Bian Zheng Lun Zhi as a Complementary and Alternative Treatment for Menstrual Cramps in Women with Dysmenorrhea: A Prospective Clinical Observation

Table 1

Summary of traditional Chinese medicine diagnoses (bian zheng or symptom patterns) and pattern-matching formulas (lun zhi) for treating menstrual cramps.

Bian zheng	Lun zhi
Symptom and signs	Treatment principle	TCM prescription	Composition
(i) Sharp shooting pain in lower abdomen may precede menstruation by several days and accompany it as menstruation tapers off; (ii) Usually coexist with excessively heavy blood loss; (iii) Or masses in the abdomen	To activate blood circulation and to remove blood stasis and mass in the abdomen	Gui-Zhi-Fu-Ling-Wan; (Cinnamon Twig and Poria Pill)	Cinnamomi Ramulus, Moutan Cortex, Paeoniae Rubra Radix, Persicae Semen, Poria
(i) Dull pain and distension of the lower abdomen (during menstruation) usually subsides as menstruation tapers off; (ii) Usually bleed more frequently; (iii) Pain is relieved with warmth but not with pressure	To warm the uterus and expel cold while invigorating and nourishing blood	Shao-Fu-Zhu-Yu-Tang; (Fennel Seed and Corydalis Combination)	Angelicae Sinensis Radix, Cinnamomi Cortex, Corydalis Tuber, Foeniculi Fructus, Ligusticum Rhizoma, Myrrha, Paeoniae Rubra Radix, Trogopterori Faeces, Typhae Pollen, Zingiberis Rhizoma
(i) Stabbing pain of fixed location over the lower abdomen (during menstruation); (ii) Usually coexist with menstrual headache or chest discomfort; (iii) Frequently become agitated; (iv) More likely to be a poor sleeper	To invigorate the blood and expel blood stasis while regulating Qi and unblocking the channels	Xue-Fu-Zhu-Yu-Tang; (Persica and Carthamus Combination)	Angelicae Sinensis Radix, Asini Gelatinum, Evodiae Fructus, Cinnamomi Ramulus, Ginseng Radix, Glycyrrhizae Radix, Ligusticum Rhizoma, Moutan Cortex, Ophiopogonis Radix, Paeoniae Alba Radix, Pinellia Tuber, Zingiberis Rhizoma
(i) Dull pain in lower abdomen may precede menstruation by several days and usually subsides as menstruation tapers off; (ii) Usually bleed more frequently; (iii) Weak and cold lower part of the body with difficulty in conception; (iv) Pain is relieved with warmth or/and with pressure	To warm the uterus and expel cold while invigorating Qi and nourishing blood	Wen-Jing-Tang; (Tangkuei and Evodia combination)	Achyranthis Radix, Angelicae Sinensis Radix, Aurantii Fructus, Bupleuri Radix, Carthami Flos, Glycyrrhizae Radix, Ligusticum Rhizoma, Paeoniae Rubra Radix, Persicae Semen, Platycodi Radix, Rehmannia Rhizoma
(i) Dull pain in lower abdomen may precede menstruation by several days and usually subsides as menstruation tapers off; (ii) Usually coexist with menstrual headache or dizziness; (iii) lower extremity swelling with difficulty in conception; (iv) Pain is relieved with pressure	To nourish the blood and soothe the liver, fortify the spleen, and eliminate dampness	Dang-Gui-Shao-Yao-San; (Tangkuei and Peony powder)	Alismatis Rhizoma, Angelicae Sinensis Radix, Atractylodis Ovatae Rhizoma, Ligusticum Rhizoma, Paeoniae Alba Radix, Poria
(i) Throbbing pain in lower abdomen may precede menstruation by several days and usually subsides as menstruation tapers off; (ii) Weak lower part of the body with achy legs	To tonify the Qi	Shao-Yao-Gan-Cao-Tang; (Peony and Licorice combination)	Glycyrrhizae Radix, Paeoniae Alba Radix
(i) Throbbing, nauseating pain may last until the end of menstruation; (ii) Usually coexist with excessively heavy blood loss; (iii) Dizziness, fatigue, and loss of appetite; (iv) Watery discharge expelled from the vagina	To replenish Qi, invigorate the spleen, nourish the heart, and calm the mind	Qui-Pi-Tang; (Ginseng and Longan combination)	Angelicae Sinensis Radix, Astragali Radix, Atractylodis Ovatae Rhizoma, Ginseng Radix, Poria, Glycyrrhizae Radix, Longan Arillus, Polygalae Radix, Vladimiria Radix, Zingiberis Rhizoma, Zizyphi Spinosi Semen, Zizyphus Fructus
(i) Dull pain in lower abdomen and distending pain in the breasts may precede menstruation by several days and usually subsides as menstruation tapers off; (ii) Usually coexist with menstrual headache or chest oppression/pain; (iii) Frequently become agitated	To spread the liver Qi, strengthen the spleen, nourish the blood, and clear the heat	Jia-Wei-Xiao-Yao-San; (augmented rambling powder)	Angelicae Sinensis Radix, Atractylodis Ovatae Rhizoma, Bupleuri Radix, Poria, Gardeniae Fructus, Glycyrrhizae Radix, Menthae Herba, Moutan Cortex, Paeoniae Alba Radix, Zingiberis Rhizoma
(i) Dull pain (during menstruation) in lower abdomen may precede menstruation by several days and usually subsides as menstruation tapers off; (ii) Usually coexist with breast swelling and tenderness or shortness of breath; (iii) Dizziness, fatigue, and loss of appetite	To regulate the liver Qi, tonify the spleen, and nourish the blood	Xiao-Yao-San; (Tangkuei and Bupleurum formula)	Angelicae Sinensis Radix, Atractylodis Ovatae Rhizoma, Bupleuri Radix, Poria, Glycyrrhizae Radix, Menthae Herba, Paeoniae Alba Radix, Zingiberis Rhizoma
(i) Sharp shooting pain in lower abdomen may precede menstruation by several days and accompany it even menstruation tapers off; (ii) Usually coexist with menstrual migraines and breast lumps; (iii) Yellowish, foul smelling discharge expelled from the vagina; (iv) Swollen and itchy genitalia; (v) Difficult and painful urination with a heat sensation in the urethra	To drain damp and clear the heat from the lower burner (the Liver, intestines, bladder, and kidneys)	Long-Dan-Xie-Gan-Tang; (Gentiana drains the liver decoction)	Akebia Caulis, Alismatis Rhizoma, Angelicae Sinensis Radix, Bupleuri Radix, Gardeniae Fructus, Gentianae Radix, Glycyrrhizae Radix, Plantaginis Semen, Rehmannia Rhizoma, Scutellariae Radix