Evidence-based Traditional Chinese Medicine
Authors: Ju-Tzu Li M.D. (Taiwan), MSAOM.
Dysmenorrhea, painful menstruation, is a common women's disorder. This is also one of the common causes of teenage girls or young women's absence from school or work. According to a survey conducted in Sweden, 72% of 19-year-old girls had dysmenorrhea, which resulted in limitation of daily activities. Dysmenorrhea also causes financial losses. From an early report, dysmenorrhea was associated with annual productivity loss of 600 million work hours, and financial losses of up to $2 billion dollars. Mostly, those who suffered from dysmenorrhea choose non-steroidal anti-inflammatory drugs (NSAIDs) as their first option of treatment. Besides, oral contraceptives are also commonly used for dysmenorrhea as a conventional therapy. However, the patients who did not have respond to the conventional treatment or who have side effects from the conventional therapy may seek alternative therapy. Traditional Chinese medicine (TCM) therapies, which have been practiced for more than two thousand years in China, are becoming more popular in the West in recent years. How effective is traditional Chinese medicine (TCM) therapies for dysmenorrhea? How does it work? Lately, some clinical studies were conducted to investigate the efficacy and the mechanism of TCM treatment for dysmenorrhea.
Dysmenorrhea can be classified into primary and secondary dysmenorrhea. Primary dysmenorrhea is defined as painful menstruation associated with normal pelvic anatomy. Whereas, secondary dysmenorrhea is defined as painful menses associated with pelvic pathology, for example, endometriosis (the presence of endometrial tissues outside uterine cavity). Most patients are categorized into primary dysmenorrhea. The typical clinical presentation is characterized by cyclic pelvic pain before or at the onset of periods, frequently associated with blood clots, in a woman in her 20's to 40's.
According to TCM, the pathogenesis of dysmenorrhea may be caused by negative emotions (such as anger, or emotional stress), cold and dampness invasion, over-exertion or chronic illness. Based on patients' clinical manifestations including menstrual history, symptoms, and tongue and pulse findings, the patterns of dysmenorrheal patients are identified as excess or deficiency, heat or cold, or combined. Most patients are categorized into the one the following patterns or combinations: Qi stagnation and blood stasis, excess cold congealment, dampness-heat accumulation, Qi and blood deficiency, yang deficiency with cold, kidney and liver deficiency. Different formulas will be prescribed for different patterns. The commonly used formulas include “Dang Gui & Bupleurum Formula” (Xiao Yao San); “Persica, Carthamus & Dang Gui Four Combination” (Tao Hong Si Wu Tang); “Drive Out Blood Stasis Below the Diaphragm Decoction” (Ge Xia Zhu Yu Tang); “Drive Out Blood Stasis in the Lower Abdomen Decoction” (Shao Fu Zhu Yu Tang); “Dang Gui & Evodia Combination” (Wen Jing Tang); “Regulate Liver Decoction” (Tiao Gan Tang).
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* Articles Originally Published in SUN TEN Quarterly Newsletter Fall 2007
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