems to outsiders. Even if they encounter trouble, they have to endure it themselves. Many men have no sexual knowledge, lack of understanding of women’s sexual requirements and responses, and even have male chauvinism. They only seek to satisfy their personal desires during sex, and do not observe, understand or consider women. Long-term sexual inhibition and unsatisfied sexual life make middle-aged women tired of sexual life.
中医
本病相当于中医的”绝经前后诸证”。
病因病理
西医认为更年期综合征的病因病理是：卵巢功能衰退，体内雌激素水平下降，机体老化的变化，使神经血管功能不稳定，从而产生更年期综合征。
而中医认为是以肾虚为根本病理：七七天癸将竭，肾气衰竭，冲任功能衰落紊乱，肾中阴阳失衡，机体衰弱，出现绝经前后诸证。
Traditional Chinese Medicine
This disease is equivalent to the “pre- and post-menopausal syndromes” in traditional Chinese medicine.
Etiology and pathology
Western medicine believes that the etiology and pathology of menopausal syndrome are: decline in ovarian function, decrease in estrogen levels in the body, and aging changes in the body, which make neurovascular functions unstable, resulting in menopausal syndrome.
Traditional Chinese medicine believes that kidney deficiency is the fundamental pathology: the Tiangui will be exhausted around the age of 49, the kidney qi will fail, the Chong and Ren functions will decline and become disordered, the yin and yang in the kidney will be imbalanced, the body will be weak, and various syndromes before and after menopause will appear.
诊断要点
1.根据本病发生在更年期，断经前后出现一系列与绝经有关的征候，如潮热，出汗，烦躁，头晕耳鸣或月经失调等自主神经（植物神经）、血管功能失调的征候群进行诊断。血内分泌检查表现为FSH升高，LH不变或升高。妇科检查及B超提示生殖器已趋萎缩。
2.如出现不规则阴道流血，须作妇科检查、B超或血内分泌检查、CA―125，CEA等，必要时作诊断性刮宫，以排除生殖器病变等。
Diagnostic points
1. Based on the fact that this disease occurs during menopause and a series of menopausal-related symptoms appear before and after menopause, such as hot flashes, sweating, irritability, dizziness, tinnitus or menstrual disorders and other symptoms of autonomic nerve (vegetative nerve) and vascular dysfunction.Blood endocrine examination showed increased FSH and unchanged or increased LH. Gynecological examination and B-ultrasound showed that the genitals were shrinking.
2. If irregular vaginal bleeding occurs, gynecological examination, B-ultrasound or blood endocrine examination, CA-125, CEA, etc. are required. If necessary, diagnostic curettage is performed to rule out genital lesions.
3.更年期综合征早期主要表现为自主神经、血管功能不稳定，如潮热出汗，激动烦躁等。晚期表现为生殖器萎缩，心血管系统变化，如胆固醇、甘油三脂和动脉粥样硬化、脂蛋白升高、抗动脉硬化脂蛋白降低等变化，还有骨骼疏松等。以上可通过妇科检查名超及血生化检查而作诊断。
3. The early symptoms of menopausal syndrome include unstable autonomic nervous system and vascular function, such as hot flashes, sweating, agitation and irritability. Late stage manifestations include genital atrophy, changes in the cardiovascular system, such as changes in cholesterol, triglycerides, atherosclerosis, increased lipoproteins, decreased anti-arteriosclerotic lipoproteins, and bone porosis. The above can be diagnosed through gynecological examination, ultrasound and blood biochemical tests.
辩证分型
根据临床出现的症状可以分为以下几型：
1.肾阴不足绝经前后烘热出汗，心烦不安，头晕耳鸣，腰酸膝软，口干便结，月经失调。舌干红，脉细弱。
2.肾虚肝旺绝经前后烘热出汗，急躁易怒，头痛头晕，腰酸耳鸣，口干咽燥，大便干结，或月经失调。苔黄，舌干红少津，脉细弦。
3.肾虚肝郁绝经前后月经紊乱，或先或后，或淋漓不净，烘热出汗，抑郁多虑，善于猜疑，经前有时乳胀，腰酸头胀。苔薄，舌红，脉细弦。
Dialectical classification
Based on the clinical symptoms, they can be divided into the following types:
1. Insufficient kidney yin: heat and sweating before and after menopause, restlessness, dizziness and tinnitus, soreness in the waist and knees, dry mouth and constipation, and irregular menstruation. The tongue is dry and red, and the pulse is thin and weak.
2. Kidney deficiency and liver hyperactivity include heat and sweating before and after menopause, irritability, headache, dizziness, backache, tinnitus, dry mouth and throat, dry stool, or menstrual irregularity. The coating is yellow, the tongue is dry and red, there is less fluid, and the pulse is thin and stringy.
