Traditional Culture Encyclopedia - Weather inquiry - What medicine does dysmenorrhea take?
What medicine does dysmenorrhea take?
Abdominal pain or menstrual cramps before and after menstruation, even accompanied by low back pain, sometimes accompanied by dizziness or nausea and vomiting. In severe cases, crises such as pale face, cold sweat, cold hands and feet, severe pain and fainting can be seen.
Dysmenorrhea can be divided into primary dysmenorrhea and secondary dysmenorrhea according to the incidence. The former refers to dysmenorrhea caused by no obvious organic pathological changes in reproductive organs, while the latter refers to dysmenorrhea caused by organic pathological changes in reproductive organs, such as endometriosis, adenomyosis and pelvic inflammatory disease.
Epidemiological research shows that primary dysmenorrhea is the most common gynecological disease at present. According to domestic sampling survey, the incidence of dysmenorrhea among women in China is 33. 1%, of which 53.2% is primary, and the main population is adolescent girls and unmarried or childless young women.
So far, there is no clear consensus on the pathogenesis of dysmenorrhea. Most scholars realize that the occurrence and development of dysmenorrhea are closely related to endocrine factors such as prostaglandin, mental factors, endocrine regulation such as sex hormones and organic gynecological diseases.
At present, there are many treatments for primary dysmenorrhea. Non-steroidal anti-inflammatory drugs are the most commonly used first-line treatment drugs, and the effective rate of oral contraceptives for this disease is over 90%. Calcium channel blockers, antispasmodic sedatives, receptor agonists and vitamin E are all effective therapeutic drugs. In addition, great progress has been made in surgical treatment and traditional Chinese medicine treatment.
The cause of disease
So far, there is no clear consensus on the pathogenesis of dysmenorrhea. Most scholars realize that the occurrence of primary dysmenorrhea is related to uterine factors, endocrine factors, mental factors, genetic factors and living habits, and many organic gynecological diseases can cause secondary dysmenorrhea.
Disease factors
Gynecological diseases
Such as pelvic inflammatory disease, endometriosis, hydrazone myopathy, hysteromyoma and intrauterine device. , can lead to patients with secondary dysmenorrhea.
Related diseases
Endometriosis, adenomyosis, pelvic inflammatory disease
Non-disease factors
Uterine factor
Cervical stenosis and excessive uterine flexion lead to the increase of uterine isthmus tension, which leads to poor menstrual blood flow, which makes menstrual blood stay in uterine cavity, stimulates uterine contraction and causes dysmenorrhea; Endometrial cast shedding is also one of the causes of primary dysmenorrhea; Dysplasia of uterus leads to uncoordinated uterine contraction, which can lead to abnormal blood supply, ischemia and hypoxia of myometrium, abnormal uterine contraction and dysmenorrhea.
Endocrine factors
prostaglandin
The increase of prostaglandin in endometrium is an important cause of dysmenorrhea. After ovulation, under the action of progesterone, the synthesis and release of prostaglandin in endometrium increased significantly, and the content of prostaglandin in endometrium and menstrual blood of dysmenorrhea patients increased significantly compared with that of normal women. Prostaglandin secretion in human endometrium changes periodically. Prostaglandin E2(PGE2) and PGF2 α (PGF2 α) have two peaks in the late stage of proliferation and secretion, and reach the peak in menstrual period. The content of prostaglandin in endometrium of patients with dysmenorrhea is significantly higher than that of normal women, and the ratio of PGF2α/PGE2 is more obvious. The main reason is that PGF2α acts on the myometrium of uterus, which makes smooth muscle contract or even spasm, and at the same time leads to the increase of intrauterine pressure and the decrease of uterine blood flow, which leads to uterine ischemia, hypoxia and dysmenorrhea.
pitressin
Small blood vessels in the myometrium of uterus are more sensitive to vasopressin than large blood vessels. Vasopressin acts on vasopressin receptor in uterus, which increases the activity of myometrium and causes uterine contraction, especially the contraction of small blood vessels between myometrium, causing uterine ischemia and pain. Patients with dysmenorrhea are highly sensitive to vasopressin, and vasopressin secretion can increase uterine contractile activity and aggravate dysmenorrhea symptoms.
oxytocin
Oxytocin not only directly acts on uterine muscle cells to cause uterine contraction, but also stimulates endometrial cells to release PGs. The establishment of moderate uterine contraction must rely on the coordination of oxytocin and PGs. The content of oxytocin in dysmenorrhea patients is higher than that in normal non-pregnant women.
