Postpartum Uterine Bleeding

General

Clinical Manifestations
Treatment Principle
Herb Formulas	Dang Gui Shao Yao San
Points	Moxa HT-5, HT-7, LIV-1, LIV-3, REN-4, REN-19, SJ-5, SP-2, SP-3, SP-6, SP-9, SP-10, SP-12, UB-17 Ear: Internal Secretion, uterus, Spleen Kidney, Adrenal, Liver, Mammary Gland, Brain

Spleen Not Governing The Blood

Clinical Manifestations	Abdominal pain Uterine bleeding (metrorrhagia) Excessive menstruation Menstruation with constant spotting Postpartum bleeding Bleeding during pregnancy The Blood is pale and thin without clots Weakness Dizziness Sore lower back Post abortion bleeding Dull complexion Weakness and pain of the legs Light red, unelevated and indistinct eruptions T: Pale C: Thin and white or Whitish and moist P: Thready and weak
Treatment Principle	Nourish and warm the Blood Stop bleeding Regulate menstruation
Herb Formulas	Jiao Ai Tang Dang Gui Bu Xue Tang
Points	DU-20, LI-11, REN-4, SP-4, SP-10, SP-14, UB-17

Central Qi Sinking

Clinical Manifestations	Prolapse of one or more organs Sallow complexion Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even or Soft and thready
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang
Points	DU-20, other points are selected according to the type of prolapse

Heart Blood Deficiency

Clinical Manifestations	Hot sensations in the muscles and skin Red face Irritability Thirst with a preference for warm beverages or does not wish to drink Fatigue Fever Headache Slight perspiration Hypermenorrhea during menstruation or after labor Purulent abscesses Red eyes Dry, feverish skin Postpartum fever Distress Postpartum headache Postpartum irregular menstruation Slow healing of wounds Excessive Blood loss after labor T: Pale P: Flooding, big, forceless and Deficient when pressed hard or Big and weak
Treatment Principle	Tonify Qi Generate Blood
Herb Formulas	Dang Gui Bu Xue Tang
Points

Heart And Liver Blood Deficiency

Clinical Manifestations	Palpitations Insomnia with much dreaming Easily startled Eye dizziness Both eyes dry and rough Twitching of the eyes Pain in the ribs and flanks Numbness of the limbs Stiffness and spasms of the tendons Low grade fever Night sweats Irregular, scanty menses T: Pale and thin C: Little P: Thready, choppy and forceless
Treatment Principle	Nourish Yin Reinforce the Blood Conceal Yang Calm the Shen
Herb Formulas	Dang Gui Bu Xue Tang
Points	HT-7, LIV-3, REN-4, SP-6, ST-36, UB-15, UB-17, UB-18

Liver Qi Stagantion Turning To Heat With Underlying Spleen And Blood Deficiency

Clinical Manifestations	Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations Lower abdominal pain Difficult urination Painful urination Increased menstrual flow Uterine bleeding Early menstruation Aching in limbs Dizziness Mental instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red eyes Dry mouth Anorexia Infertility Abdominal pain Spontaneous sweating or night sweats with fever Anxiety Dry eyes Hypochondriac pain Somnolence Insomnia Aching shoulders Five Sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis Irregular menstruation Heaviness in the lower abdomen T:Red or Red edges C: Thin and yellow P: Thready, rapid and wiry or Wiry and tight and rapid
Treatment Principle	Pacify the Liver Spread Liver Qi Strengthen the Spleen Nourish the Blood and Yin Regulate menstruation Sedate the Heart Clear Heat
Herb Formulas	Jia Wei Xiao Yao San
Points

Liver Blood Stagnation Due To Blood Deficiency

Clinical Manifestations	Sharp pain in the chest or abdomen Irregular menstruation Dysmenorrhea Retention of lochia Postpartum abdominal pain Acute, colicky lower abdominal pain Severe pain in the middle abdomen Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Epigastric pain Postpartum bleeding Pain beneath the heart Swelling and pain of external injuries Maybe five sole heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale or Purple with purple spots C: Normal P: Thready and wiry or Thready and choppy or Wiry, choppy and tight
Treatment Principle	Nourish the Blood Regulate the Liver Regulate menstruation Invigorate the Blood Dispel Blood Stasis Disperse accumulation Alleviate pain
Herb Formulas	Shi Xiao Si Wu Tang Si Wu Tang Si Wu Tang Jia Wei
Points

Liver Blood Deficiency

Clinical Manifestations	Dizziness Blurred vision Pale, lusterless complexion Pale nails Pale lips Generalized muscle tension Irregular menstruation with little flow Amenorrhea Periumbilical pain Lower abdominal pain Vertigo Tinnitus Blurred vision Insomnia Spotting of pale Blood Postpartum uterine bleeding Maybe Five Sole Heat Delayed menstruation Palpitations Dizziness Dry skin Maybe leukorrhea Maybe fever Firm, painful abdomen Sporadic fever and chills Menorrhagia Hard abdominal masses with recurrent pain Unstable fetus with bleeding Chills and fever T: Pale C: Normal P: Thready and wiry or Thready and choppy
Treatment Principle	Nourish the Blood Regulate the Liver Improve Blood circulation Regulate menstruation
Herb Formulas	Si Wu Tang Si Wu Tang Jia Wei
Points

