Treatment principle: Tonify qi and nourish blood, strengthen the spleen and calm the spirit.

Treatment principle: Tonify qi and nourish blood, strengthen the spleen and calm the spirit. Prescription: Modified Guipi Decoction. Astragalus root 15g, atractylodes rhizome 10g, codonopsis root 10g, angelica root 10g, poria 10g, polygala root 6g, agarwood 6g, honey-fried licorice 6g, four red dates, sour jujube seed 10g, six slices of fresh ginger, dodder seed 10g, curcuma 6g, safflower 6g, bupleurum root 10g, costus root 6g. If appetite is poor, add fried three treasures, chicken gizzard, and raw rhubarb as appropriate; if the lower back and knees feel sore and weak, add eucommia bark, achyranthes root, and eucommia as appropriate. 7. Analysis of prescriptions used by Professor Pei Zhengxue Professor Pei Zhengxue commonly uses the following three prescriptions in clinical treatment of premature ovarian failure: 1. Modified GuiZhi FuLing Wan GuiZhi 10g, poria 12g, white peony root 15g, moutan bark 10g, peach kernel 10g, angelica root 10g, rehmannia root 12g, chuanxiong rhizome 6g, safflower 3g, panax notoginseng 3g (to be taken separately), leech powder 10g (to be taken separately). Decoct in water and take one dose daily. This prescription is suitable for young and middle-aged women in good health, The formula combines GuiZhi FuLing Wan with Taohong Siwu Decoction, adding powerful blood-stasis-breaking and blood-activating ingredients such as panax notoginseng and leech. GuiZhi FuLing Wan originates from “Jin Kui Yao Lue · Women’s Pregnancy Diseases, Pulse Diagnosis and Treatment.” It consists of equal parts of gui zhi, poria, moutan bark, peach kernel, and white peony. Gui zhi is pungent and warm, promoting blood circulation and eliminating blood stasis, serving as the chief herb. Peach kernel is the key herb for resolving blood stasis, while poria eliminates phlegm and promotes diuresis, helping to clear phlegm and facilitate water metabolism. Together, these two herbs activate blood circulation and remove stasis, promote diuresis and eliminate dampness, assisting the chief herb in its efforts to resolve both blood stasis and phlegm-dampness, acting as supporting herbs. White peony relieves spasms and stops abdominal pain. Moutan bark cools the blood, breaks up blood stasis, and removes it; when combined with the chief and supporting herbs, its blood-activating effect further enhances the overall efficacy, addressing both the pathology of stagnant blood and accumulated heat over time, serving as an auxiliary herb. Honey is used to make pills, moderating the potent effects of the other herbs, serving as a guiding herb. Together, these herbs work synergistically to activate blood circulation, transform phlegm, and alleviate blockages. 2. Modified Wenjing Decoction Codonopsis root 10g, cinnamon twig 10g, donkey-hide gelatin 10g (processed), ophiopogon root 10g, evodia fruit 10g, angelica root 10g, chuanxiong rhizome 6g, rehmannia root 128, red peony root 10g, peach kernel 10g, safflower 3g, hemp seed 10g, dried ginger 6g, four red dates, honey-fried licorice 6g, costus root 6g, motherwort 15g, decocted in water and taken one dose daily. This prescription is suitable for women of childbearing age who have not yet given birth, with scanty menstrual flow, delayed periods, or even amenorrhea in young and middle-aged women. The formula combines the Great Wenjing Decoction with Taohong Siwu Decoction, possessing blood-activating and blood-stasis-resolving effects, but its most important function is warming the meridians and dispelling cold. In the Wenjing Decoction, evodia fruit is pungent and very hot, entering the liver, stomach, and kidney meridians; its pungency can disperse, its bitterness can descend, and its intense heat can also warm and dispel cold pathogens, thus dispersing cold and relieving pain; cinnamon twig is pungent and sweet, warming the meridians and dispersing cold while promoting blood circulation, so together they serve as the chief herbs. Angelica root, chuanxiong rhizome, and red peony root enter the liver meridian, activating blood circulation and removing stasis, nourishing