Estradiol and progesterone
The peak of estradiol in the middle luteal phase promotes the increase of PGF2α production in premenstrual endometrium; Progesterone can promote the transformation of estradiol into inactive estrone, reduce the synthesis of prostaglandin and reduce the contraction activity of uterine smooth muscle, thus relieving dysmenorrhea. Domestic studies have found that estrogen and progesterone bind to their receptors, activate serum mast cells to release pain-causing substances, and participate in the occurrence of dysmenorrhea.
calcium (Ca)
The application of calcium channel blockers in the treatment of primary dysmenorrhea, such as nicardipine, has good effect and few side effects. Magnesium preparation also has a good effect, which indirectly shows that calcium has a certain effect on primary dysmenorrhea. The frequency of dysmenorrhea in menstrual cycle with ovulation is high, and Ca2+ plays an important role in oocyte maturation. This correlation may suggest that there is a subtle relationship between Ca2+ and primary dysmenorrhea, which needs further study.
Mental factors
It is found that women with dysmenorrhea are prone to negative emotions such as irritability (7 1.8%), depression (45.4%) and nervousness (28.7%) during menstruation. These bad emotions may increase the tension of uterine isthmus and cause dysmenorrhea, or may lead to psychological imbalance and lower the pain threshold, or cause neuroendocrine disorder and stimulate the uterus and cause dysmenorrhea. As a psychological factor, the pressure and attitude towards pain contained in bad emotions are easy to give themselves bad hints, which will lower the pain threshold and increase the experience intensity of dysmenorrhea pain.
hereditary factor
With the development of genetic research, it is found that there are specific genes in the mother's chromosome that transmit information to the second generation of individual women, making them unstable, easily stimulated or lowering the threshold of uterine pain, thus suffering from dysmenorrhea.
Living habits
The relationship between living habits and dysmenorrhea, a large number of epidemiological data show that some living habits of women are related to the occurrence of dysmenorrhea. Cold, nutritional status, coffee or tea, irregular sleep, sleeping posture and mood are all risk factors for dysmenorrhea. The weather is cold during menstrual period, and the uterus and fallopian tubes contract due to cold stimulation, thus inducing or aggravating dysmenorrhea; Malnutrition, obesity or irregular sleep will affect women's basal metabolism, which may lead to menstrual endocrine disorders and dysmenorrhea; Coffee or tea may induce dysmenorrhea by exciting the neuroendocrine system; The effect of supine sleep on dysmenorrhea may be related to the outflow and reflux of menstrual blood by body position. Studies have shown that the incidence of dysmenorrhea is higher when the age of menarche is 10~ 13 years old, indicating that the earlier the age of menarche, the higher the incidence of dysmenorrhea.
Age factor
Young women are prone to dysmenorrhea at menarche, and the degree of dysmenorrhea is more serious.
Physical factors
Menstrual overwork, nervousness, colds and allergies can also lead to dysmenorrhea.
Hygienic factors
People who don't pay attention to the hygiene of menstruation, pregnancy and puerperium, start sexual life prematurely, have too many sexual partners and have inflammation of genitals often suffer from dysmenorrhea.
Iatrogenic factors
Excessive induced abortion or intrauterine surgery may cause adhesion inflammation and dysmenorrhea; Placement of intrauterine device (IUD), that is, intrauterine contraceptive ring, may lead to increased prostaglandin production in endometrial tissue, thus aggravating dysmenorrhea.
Long-term smoking
The degree of dysmenorrhea in smokers is often more serious than that in non-smokers, and the degree of dysmenorrhea is often aggravated with the increase of smoking. This may be because smoking often leads to vasoconstriction, leading to ischemia, thus causing menstrual pain.
symptom
Dysmenorrhea can be primary or secondary. The symptoms of the two groups are slightly different, but the main manifestation is lower abdominal pain. Patients often have menstrual cramps, which are relieved after a few days, but the symptoms caused by secondary dysmenorrhea are generally more serious, lasting longer and even life-threatening.