3. Kidney deficiency and liver stagnation. Menstrual disorders before and after menopause, either before or after menopause, or with dirty watering, hot sweating, depression and worry, suspicion, sometimes breast bloating before menstruation, soreness of waist and head. Thin coating, red tongue, thin and stringy pulse.
4.肾阳衰弱绝经前后畏寒肢冷，面色皖白，精神萎靡，腰酸膝冷，性欲淡漠，纳少。月经量少，色淡。苔薄，舌淡，脉沉细无力。
5.脾肾阳虚绝经前后腰酸畏寒，面色皖白，纳少便溏，面肢肿胀，月经量少色淡。苔薄，脉沉细弱。
6.肾阴肾阳两虚绝经前后腰酸乏力，烘热出汗，继而畏寒肢冷，月经量中或少，淋漓不净。苔薄，舌尖红，脉沉细弱。
4. Weakness of kidney yang: Aversion to cold before and after menopause, cold limbs, pale complexion, listlessness, sore waist and cold knees, indifferent sexual desire, and poor appetite. Menstrual flow is scant and the color is light. The coating is thin, the tongue is pale, and the pulse is thin and weak.
5. Spleen and kidney yang deficiency: before and after menopause, there is soreness and chills in the lower back, pale complexion, poor appetite and loose stools, swelling of the face and limbs, and low menstrual flow and light color. The coating is thin and the pulse is deep and weak.
6. Deficiency of both kidney yin and kidney yang. Before and after menopause, there is soreness and weakness in the waist, heat and sweating, followed by aversion to cold and cold limbs, medium or scanty menstrual flow, and unclear dripping. The coating is thin, the tip of the tongue is red, and the pulse is deep and weak.
分型治疗
1.肾阴不足治法：补肾养阴。
方药：六味地黄汤加减。
生地15克,生白芍12克,茯苓12克,女贞子10克,山茱萸9克,牡丹皮9克,泽泻10克,杜仲10克,潼蒺藜12克,当归9克,麦冬9克。加减：阴虚火旺者，加知母9克、黄柏9克、龟板胶10克（烊冲）。
Type treatment
1. Treatment method for kidney yin deficiency: nourish kidney and yin.
Prescription: Liuwei Dihuang Decoction (modified).
15 grams of raw rehmannia, 12 grams of raw white peony root, 12 grams of Poria, 10 grams of Ligustrum lucidum, 9 grams of Dogwood, 9 grams of paeonol, 10 grams of Alisma ， 10 grams of DuZhong, 12 grams of Tribulus terrestris, 9 grams of Angelica sinensis, 9 grams of Ophiopogon japonicus. Modifications : For those with yin deficiency and excessive fire, add 9 grams of Anemarrhena, 9 grams of Cortex Phellodendron, and 10 grams of Gubanjiao ( to be melted ).
2.肾虚肝旺治法：益肾平肝。
方药：左归丸加减。
生地12克，淮山药10克，山茱萸9克，菟丝子10克，枸杞子10克，丹皮9克，潼蒺藜10克 ，钩藤10克，生山栀10克，麦冬12克，当归9克，龟版胶9克（烊冲），煅龙齿12克（先煎）
2.Treatment method for kidney deficiency and liver stagnation : nourishing the kidney and calming the liver.
Prescription: Zuogui Pills.
12 grams of raw rehmannia, 10 grams of Chinese yam , 9 grams of dogwood,10 grams of dodder , 10 grams of wolfberry , 9 grams of paeonol , 10 grams of Tribulus terrestris ,10g of raw gardenia, 12g of Ophiopogon japonicus, 9g of Angelica sinensis, 9g of turtle glue (yangchong), 12g of forged dragon tooth (fried first) 3.
3.肾虚肝郁治法：益肾舒肝。
方药：一贯煎加减。
生地12克,沙参15克,麦冬12克,当归9克,枸杞子10克,川楝子9克，广郁金10克，柴胡9克，八月札9克，山茱萸9克，佛手片9克，黄芩9克，煅牡蛎30克（先煎），炒白芍12克。加减：多虑猜疑，抑郁不欢者，可用下方：柴胡9克、郁金9克、合欢皮9克、佛手片9克、浮小麦30克、炙甘草5克、大枣9枚、生地15克、苏梗9克、百合15克、炒白芍15克、六曲9克。待情绪稍稳定后再服一贯煎加减方。
3. Treatment method for kidney deficiency and liver stagnation: nourish the kidney and soothe the liver.
Prescription: Yiguan Decoction with addition and subtraction.
