To analyze the medication rules of TCM for abnormal uterine bleeding during puberty by data mining of clinical cases.Methods:The medical records of adolescents with abnormal uterine bleeding from January 2020 to December 2022 were extracted from the information management system of Beijing Children's Hospital，Capital Medical University.The data were divided into two stages：hemostasis stage and conditioning stage，and the medication rules of the treatment based on syndrome differentiation were summarized.Results:A total of 663 adolescents with 1 020 medical records in the hemostasis stage and 796 adolescents with 2 047 medical records in the conditioning stage were included.In the hemostasis stage，169 Chinese medicinals were involved，among which the top 5 were carbonated Platycladi Cacumen，Moutan Cortex，Cirsii Herba，Ailanthi Cortex stir-fried with bran，and Paeoniae Radix Alba.The commonly used medicinals were cold and bitter，with tropism to the liver meridian and the effects of stopping bleeding and tonifying.In the conditioning stage，232 Chinese medicinals were involved，among which the top 5 were Angelicae Sinensis Radix，wine-processed Ligustri Lucidi Fructus，processed Epimedii Folium，Astragali Radix，and Rehmanniae Radix.The commonly used medicinals were warm and sweet，with tropism to the liver and kidney meridians and the effect of tonifying.The cluster analysis was conducted for high-frequency medicinals in the hemostasis stage and the conditioning stage，which revealed 4 and 5 core medicinal combinations，respectively.Conclusion:The real world clinical data showed that kidney yin deficiency and blood heat harassing internally were common syndromes of abnormal uterine bleeding during puberty.The treatment should stop bleeding first and then restore the functions of the spleen and kidney.Accordingly，the prescriptions should be formulated by compatibility of hemostatic，tonic，astringent，and heat-clearing medicinals.