Symptom classification
Primary dysmenorrhea
It is common in adolescence and usually occurs after menarche 1~2 years. Pain mostly begins after menstrual cramps and first appears before menstruation 12 hours. The pain is the most severe on 1 day after menstruation, and it will be relieved after 2~3 days. The pain is often spasmodic, usually located on the pubic bone of the lower abdomen, and can radiate to the lumbosacral part and the inner thigh. May be accompanied by nausea, vomiting, diarrhea, dizziness, fatigue and other symptoms, severe pale face, cold sweat, occasional syncope and collapse. No abnormality was found in gynecological examination. Primary dysmenorrhea disappears automatically after delivery, or gradually disappears with age after marriage.
Secondary dysmenorrhea
Menstrual fever and lower abdominal pain may be caused by pelvic inflammatory disease. Normal menstrual blood is dark red. If the color of menstrual blood is light brown, or the smell changes when the body temperature rises and the lower abdominal pain, it may be menstrual low back pain related to endometrial inflammation caused by posterior uterus or other diseases. If dysmenorrhea becomes more and more serious and lasts longer, it is related to endometriosis.
characteristic symptoms
Primary dysmenorrhea
It is more common in adolescence and often occurs after menarche 1~2 years. Pain mostly begins after menstrual cramps and first appears before menstruation 12h. The pain is the most severe on 1 day after menstruation, and it will be relieved after 2~3 days. Pain is often spasmodic, usually located on the pubic bone of the lower abdomen, which can radiate to the lumbosacral part and the inner thigh, and may be accompanied by nausea and nausea.
Secondary dysmenorrhea
Secondary dysmenorrhea is mostly progressive, the pain is mostly located in the lower abdomen, lumbosacral region and the middle of pelvic cavity, and sometimes it can radiate to perineum, anus and thigh, which often occurs during menstrual cramps and lasts until the whole menstrual period. In severe cases, the pain after menstruation cannot be relieved.
Concurrent syndrome
Dysmenorrhea can appear alone in the lower abdomen discomfort and radiation pain in the lumbosacral region, or accompanied by other symptoms. May be accompanied by nausea, vomiting, diarrhea, dizziness, fatigue and other symptoms, severe pale face, cold sweat, occasional syncope and collapse and other symptoms.
to be hospitalized/be admitted to hospital
More than 90% of dysmenorrhea is primary dysmenorrhea. The patient has no organic gynecological diseases, but has obvious abdominal pain symptoms, which seriously affects his work and life, so he needs to see a doctor in time. In addition, a small number of patients are secondary dysmenorrhea caused by gynecological diseases, so they need to see a doctor in time to find out the primary disease and then carry out symptomatic treatment.
Indications of drug therapy
The patient has severe pain, severe nausea, vomiting, syncope and collapse, and needs immediate medical attention.
If you have low back pain, vomiting or chills in your limbs, you should seek medical attention immediately.
Medical department
1. Gynecological treatment is preferred.
2. If you have symptoms such as diarrhea, syncope and collapse, you can also go to the emergency department first.
The doctor inquired about the illness.
What is the patient's age?
Age of first dysmenorrhea, frequency of dysmenorrhea, onset time, duration, tolerance and menstrual blood color?
Dysmenorrhea symptoms? (lumbosacral pain, lower abdominal pain, inner thigh radiation pain, nausea, vomiting, diarrhea, dizziness, fatigue, etc.). )
Any other symptoms? (such as fever, general fatigue, syncope, pale face, chills in limbs, collapse, etc.). )
Have you ever diagnosed other organic gynecological diseases or other systemic diseases?
Inspection that needs to be carried out
survey fee
routine blood test
Red blood cell count and hemoglobin detection are helpful to infer menstrual flow and bleeding degree. If white blood cells are elevated, mainly neutrophils, it is considered to be related to inflammation.
Coagulation function
The bleeding time, coagulation time, prothrombin time and platelet count are helpful for the diagnosis of hemorrhagic diseases (hemophilia, thrombocytopenic purpura, etc.). ).
Gynecological color Doppler ultrasound
It can be used to observe the morphology of uterus and reproductive tract, so as to screen dysmenorrhea caused by abnormal uterine morphology.
Routine examination of leucorrhea and secretion culture
It is generally used for screening and diagnosis of gynecological inflammatory diseases.
Laparoscopy plus pathological examination
It is the gold standard for the diagnosis of endometriosis and adenomyosis, so as to diagnose secondary dysmenorrhea.