blood and regulating menstruation; moutan bark is bitter and pungent, slightly cool, entering the heart, liver, and kidney meridians, activating blood circulation and removing stasis, while also dissipating latent heat in the blood, serving as supporting herbs. Donkey-hide gelatin is sweet and neutral, nourishing the liver blood and enriching kidney yin, having the effect of nourishing blood, stopping bleeding, and moistening dryness; ophiopogon root is sweet and slightly bitter, nourishing yin and clearing heat, and can also temper the warming and drying effects of evodia fruit and cinnamon twig; codonopsis root and licorice are sweet and enter the spleen meridian, benefiting qi and replenishing the source of life, allowing yang to flourish and yin to grow, strengthening qi and enriching blood; pinellia ternata is pungent and warm, able to descend stomach qi and disperse knots, working with codonopsis root and licorice to strengthen the spleen and harmonize the stomach, aiding in removing stasis and regulating menstruation; fresh ginger warms the interior and dispels cold, working with pinellia ternata to warm the center and harmonize the stomach, assisting in the process of generating life, all of which serve as auxiliary herbs; licorice can also harmonize the other herbs, serving as a guiding herb. Together, these herbs warm the meridians and dispel cold to activate blood circulation, nourish the Chong and Ren channels to consolidate the foundation, remove blood stasis, generate new blood, and thereby regulate menstruation and cure the disease. Research shows that the Wenjing Decoction can regulate the physiological functions of the hypothalamus-pituitary-ovarian axis, regulate the menstrual cycle, and promote the secretion of luteinizing hormone. Pharmacological studies show that evodia fruit contains evodiamine, a derivative of evodiamine, which has the effect of contracting the uterus, while angelica root has a bidirectional regulatory effect on the uterus, and pinellia ternata and fresh ginger form the Xiao Banxia Tang, treating phlegm and drink, stomach cold and vomiting, and can also reverse and stabilize the flow. 3. Modified Danzhi Xiaoyao Powder Angelica root 10g, atractylodes rhizome 10g, white peony root 10g, poria 12g, bupleurum root 10g, fresh ginger 6g, peppermint 3g, rehmannia root 12g, cornelian cherry 10g, Chinese yam 10g, alisma 10g, cinnamon twig 10g, peach kernel 10g, deer antler 3g (to be taken separately). Decoct in water and take one dose daily. This prescription is suitable for middle-aged women with decreased libido and early menstruation. The formula uses Danzhi Xiaoyao Powder, GuiFu BaWei Wan, and modified GuiZhi FuLing Wan, aiming to enhance endocrine function and increase estrogen secretion. The deer antler in this formula is the finishing touch, as this medicine contains both male and female hormones—previously used for male impotence, now used for female premature ovarian failure. This can be described as “those who are good at tonifying yang should tonify yang within yin, and those who are good at tonifying yin should tonify yin within yang.” In Danzhi Xiaoyao Powder, moutan bark has the effect of clearing heat and cooling blood, atractylodes rhizome strengthens the spleen and benefits qi, poria strengthens the spleen and promotes diuresis, gardenia fruit clears heat, promotes diuresis, and cools blood to detoxify, white peony balances liver yang and nourishes blood, angelica root nourishes blood, bupleurum soothes the liver and harmonizes the stomach while lifting yang and raising the fallen, and peppermint disperses wind and dissipates heat. Moutan bark and gardenia fruit work together to release blood and extinguish the fire of the three jiao; poria and atractylodes rhizome work together to strengthen the spleen and promote diuresis, helping the blood to be produced abundantly; angelica root, white peony, and bupleurum work together to ensure smooth flow of liver qi. The entire formula has the effects of soothing the liver and clearing heat, strengthening the spleen and harmonizing the center, and nourishing blood and regulating menstruation. 