This disease is usually divided into acute and chronic. Acute vulvar ulcer is more common in nonspecific vulvitis, Behcet's disease (gangrene type, chancre type and miliary type according to clinical manifestations), herpes virus infection and sexually transmitted diseases (such as syphilis and chancre). Chronic vulvar ulcer can be seen in tuberculosis and cancer. Treatment requires keeping the vulva clean and dry; Antibiotics were selected locally for nonspecific vulvitis; Corticosteroids can be given to relieve the symptoms of Behcet's disease in the acute stage.
This disease generally belongs to the category of "yin erosion" in traditional Chinese medicine, and the downward flow of damp-heat is the basic pathogenesis, so the treatment has always been based on clearing heat and promoting diuresis. In this section, five prescriptions, such as ancestral fire and water pill and catechu cervical vertebra powder, are selected for clinical reference.
1. The ancestral fire and water elixir consists of 500g of ointment, 50g of gypsum, 20g of borneol, 0g of coptis root100g and a proper amount of Huang Dan.
Treatment: First, soak Coptidis Rhizoma in 3000ml boiling water for 3 days, then grind and mix Gypsum Fibrosum and Gypsum Fibrosum Plastrum Fibrosum, disperse with Coptidis Rhizoma water, and dry in the shade. Then add plumbum preparatium to pink, finally add Borneolum powder, grind into fine powder, and put it in a bottle and seal it for later use. At the same time, local routine disinfection or external washing with Chinese herbal medicine for clearing away heat and toxic materials, and then the powder is directly sprinkled on the ulcer surface. Take Longdan Xiegan Decoction for oral administration.
Efficacy: This prescription is mainly used for external use to detoxify, promote diuresis, remove putrefaction and promote granulation. Indications: vulvar ulcer.
38 cases were clinically applied in this group, all of which were cured. The longest cure time is 24 days and the shortest is 6 days, with an average of 1 1 day. Such as Feng XX, 1 1 year. 1978165438+1October 7. The pruritus vulvae has been 16 days, and the treatment is ineffective. Examination showed that there were scattered red rashes and five ulcers on vulva and perineum, and a little yellow secretion was oozing out. The prescription is Longdan Xiegan Decoction plus Cortex Moutan, Cortex Phellodendri and Fructus Cnidii for oral administration. Fire and water pills for external use. * * * cured after 8 days of treatment.
Experience shows that this prescription is an ancestral prescription, which has the functions of clearing away heat and toxic materials, promoting diuresis and removing rot, and promoting granulation, so it can cure this disease. Longdan Xiegan Decoction should be taken orally during the treatment. Married women are forbidden to have sex.
The prescription comes from Gong Guilie. "Shuihuo Dan" is used to treat vulvar ulcer. Sichuan Traditional Chinese Medicine, 1985, (3): 53.2. Danggui Aloe Soup consists of 60g of Danggui, aloe powder 1g (taken separately), 2g of Indigo Naturalis (taken separately), Rhizoma Chuanxiong, Cortex Phellodendri, Fructus Gardeniae, Radix et Rhizoma Rhei and 8g of Rhizoma Dioscoreae.
The treatment method is decoction, daily 1 dose. Generally, the dosage is 10 ~ 15.
Efficacy is mainly used for clearing heat and promoting diuresis, detoxifying and killing insects, cooling blood and nourishing yin. Indications: Acute vulvar ulcer.
The clinical application of patients with acute vulvar ulcer mainly shows that the front of vulva is red and swollen, the skin inside and outside labia minora, near vaginal vestibule, urethral orifice and upper vulva is ulcerated, the ulcer surface is different in size, the edge is irregular, the depth is different, the texture is soft, and some ulcer parts are covered with pus. Laboratory examination: Mycobacterium in secretion, syphilis serum reaction (1 min) and urine routine (1 min). Seven patients in this group were cured with a dose of 10 ~ 15.