Tumor markers
The tumor marker that is often checked is CA 125. By examining tumor markers, we can rule out whether the patient's tissue is cancerous.
Nuclear magnetic resonance examination
MRI examination is used to observe whether the patient's uterine appendages or other tissues are diseased and whether there are abnormal changes in nerves or tissues around the uterine cavity.
gynaecological examination
Those without positive signs belong to functional dysmenorrhea, and some patients can see extreme flexion of uterine body or cervical stenosis, such as adhesion in pelvic cavity, lumps, nodules, thickening of adnexal area or uniform enlargement of uterine body, which may be caused by pelvic inflammatory disease, endometriosis, adenomyosis and other diseases.
Hysterosalpingography
Hyposalpingography is an X-ray examination method, which shows the cervical canal, uterine cavity and bilateral fallopian tubes by injecting contrast agent into the cervix, and judges according to the position, size and shape of the sub-organs and fallopian tubes. In addition, contrast agent can dilate and dredge fallopian tubes, which can make blocked fallopian tubes unobstructed, so hysterosalpingography not only plays a diagnostic role, but also occasionally has a therapeutic role. This inspection method has been widely used at present.
diagnostic criteria
Diagnosis of primary dysmenorrhea
Make a preliminary judgment according to the symptoms
Ask about the medical history in detail, and pay attention to the time, type and characteristics of pain. According to the onset within 65,438+0 ~ 2 years after menarche, the pain starts a few hours before the onset of menstrual blood, and the pain lasts no more than 48~72 hours. The pain is spasmodic or similar to labor pain.
Other screening tests were negative.
Can be excluded diagnosis, gynecological Shuanghe town or anal diagnosis is negative.
Diagnosis of secondary dysmenorrhea
Make a preliminary judgment according to the medical history and symptoms
Have a history of recurrent pelvic inflammatory disease, irregular menstruation, menorrhagia, intrauterine device placement, infertility, etc. Through gynecological examination, some causes of dysmenorrhea were found, such as uterine malformation, hysteromyoma, ovarian tumor, pelvic inflammatory disease and so on.
Carry out relevant examinations to diagnose organic gynecological diseases.
Other examinations, such as leucorrhea culture, gynecological B-ultrasound, hysterosalpingography, diagnostic curettage, hysteroscopy and laparoscopy, can identify the cause of dysmenorrhea as soon as possible.
differential diagnosis
treat cordially
The principle of treating dysmenorrhea is to relieve symptoms. According to the pathogenesis, primary dysmenorrhea can be treated by adjusting lifestyle and eating habits, improving mood and drug treatment, while the most important thing for secondary dysmenorrhea is to clarify the primary disease and carry out symptomatic treatment. For example, endometriosis usually requires surgery.
Family handling
Pay attention to menstrual hygiene and change sanitary napkins frequently.
Eat less cold and spicy food before and during menstruation, and try to eat lightly.
Paying attention to psychotherapy and eliminating tension and anxiety can relieve pain.
Ensure adequate rest and sleep, participate in labor and exercise properly, but avoid strenuous exercise and overwork.
To prevent colds and abdominal pain, you can apply hot compress to the lower abdomen and drink hot brown sugar and Jiang Shui.
Quitting smoking helps to relieve pain.
Go to the hospital for treatment
medicine
Prostaglandin synthase inhibitor
Indoleacetic acid, such as indomethacin and inflammatory pain.
Acetic acid and formic acid are also called paracetamol, and flumizinic acid is also called Xiaoyan Ling.
Phenylpropionic acid derivative, p-isobutyl propionic acid is called ibuprofen; Methoxynaproxen sodium is also called naproxen.
Paterson, Paterson or Hydroxy Paterson. The above four drugs are absorbed quickly and can be taken within 48 hours before menstruation. However, due to the frequent differences in the onset time of menstruation, it is generally appropriate to give drugs three days before menstruation to ensure the curative effect, and the remission rate is about 70%. If the above drugs are replaced, the effective rate can reach 90%. Gastrointestinal ulcer and people who are allergic to the above drugs are prohibited. The side effects are mild and most of them can be tolerated. Among them, only indomethacin has a high incidence of intestinal reaction, and symptoms such as dizziness, fatigue and headache can also appear, which makes more people stop taking drugs during treatment.