Kidney Yin Deficiency With Fire Rising

Clinical Manifestations	Postpartum uterine bleeding Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back Spermatorrhea or Premature ejaculation Aching in the bones Aching in the leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Dizziness Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire
Herb Formulas	Zhi Bai Di Huang Wan
Points	KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

Qi Deficiency Collapse Leading To Severe Blood Loss And Devastated Yang

Clinical Manifestations	Pale, watery Blood Palpitations Shortness of breath Laconic speech A sinking sensation in the lower abdomen Fatigue A shiny, pale complexion Abdominal fullness Lower back pain T: Pale C: Moist and thin P: Deficient and frail or Weak and smooth
Treatment Principle	Tonify Qi Tonify the Blood Raise Yang Qi
Herb Formulas	Ju Yuan Jian
Points

Qi And Blood Deficiency

Clinical Manifestations	Prolonged lochia Excessive postpartum bleeding Profuse bleeding Puerperal fever Spontaneous sweating Dry mouth Heart irritability Light headedness Delirium Irritability Nausea Vomiting Nervousness Anorexia Abdominal pain Flank distention and fullness Dizziness Blurred vision Tinnitus Excessive loss of Blood Emotional instability Fullness and distention of the hypochondrium Epigastric pain Aversion to Cold T: Pale C: Slippery P: Weak and Deep
Treatment Principle	Tonify Qi and Blood Invigorate the Blood Regulate Qi Transform Stasis Harmonize the Liver and Spleen Regulate menstruation
Herb Formulas	Xiong Gui Tiao Xue Yin
Points

Postpartum Blood Stagnation

Clinical Manifestations	Mild, persistent uterine bleeding of purple and black blood during pregnancy Abdominal pain that is worse with pressure Abdominal spasms and tension Immobile masses in the lower abdomen with pain and tenderness Amenorrhea with distention and pain Dysmenorrhea Headache Sinus congestion Constipation Excess weight in the pelvis Lower back ache Irregular menstruation Nervousness Fatigue Fetal instability Skin eruptions Scanty menstrual flow Scaly, dry skin Retention of lochia Shoulder stiffness Vertigo Cold low body and feet Flushed face Protruding abdomen T: Dark purple or with echymoses or petechiae or pale with purplish spots C: White P: Choppy or Tense, deep and slow
Treatment Principle	Invigorate the Blood Transform Blood Stasis Soften lumps Reduce fixed abdominal pain
Herb Formulas	Gui Zhi Fu Ling Wan Shi Xiao San Zhe Chong Yin
Points

Blood Heat With Blood Deficiency

Clinical Manifestations	Chronic, continuous uterine bleeding A pale complexion Stabbing pain in the abdomen Alternating chills and fever Irregular menstruation with profuse bleeding Abdominal pain Fever Thirst Itchy skin Heat in the upper body with Cold in the lower body Irritability and restlessness despite fatigue and exhaustion Mood swings A sallow complexion Emaciation T: Dry with a red tip C: Thin white P: Deep and rapid
Treatment Principle	Drain Fire Resolve toxicity Tonify the Blood Stop bleeding Warm the menses Cool the Blood
Herb Formulas	Wen Qing Yin
Points

Blood Deficiency With Cold Stagantion

Clinical Manifestations	Postpartum uterine bleeding Retention of the lochia with Cold, hardness and pain in the lower abdomen The pain is worse with pressure May be masses in the sore area The Blood is dark purplish T: Pale and purple or Pale with purple spots C: Normal P: Deep and choppy
Treatment Principle	Invigorate the Blood Transform and dispels Blood Stasis Warm the menses Warm the channels Alleviate pain
Herb Formulas	Sheng Hua Tang
Points

Deficiency Of The Chong And Ren

Clinical Manifestations	Menorrhagia or Prolonged menstruation Lower abdominal Cold, distention and pain Sporadic abdominal pain which is better with warmth pressure Irregular menstruation (usually long and heavy or scant with clots) Delayed menstruation with a small amount of pale Blood Mild, persistent uterine bleeding Lumbar and sacral pain which are worse following menstruation or when tired Profuse, clear, watery leukorrhea Maybe infertility Maybe dark rings around the eyes Palpitations Shortness of breath Faint, weak respiration Drenched with perspiration Dizziness Vertigo Above symptoms worse on exertion or when tired Four limbs cold and sore Intolerance of Cold Cold abdominal pain An extremely pale face Cyanosis of mouth and lips Reduced appetite Loss of taste Fatigue Upset stomach Loose stools T: Pale and thick with teeth marks C: White and greasy P: Minute (on the point of collapse) or Deep and slow
Treatment Principle	Return Yang Scatter Cold Consolidate Exhaustion
Herb Formulas	Gu Chong Tang
Points	Moxa REN-8, Moxa-needle REN-4, REN-6, ST-36, DU-25 For shock:  PC-6 In combination with DU-25,  DU-26, PC-9, KI-1 Moxa REN-4, REN-8, Moxa-needle UB-23, UB-26, DU-4 For menstruation with clots: SP-10, SP-6 For infertility: Bao Men Zi Hu (3 cun below the umbilicus and 2 cun lateral to the umbilicus) For clear, thin vaginal discharge: UB-52, GB-26 For lower abdominal pain: SP-8 For dysmenorrhea: SP-10, ST-29