Patient's question:
I checked and found fecal Streptococcus in the leukorrhea. The doctor said it was bacterial vaginosis and prescribed medication. However, there's still some oxygen left. Can I use baking soda to wash?Doctor's answer:
Hello, women with vulvar and vaginal itching, severe to the point of unbearable itching and pain, unable to sit or lie down, or accompanied by increased discharge, are called "vulvar pruritus." It is also known as "pruritus of the vulva." This condition is equivalent to Western medicine's "vulvar pruritus," "vulvitis," "vaginitis," and "vulvar dystrophy."Etiology and Pathogenesis
The pathogenesis of this condition is primarily related to the dysfunction of the liver, kidneys, and spleen. The liver meridian encircles the external genitalia and governs blood storage; the kidneys store essence and govern reproduction, with orifices in the two lower orifices; the spleen governs the transportation and transformation of body fluids. Liver channel damp-heat, or liver stagnation and spleen deficiency transforming into fire and dampness, leading to damp-heat descending or damp-heat generating parasites, which erode the vulva, can cause vulvar pruritus. Kidney and liver yin deficiency, with essence and blood depletion, leading to wind and dryness transformation, causing the external genitalia to lack nourishment, can also result in vulvar pruritus. The former is an excess pattern, while the latter is a deficiency pattern.
Diagnosis and Clinical Diagnosis
Clinical manifestations: Itching of the vulva and vagina, which may also affect the anus, with intense itching, burning, pain, and even affect urination and sexual activity. Accompanied by increased discharge that is foul-smelling, with itching being particularly severe at night.
Examination: Gynecological examination may reveal redness or red swelling with eczema on the vulvar skin, scratching and broken skin with yellow fluid oozing, or persistent ulcers; or the vulvar skin may appear thickened, rough, and cracked with ulcers; or the vulvar skin may show depigmentation and whiteness, with atrophy. The vagina may contain grayish-yellow frothy discharge, or curd-like or cheesy discharge, or large amounts of purulent discharge. A vaginal discharge examination should also be performed to observe for trichomonads or fungi under a microscope.
Differential Diagnosis
Pubic lice: Vulvar itching with red spots or papules locally, and nits or short, wide pubic lice may be found on the pubic hair.
Key Points for Pattern Differentiation
1. Based on the itching of the vulva, combined with discharge and systemic symptoms, pattern differentiation is performed.
- Dryness, heat, or skin whitening, thickening, or atrophy in the vulva with severe itching at night indicates kidney and liver yin deficiency.
- Vulvar pruritus accompanied by increased discharge that is yellow and purulent, viscous, and foul-smelling indicates liver channel damp-heat.
- Vulvar itching with an insect-like sensation, severe itching, burning pain, and increased discharge that is yellow and frothy or curd-like and foul-smelling is often due to damp parasites thriving.
2. Inquire about the medical history to identify the underlying cause.
3. Combine gynecological examinations and vaginal discharge tests.
Treatment Principles
Treatment focuses on regulating the functions of the liver, kidneys, and spleen, adhering to the principle of "treating the exterior must start from the interior." An integrated approach combining oral medication and external treatment is employed.
Treatment Based on Pattern Differentiation
Traditional Chinese medicine requires a combination of external washing and oral medication. Avoid scratching to prevent infection.
Treatment aims to clear heat, resolve dampness, kill parasites, and relieve itching. The Huaihua Jiedu San formula is most effective.
Washing formula: Shechuanzi San to maintain vulvar cleanliness and encourage increased fluid intake.
If additional symptoms are present, medication can be guided to ensure rapid recovery.
If this is satisfactory, please support and adopt the recommendations.