Sex hormone drugs
Inhibition of ovulation, dysmenorrhea mainly occurs in the ovulation cycle. Try to take oral short-acting contraceptives to inhibit ovulation, and the usage is the same as contraception; It can relieve symptoms. Medroxyprogesterone acetate, norethindrone or megestrol acetate can also be taken orally once a day 1 time, starting from the fifth day of menstruation, for 20-22 consecutive days with an interval of ***3 days, which can be used for endometriosis and the elderly.
Estrogen is often used for people with uterine dysplasia. Take estradiol valerate 1~2mg every night, starting from the fifth day of menstrual cycle, and take it continuously for 20 days, repeating 3 cycles. This method can inhibit ovulation and promote uterine development, but it should be followed up.
Progesterone, treating membranous dysmenorrhea. By supplementing progesterone, restoring the balance with estrogen, and peeling off the endometrium in menstrual period according to normal conditions, the pain caused by uterine spasmodic contraction can be alleviated.
Analgesia and spasmolysis
Take codeine or belladonna mixture orally, and inject atropine 0.5mg if necessary. It is best not to use dolantin or less morphine to prevent addiction.
needle therapy
Acupuncture therapy can not only effectively treat dysmenorrhea, but also prevent its onset. In recent years, it has been favored by clinicians and patients and achieved rapid development. Among them, acupuncture treatment, whether based on syndrome differentiation, single point or special acupuncture, has a rapid and significant effect on dysmenorrhea and can immediately relieve pain; Acupuncture combined with medicine can be used for simple acupuncture or intractable dysmenorrhea with no obvious curative effect. Ear acupuncture for dysmenorrhea is simple and less painful, which is more acceptable to patients.
Symptomatic treatment
Secondary dysmenorrhea is usually symptomatic treatment. For example, the western medicine pathology of endometriosis is that ectopic endometrium causes periodic bleeding under the action of female hormones. Because the blood does not follow the normal route, it cannot be excreted normally and accumulates in local lesions. Therefore, at present, dysmenorrhea caused by this reason is mostly treated by gonadotropin-releasing hormone agonist and anti-addition, or by laparoscopic surgery to remove the focus.
Traditional therapy in China
Qi stagnation and blood stasis
The principle of treatment is to promote qi circulation to relieve depression, promote blood circulation to remove blood stasis.
The ointment is prepared from Radix Angelicae Sinensis, Semen Persicae, Rhizoma Cyperi preparata, Areca catechu, Herba Taxilli, Radix Paeoniae Rubra, Radix Paeoniae Alba, Flos Carthami, Fructus Toosendan, Caulis Spatholobi, Massa Medicata Fermentata, Rhizoma Chuanxiong, Radix Salviae Miltiorrhizae, Rhizoma Corydalis, Herba Lycopi, Radix Rehmanniae, Herba Leonuri, Radix Aucklandiae, Radix Cyathulae and Radix Glycyrrhizae.
If every dysmenorrhea is accompanied by vomiting, Pinellia ternata, ginger and Evodia rutaecarpa can be added or subtracted; For those who refuse to press because of cold pain in the lower abdomen, remove Radix Paeoniae Rubra and Radix Rehmanniae, and add Cortex Cinnamomi, Fructus Foeniculi and Radix Linderae; If pelvic inflammatory disease is serious, Caulis Sargentodoxae, Cortex Moutan and Herba Patriniae can be added.
insufficiency of Qi and Blood
Treatment principle, benefiting qi and nourishing blood.
Plaster prescription: Radix Codonopsis, Rhizoma Chuanxiong, Rhizoma Polygonati, Fructus Ligustri Lucidi, Rhizoma Chuanxiong, Radix Achyranthis Bidentatae, Rhizoma Corydalis, Massa Medicata Fermentata, Pericarpium Citri Tangerinae, Radix Astragali, Radix Paeoniae Alba, Herba et Gemma Agrimoniae, Mulberry, Rhizoma Cyperi preparata, Oletum Trogopterori, Colla Plastrum Testudinis, Radix Angelicae Sinensis, Radix Rehmanniae Preparata, Ecliptae Herba, Radix Salviae Miltiorrhizae, Fructus Toosendan, Radix Aucklandiae and Colla
Add or subtract, such as cold pain in the lower abdomen, warm pressing, and add Folium Artemisiae Argyi, Herba Violae and Cortex Cinnamomi; For patients with soreness of waist and knees, Herba Taxilli, Cortex Acanthopanacis and Radix Morindae Officinalis are added.
prescribe a diet
Dietary conditioning of dysmenorrhea patients is very important. Generally speaking, to avoid cold stimulation of food, the diet is mainly light and warm. You can eat more foods with the same origin as medicine and food, such as longan, dried tangerine peel, angelica, Evodia rutaecarpa, etc., but the specific diet adjustment depends on the patient's condition.
