崩漏
Alias功能性子宫出血
Traditional Chinese Medicine Definition
In traditional Chinese medicine, "Bleeding and Leaking" (menorrhagia) refers to the non-cyclic uterine bleeding in women, characterized by excessive menstrual bleeding, persistent spotting, or sudden, profuse bleeding. The color of the blood may range from red to pale, with a consistency that can be thick or thin. It is often accompanied by symptoms such as weakness in the lower back and knees, dizziness, tinnitus, palpitations, and insomnia. According to the "Internal Medicine of Traditional Chinese Medicine," bleeding and leaking is categorized under "irregular menstruation" and "menstrual collapse," and is one of the common gynecological syndromes.
In clinical practice of traditional Chinese medicine, the core pathogenesis of bleeding and leaking is the instability of the Chong and Ren meridians, leading to disharmony of Qi and blood. Common precipitating factors include emotional disturbances, irregular diet, and excessive fatigue. During the differential diagnosis, attention should be paid to distinguishing between cold and heat, deficiency and excess, such as blood heat syndrome, which presents with irregular menstruation, excessive bleeding, bright red color, and thick blood; kidney deficiency syndrome, characterized by irregular menstruation, persistent spotting, weakness in the lower back and knees; and spleen deficiency syndrome, which manifests as excessive bleeding with pale and thin blood, fatigue, and a sallow complexion. The overall approach to treatment suggests focusing on consolidating the Chong meridian and stopping bleeding, adopting corresponding treatment methods based on different patterns, such as clearing heat and cooling blood, reinforcing the kidneys and consolidating the Chong meridian, and replenishing Qi to control bleeding. Traditional Chinese medicine believes that the treatment of bleeding and leaking should emphasize harmonizing Qi and blood, balancing Yin and Yang, to achieve the purpose of treating both the root and the branch.
Common Syndrome Types and Key Points of Differentiation
血热证
Main Manifestations：经来无期，量多色红质稠，心烦口渴
Management Approach：清热凉血，固冲止血
肾虚证
Main Manifestations：经来无期，出血淋漓不尽，腰膝酸软
Management Approach：补肾固冲，调经止血
脾虚证
Main Manifestations：崩漏下血，色淡质稀，神疲乏力，面色萎黄
Management Approach：补气摄血，固冲止崩
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
The key to treating bleeding and leaking lies in stopping bleeding and regulating menstruation, while also reinforcing the body's vital essence.
— 柴夏阳 中医执业医师
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参考文献：《中医内科学》（十三五规划教材）、《中医病证诊断疗效标准》(ZY/T001.1-94)、《中医病证分类与代码》(GB/T 15657-2021)