This case report describes the treatment process of a 25-year-old female patient with refractory primary dysmenorrhea. The patient experienced significant lower abdominal pain since menarche, particularly during the first two days of menstruation, along with fatigue and decreased mental energy. Symptoms intensified with age, severely impacting her daily life and academic performance. Refractory dysmenorrhea, characterized by persistent symptoms despite standard treatments, not only poses a physical challenge but also severely affects the psychological well-being and quality of life of patients, often leading to anxiety, mood disturbances, and reduced productivity. The patient previously attempted various treatments, including NSAIDs and traditional Chinese herbal formulas such as Jia-Wei-Xiao-Yao-San and Chai-Hu-Shu-Gan-San, but found no significant relief. In this study, the patient received a combination of Chinese herbal treatments focusing on Si-Ni-San and Dang-Gui-Shao-Yao-San, leading to significant symptom improvement, with the pain intensity decreasing from VAS 8-9 to 1-2, and reduced dependency on analgesics. This case report suggests that the pathogenesis of refractory dysmenorrhea involves not only qi stagnation and blood stasis but also other factors such as dampness and liver qi stagnation with spleen deficiency. Through the application of herbal therapies aimed at soothing the liver, invigorating blood, and eliminating dampness, there was a noticeable reduction in dysmenorrhea symptoms, including associated fatigue and emotional distress. This report demonstrates the potential clinical value of traditional Chinese medicine (TCM) in treating refractory dysmenorrhea and offers healthcare practitioners an alternative treatment option for patients unresponsive to conventional Western medicine. It emphasizes the importance of a comprehensive syndrome differentiation approach in dysmenorrhea treatment and highlights the positive impact of TCM on improving women’s quality of life.
【Keywords】
primary dysmenorrhea ； refractory dysmenorrhea ； Si-Ni-San ； Dang-Gui-Shao-Yao-San ； traditional Chinese medicine treatment
291-6 複雜性痛經中醫治療病例報告