Diet regulation
Patients with dysmenorrhea should eat more drugs and foods such as dried tangerine peel, rice, plum beans, etc.
Eat less cold and spicy food during menstruation, try to have a light diet and eat more warm foods, such as Evodia rutaecarpa, longan, angelica, mutton and ginger.
Later, you should eat more nourishing foods, such as mutton, donkey-hide gelatin and astragalus. And you can cook porridge or stew.
Eat more foods rich in B vitamins, such as coarse grains, milk and beans.
During the treatment, keep a light diet, drink plenty of water, eat more vegetables and eat foods with certain antibacterial effects, such as purslane, houttuynia cordata and amaranth.
Eat less sour food, including rice vinegar, strawberries, cherries, mangoes and lemons.
Do not eat cold food, such as all kinds of cold drinks, iced drinks, raw mixed cold dishes, pears, persimmons, watermelons, horseshoes, etc. Do not eat irritating foods, such as peppers, peppers and spicy condiments. Otherwise, it will aggravate pelvic congestion and inflammation, leading to excessive contraction of uterine muscles, leading to aggravated dysmenorrhea.
nurse
It is necessary for patients with dysmenorrhea to take corresponding care in their lives, especially those with primary dysmenorrhea. Through the adjustment of diet, living habits, psychological emotions and other aspects, dysmenorrhea can be relieved to a great extent, and symptoms can be eliminated or the disease can be recovered.
Daily nursing
Avoid catching a cold, pay attention to the weather changes, put on more clothes and keep your abdomen warm.
The diet is light and warm, avoid cold, irritating, greasy and other foods, pay attention to diet diversification and ensure nutrition.
Develop good living habits, avoid fatigue and staying up late, exercise properly, adjust your mood and maintain a good emotional state.
Pay attention to the changes of patients' condition, prevent the onset of dysmenorrhea symptoms by abdominal hot compress and oral Chinese medicine before menstruation, and see a doctor in time if necessary.
Disease surveillance
Pay close attention to the onset time, frequency, degree of pain, color of menstrual blood, and whether there are symptoms such as nausea, vomiting, diarrhea, dizziness, fatigue, pale face, cold sweat, syncope and collapse. Pay attention to distinguish between primary dysmenorrhea and secondary dysmenorrhea. If it is primary dysmenorrhea, it will disappear automatically after sexual intercourse or delivery. If it is secondary dysmenorrhea, you should see a doctor in time to find out the primary disease and treat it.
Psychological nursing
Patients with dysmenorrhea may have excessive mental stress, so family members should be careful and patient to comfort them, so that patients can maintain a happy mood, which will help relieve symptoms and better cooperate with doctors.
prevent
preventive measure
Pay attention to balanced nutrition, avoid eating too much food stimulated by cold, and take more warm food with the same origin of medicine and food.
Adjusting mood, exercising properly and improving immunity can prevent dysmenorrhea to some extent.
For people with frequent dysmenorrhea, pay attention to cold and warmth, and take hot compress, acupuncture, oral drugs for promoting blood circulation and removing blood stasis, and analgesic drugs to prevent dysmenorrhea before menstruation.
Patients with secondary dysmenorrhea should be treated in time and reviewed regularly.
- Previous article:Weather forecast in Shanxi and Shanghai
- Next article:Weather forecast of Zhuantang in Hangzhou
- Related articles
- The name of typhoon weather in weather forecast
- How to download the weather forecast when it will rain?
- Basic introduction of bordeaux producing areas
- How to identify the weather by looking at the clouds?
- What is the weather like in Fangchenggang, Guangxi recently? What are you wearing?
- What is the area of Gibraltar?
- What clothes are suitable for the grave?
- The West Garden of Lujiang Light Energy Garden has been delayed for three months, and the quality of the house is not good, which is very tangled. What should I do?
- What month is better to go to Tibet?
- Great Barrier Reef Travel Guide Great Barrier Reef Scenery