12 grams of raw rehmannia, 15 grams of adenophora, 12 grams of Ophiopogon japonicus, 9 grams of Chinese angelica, 10 grams of wolfberry, 9 grams ofSzechwan Chinaberry Frui, 10 grams of turmeric, 9 grams of Bupleurum, 9 grams of August root, 9 grams of dogwood, 9 grams of bergamot slices, 9 grams of skullcap, and roasted oysters. 30g (fried first ) 12 grams of fried white peony root. For those who are worried, suspicious, depressed and unhappy, you can use the following: 9 grams of bupleurum, 9 grams of turmeric, 9 grams of albizia bark, 9 grams of bergamot slices, 30 grams of floating wheat, and 5 grams of licorice, 9 jujubes, 15 grams of raw rehmannia root, 9 grams of Scutellaria baicalensis root, 15 grams of lily, 15 grams of fried white peony root, and 9 grams of Medicated Leaven. Wait until your mood is slightly stable before taking Yiguan Decoction.
4.肾阳衰弱治法：温肾调冲。
方药：右归丸加减。
熟地10克,淮山药10克,山茱萸9克,枸杞子10克,杜仲12克,菟丝子12克,熟附片9克（先煎）, 仙灵脾9克,巴戟天9克,鹿角胶10克（烊冲）。加减：月经量多者，加黄芪15克、仙鹤草30克；性欲淡漠者，加黄芪12克、锁阳9克，去熟附片。
4. Treatment method for kidney yang deficiency: warm the kidneys and adjust the flow.
Prescription: Yougui Pills (modified ).
10 grams of Rehmannia glutinosa,10 grams of Chinese yam, 9 grams of Cornus officinale ,10 grams of wolfberry , 12 grams of Eucommia ulmoides , 12 grams of dodder , 9 grams of prepared Fuzi slices (to be boiled first),9 grams of Epimedium Herb，9 Gram， 10 grams of deer antler gum (to be melted ) . Modifications : For those with heavy menstruation, add 15 grams of astragalus, 30 grams of agrimony；for those with weak sexual desire, add 12 grams of astragalus and 9 grams of Cynomorium cynomorium, remove Fuzi slices.
5.脾肾阳虚治法：健脾温肾。
方药：补肾固冲丸。
党参12克，炒白术12克，菟丝子10克，熟地10克，枸杞子10克，巴戟天9克，吴茱萸6克，淮山药12克，砂仁3克（后下），陈皮6克。加减：清晨泄泻者，加河子9克、炮姜炭9克，去熟地；月经量多者，加阿胶9克（烊冲）、煅牡蛎30克（先煎）、仙鹤草30克。
5.Treatment method for spleen and kidney yang deficiency: strengthen the spleen and warm the kidneys.
Prescription: Bushen Guchong Pills.
12 grams of Codonopsis pilosula ，12 grams of fried Atractylodes ，10 grams of dodder ，10 grams of Rehmannia glutinosa ，10 grams of wolfberry Morinda officinalis ，9 grams Evodia ，6 grams Huaiyam ，12 grams of Chinese yam,, 3 grams of Amomumvillosum
(to be boiled short time ), 6 grams of tangerine peel. Modifications : For those who have diarrhea in the morning, add 9 grams of Hezi, 9 grams of Paojiang charcoal, and remove the Rehmannia glutinosa; for those with heavy menstruation, add 9 grams of donkey-hide gelatin (to be melted ) and 30 grams of calcined oysters (to be boiled first ), 30 grams of agrimony.
6.肾阴肾阳两虚治法：调补肾阴肾阳。
方药：二仙汤加减。
仙茅9克，仙灵脾9克，知母10克，黄柏9克，巴戟肉9克，当归9克，淮小麦30克，炙甘草5克，黄芪12克，菟丝子12克，枸杞子12克。加减：经血淋漓不净者，加生蒲黄10克（包煎）、煅牡蛎30克（先煎）、侧柏叶9克。
6. Treatment method for kidney yin and kidney yang deficiency: regulate and replenish kidney yin and kidney yang.
Prescription: Erxian Decoction.
Curculigo 9g, Fairy Spleen 9g, Anemarrhena 10g, Phellodendron 9g, Morinda Meat 9g, Danggui 9g, Huai wheat 30g, 5 grams of prepared licorice root, 12 grams of stilbene, 12 grams of dodder, 12 grams of wolfberry. Modifications: For those with dirty menstrual blood, add 10 grams of raw puhuang (to be boiled in a package), 30 grams of calcined oysters (to be boiled first), and 9 grams of Platycladus orientalis leaves.
中成药
1.知柏地黄九每日2次，每次4.5克，吞服。用于肾阴虚，虚火旺者。
2.生脉饮每日2次，每次2支，口服。用于气阴两虚者。
3.左归丸每日2次，每次4.5克，吞服。用于肾阴者。
4.右归丸每日2次，每次4.5克，吞服。用于肾阳虚者。
5.大补阴丸每日2次，每次4.5克，吞服。用于阴虚者。
6.全鹿九每日2次，每次4.5克，吞服。用于肾阳衰弱者。
7.逍遥丸（或越鞠丸）每日2次，每次3克，与左归丸或右归丸同服。用于肾虚肝郁者。
Chinese patent medicine
1. Zhibai Dihuan pills, 2 times a day, 8 pills each time, swallow. It is used for those with kidney yin deficiency and excessive fire.