Experience shows that the main cause of this disease is wet and hot soaking. In clinic, Danggui Aloe Pill, which has the functions of clearing away heat and toxic materials, eliminating dampness and killing insects, is changed into decoction, which can be handled flexibly according to different situations. Please pay attention to the dosage of each drug when using this prescription. Sweet angelica has the functions of promoting blood circulation, enriching blood and promoting granulation. It is the main medicine for treating this disease, and the dosage is large, which can be used up to 60g. Aloe vera is a detoxification and insecticidal product, and the dosage is1g. You can't take it as medicine, you should take it in a single package. In addition, Gentiana scabra should not be less than 15g. In clinical practice, the decoction has achieved good results in treating acute vulvar ulcer.
Treatment of acute vulvar ulcer with prescription Yuanjin, Danggui Aloe Decoction. Beijing Traditional Chinese Medicine, 1992, (6): 29.3. Composition of Qingre Qushi Decoction ① Oral prescription: Damp-heat endogenous kidney yin deficiency: Radix Adenophorae 20g, Radix Scrophulariae, Radix Sophorae Flavescentis, Cornus officinalis, Herba Dendrobii 20g, Fructus Lycii and Radix Salviae Miltiorrhizae 20g, pollen 12g. Type of damp-heat and qi stagnation and blood stasis in liver and gallbladder: Radix Gentianae, Radix Angelicae Sinensis, Radix Rehmanniae, Flos Chrysanthemi Indici, Fructus Gardeniae, Poria and Scutellariae Radix each 65438±02g, Radix Isatidis, Rhizoma Dioscoreae and Coicis Semen each 65438±05g, Herba Plantaginis, Radix Bupleuri and Radix Glycyrrhizae each 6g.
② External use: Coptidis Rhizoma, Cortex Phellodendri, Indigo Naturalis, Lead Preparata, Fructus Cnidii, Olibanum, Myrrha and Rosin each 65438±00g, Calcined Clam Powder and Sanguis Draxonis each 65438±05g, Borneolum Syntheticum, Ammonium Salt and Borax each 8g.
Treatment method ① Oral prescription: decoction, daily 1 dose, continuous administration 1 dose is1course of treatment. (2) External application: store the above ground powder in a bottle and spray a little powder 2-3 times a day.
The main effects are nourishing yin, clearing away heat and toxic materials, invigorating spleen and regulating qi, and promoting blood circulation to remove blood stasis. Indications: vulvar ulcer.
Clinical application: The shortest course of this group is 2 days, and the longest is over 9 years. Gangrene 1 case, chancre in 9 cases, miliary type in 33 cases. Histological examination: 8 cases were chronic inflammatory changes, 2 cases were vulvar skin tuberculosis, 2 cases were vulvar white lesions, 1 case was endometriosis. Of the 43 patients, 38 were cured, 3 were markedly effective and 2 were ineffective. The total effective rate was 95.3%.
Experience shows that 43 cases of vulvar ulcer can be treated by oral administration combined with local medication, which can remove putrefaction and promote granulation, eliminate dampness and promote blood circulation, improve skin metabolism and nutrition, and repair wounds. When used for inflammatory ulcer, good results can be obtained.
The prescription came from Sun. Clinical observation on 43 cases of vulvar ulcer treated by combination of traditional Chinese and western medicine. Shanxi Traditional Chinese Medicine, 1992, (2): 1 1.4. Catechu Cervical Powder consists of Catechu, cuttlebone and Zhang Dan in equal parts, which are mixed and ground into powder for later use.
The treatment method is to disinfect the affected area with11000 bromogeramine, and then spread the powder evenly on the plane. Take 1 ~ 2 times a day. Used for more than 3 times.
Efficacy: The prescription can clear away heat and toxic materials, prevent corrosion and remove dampness. Indications: vulvar ulcer.
This group 100 cases of clinical application, clinical observation shows that it has a good effect on vulvar ulcer. For example, 1 female, clinically diagnosed as "Behcet's syndrome", was discharged after taking 10. Some patients only need to take medicine for 2 ~ 3 times to recover.
Experience shows that vulvar ulcer, which is called "yin erosion" in Chinese medicine, is mostly caused by damp-heat accumulation and burning, and the treatment should be based on clearing away heat and toxic materials and eliminating dampness. This prescription not only has obvious curative effect on vulvar ulcer, but also has good curative effect on gynecological diseases such as cervical erosion and vaginitis. Because this medicine is cheap and simple to make, it has clinical value.