8. Case examples Case 1: A 37-year-old woman presenting with amenorrhea for half a year. The patient is obese, with a pale and dull complexion, and her menstruation has gradually stopped over the past six months. Gynecological examination ruled out pregnancy, accompanied by abdominal distension, lower back pain, ulcers in the mouth and nose, sores on the tip of the tongue, irritability, a pale tongue, and a thin, wiry pulse. [Western medical diagnosis] Amenorrhea. [Traditional Chinese medicine differentiation] Qi stagnation and blood stasis. [Treatment principle] Regulate qi, remove stasis, and unblock the meridians. [Prescription] Modified Taohong Siwu Decoction, Danzhi Xiaoyao Powder, and modified GuiZhi FuLing Wan. Peach kernel 10g, safflower 6g, angelica root 10g, rehmannia root 12g, chuanxiong rhizome 6g, white peony root 15g, licorice 6g, atractylodes rhizome 10g, bupleurum root 10g, poria 12g, moutan bark 6g, gardenia fruit 10g, cinnamon twig 10g, peach kernel 10g, leech 6g (ground into powder and taken separately). Decoct in water and take one dose daily. After taking more than 30 doses, menstruation returned in abundant amounts, abdominal distension, lower back pain, and ulcers in the mouth, nose, and on the tongue all subsided, the mood improved, and menstruation occurred monthly. Case 2: A 35-year-old married woman, first visit on August 7, 2017. Chief complaint: amenorrhea for more than five months. Past medical history: the patient reported irregular menstrual cycles after an induced abortion in July 2014, with infrequent periods lasting up to three months each, and scanty, reddish flow. Now the patient also experiences hot hands and feet, flushing and sweating, insomnia and vivid dreams, vaginal dryness and burning pain, dizziness and tinnitus, lower back and knee soreness, dry eyes and blurred vision, a red tongue, little coating, and a thin, wiry pulse. Reproductive history: two pregnancies, one cesarean section, one induced abortion. Auxiliary examinations: urine pregnancy test (-), so she went to a Grade III hospital for a sex hormone panel: FSH: 65.23 mIU/ml; LH: 58.14 mIU/ml; PRL: 7.22 ng/ml; E2: 34.16 pg/ml; PRGE: 0.3 ng/ml; T: 0.34 ng/dl; Ultrasound showed: uterus; 44mm x 29mm x 34mm, endometrium: 5mm, left ovary: 13mm x 15mm, right ovary: 14mm x 15mm, the uterus is relatively small. [Western medical diagnosis] Premature ovarian failure. [Traditional Chinese medicine differentiation] Liver qi stagnation and blood stasis. [Treatment principle] Soothe the liver, activate blood circulation, and unblock the meridians. [Prescription] Modified Taohong Siwu Decoction, Danzhi Xiaoyao Powder, and modified GuiZhi FuLing Wan. Peach kernel 10g, safflower 6g, angelica root 10g, rehmannia root 12g, chuanxiong rhizome 6g, white peony root 15g, licorice 6g, atractylodes rhizome 10g, bupleurum root 10g, poria 12g, moutan bark 6g, gardenia fruit 10g, cinnamon twig 10g, peach kernel 10g, costus root 6g, motherwort 15g, leech 6g (ground into powder and taken separately). Decoct in water and take one dose daily. Take half an hour after breakfast and dinner. Also advise the patient to keep a calm mood. Second visit: August 22, 2017. Menstruation has not yet returned, but perimenopausal symptoms have improved, with a dark tongue, thin coating, and a deep, tight pulse. On top of the previous prescription, add Wenjing Decoction, with the following formula: Codonopsis root 10g, evodia fruit 6g, ophiopogon root 10g, donkey-hide gelatin (processed) 10g, dried ginger 6g, peach kernel 10g, safflower 6g, angelica root 10g, rehmannia root 12g, chuanxiong rhizome 6g, white peony root 15g, licorice 6g, atractylodes rhizome 10g, bupleurum root 10g, poria 12g, moutan bark 6g, gardenia fruit 10g, cinnamon twig 10g, peach kernel 10g, leech 6g (ground into powder and taken separately). Third visit: October 8, 2017, menstruation returned, with acceptable flow, lasting for four days. Advise the patient to continue taking the above prescription. Six months later, a follow-up sex hormone panel at another hospital showed: FSH: 7.25 mIU/ml; LH: 8.13 mIU/ml; E2: 109.19 pg/ml; menstruation came regularly, 5