2. Shengmai Yin is taken orally, 2 times a day, 2 bottles each time. It is used for those with Qi and Yin deficiency.
3. Zuogui Pills: 2 times a day, 4.5 grams each time, swallow. For those with kidney yin.
4. Yougui Pills: 2 times a day, 4.5 grams each time, swallow. Used for those with kidney yang deficiency.
5. Dabuyin Pills 2 times a day, 4.5 grams each time, swallow. Used for those with yin deficiency.
6. Quanlu pills 2 times a day, 4.5 grams each time, swallow. Used for those with weak kidney yang.
7. Xiaoyao Pills (or Yueju Pills), 2 times a day, 3 grams each time, taken together with Zuogui Pills or Yougui Pills. Used for patients with kidney deficiency and liver stagnation.
简便方
1.炙甘草6克、浮小麦60克、大红枣50克，煎服。用于烘热出汗，心悸怔忡者。
2.野百合30克、肥知母10克、熟地黄12克，煎服。用于烘热出汗，口干咽燥，情绪不宁者。
3.仙灵脾10克、知母9克、煅牡蛎30克（先煎）、浮小麦30克、黄芪12克、巴戟10克，煎服。用于肾虚烘热出汗者。
4.五倍子9克，研末
Simple and convenient formula:
1. 6 grams of licorice, 60 grams of floating wheat, 50 grams of red dates, decoct and take. It is used for those who suffer from heat, sweating, palpitations and aching heart.
2. 30 grams of wild lily, 10 grams of Anemarrhena, and 12 grams of Rehmannia glutinosa, decoct and take. It is used for those who suffer from heat, sweating, dry mouth and throat, and restless mood.
3. 10 grams of Epimedium Herb ， 9 grams of anemarrhena, 30 grams of calcined oysters (to be boiled first), 30 grams of floating wheat, 12 grams of astragalus, and 10 grams of Morinda citrifolia, decoct and take. It is used for those with kidney deficiency who experience heat and sweating.
4. 9 grams of gallnut, grind into powder
其它疗法
耳针埋藏取神门、内分泌、交感、心、肾等穴。
用耳针或磁石埋穴。
Other treatments
Ear acupuncture buried points are used on the points: Shenmen, endocrine, sympathetic, heart, kidney and other points.
Use ear acupuncture or magnets to bury the holes.
注意事项
1.更年期是肾中阴阳衰竭，机体免疫功能下降，为肿瘤好发时期，应加强体格检查，参加妇科普查，及早发现妇科肿瘤，早期治疗。
2.避免过度疲劳，做到劳逸结合，适当参加体育活动，饮食以清淡而有营养为主，增加水果及蔬菜食谱。
3.更年期因肾气虚弱，肾的主骨髓功能减退，导致低钙或缺钙，故平时多服含钙的食物，如贝壳类、虾类食物，并可在医生指导下，适当服用钙片或雌激素类制剂。Things to note
1. Menopause is a period when the yin and yang in the kidneys fail and the body’s immune function declines. Tumors are prone to occur during menopause. Physical examinations should be strengthened and gynecological screening should be carried out to detect gynecological tumors early and treat them early.
2. Avoid excessive fatigue, achieve a balance between work and rest, participate in appropriate physical activities, eat a light and nutritious diet, and increase the number of fruits and vegetables.
3. During menopause, due to weak kidney qi, the main bone marrow function of the kidneys decreases, resulting in low calcium or calcium deficiency. Therefore, you usually take more calcium-containing foods, such as shellfish and shrimp foods, and you can take appropriate calcium tablets under the guidance of a doctor. or estrogen preparations.
4.更年期综合征患者情绪变化较大，尤其是容易急躁发怒或抑郁猜疑，故医务人员或家庭成员要同情患者，给予精神安慰和思想开导等心理疗法，有助疾病恢复。
5.更年期综合征患者在治疗后症状改善，但体力仍虚弱，于秋冬季节可服膏方调理，以增强脏腑功能，平衡肾中阴阳，可以防止症状复发。
4. Patients with menopausal syndrome have great emotional changes, especially they are prone to irritability, anger, depression and suspicion. Therefore, medical staff or family members should sympathize with the patients and provide psychological comfort, ideological enlightenment and other psychological therapies to help recover from the disease.
5. The symptoms of menopausal syndrome patients have improved after treatment, but their physical strength is still weak. They can take ointments for conditioning in autumn and winter to enhance the function of the organs, balance the yin and yang in the kidneys, and prevent the recurrence of symptoms.
（作者简介：张恩勤教授，英国中医学院院长，英国皇家医学会和英国中医药学会资深会员）