According to clinical observation, this prescription has the best effect of taking medicine before going to bed.
Ma's prescription comes from the fact that Jingjing Powder is used to treat vulvar ulcer. Jilin traditional Chinese medicine, 1983, (6): 2 1.5. Prescription composition of Behcet's disease: ① Internal medicine: Radix Pseudostellariae, Radix Adenophorae, Radix Scrophulariae and Rhizoma Anemarrhenae each 65438±05g, Rhizoma Smilacis Glabrae, Radix Polygoni Multiflori and Radix Astragali each 30g, and Cortex Phellodendri 60.
Changes in addition and subtraction: Radix Rehmanniae, Folium Bambusae, Caulis Akebiae and Glycyrrhrizae Radix can be added for patients with tongue and mouth ulceration, restless heart fire, restless night sleep and thirst due to stagnation of heart meridian and heat in small intestine; Radix Rehmanniae, Gypsum Fibrosum, and Radix et Rhizoma Rhei are added if fever, constipation, gluttony, and hunger are caused by stomach fire accumulation; Radix Rehmanniae Preparata, Fructus Corni and Rhizoma Dioscoreae can be added for patients with low fever, hand and foot heart fever, night sweats, dizziness, tinnitus and skin spots caused by liver and kidney yin deficiency; Radix Rehmanniae Preparata, Rhizoma Dioscoreae, Corni Fructus, Semen Cuscutae, and Fructus Lycii can be added for patients with oral ulcer or genital ulcer lasting for a long time, poor diet, and depression due to yin deficiency of spleen and kidney.
② There are two kinds of external medicines: one is Qingkuikou Powder (oral cavity): gypsum 9g, calcined Renzhong 9g, indigo naturalis 3g, mint 0.9g, Cortex Phellodendri 2. 1g, Rhizoma Coptidis 15g, calcined Lunatone 18g, and borneol 3g. Indigo powder (pudendum): Indigo 60g, gypsum, talc 120g, and Cortex Phellodendri 60g.
Treatment: ① 65,438+0 doses per day, taken as decoction, twice. ② Qingshuaikou Powder, for external use, gargle with salt water, and then blow into the mouth. Qingdai Powder washes vulva with warm boiled water, and then stops taking medicine by itself, every night/kloc-0 times.
The efficacy is mainly used for invigorating qi and nourishing yin, clearing heat and promoting diuresis, and dredging collaterals. Indications: Behcet's syndrome.
Clinical application: All cases in this group 10 were treated with traditional Chinese medicine, and 1 month to 1 half month was 1 course of treatment. After 1 course of treatment, symptoms and signs basically disappeared, accounting for 3 cases; 5 cases were effective when symptoms and signs improved; Patients with unstable or no improvement in symptoms and signs were ineffective, including 2 cases. The total effective rate is 80%.
Experience shows that "Behcet's syndrome" is equivalent to fox confusion in Synopsis of the Golden Chamber. The so-called "those who corrode the throat are confused, and those who corrode the yin are foxes." In this paper, a total of 10 cases were observed, mainly with deficiency of both qi and yin and damp-heat type. Therefore, self-made prescription treatment often works. In the prescription, Radix Scrophulariae and Cortex Moutan clear away heat and cool blood; Flos Lonicerae, Rhizoma Anemarrhenae, Cortex Phellodendri and Fructus Gardeniae are helpful for clearing away heat and toxic materials, releasing triple energizer and releasing heat. Smilax glabra helps to remove dampness and detoxify; Yiqi Shengjin, Radix Pseudostellariae Yiqi Jianpi; Polygonum multiflorum Thunb. And radix adenophorae. Nourish lung and kidney, ascend to the upper source, and open the water from the lower source.
The prescription originated from Wang Xicuo. Treatment of Behcet's disease 10 cases by oral and external use of traditional Chinese medicine. Journal of traditional chinese medicine, Liaoning, 1990, (1): 17.