Hunan University of Chinese MedicineProfessor Wang Ruoguang, Doctoral Tutor (medical doctor, postdoctoral Biology)The purpose of writing thi
Hunan University of Chinese Medicine
Professor Wang Ruoguang, Doctoral Tutor (medical doctor, postdoctoral Biology)
The purpose of writing this article is mainly to see a lot of mycotic vaginitis patients in clinical treatment, because the drug selection procedures are not standardized or have problems, resulting in many cases in time to healing of lingering illness. Therefore, I would like to talk about their own experience in diagnosis and treatment.
Candida, is a new method, formerly known as mold, Candida (mostly Candida albicans), etc.. Under the microscope can often be seen, such as pollution in the process of cell culture, pathogen detection, can make glycolysis, showing long filamentous, almost all parts of the body, such as foot, mouth, under normal circumstances do not cause disease, when the body flora, resistance drops, or long-term use of antibiotics, glucocorticoid hormone, chronic wasting disease, diabetes mellitus, easy onset.
From a clinical point of view, the anus is a major source of infection of vulvovaginal mildew fungus; intestines and an anus also lead to women's high number of fungal contamination source. Therefore, sometimes fungal infection has become one of sexually transmitted diseases. This is very common in clinical, a lot of women's infection, one aspect of their anus source, on the other hand is sexually transmitted! Drug resistance caused by sexually transmitted infections, treatment is more difficult.
Candida vaginitis is one of the most common diseases in gynecology clinic. However, often see some cases of prolonged does not heal, persisting for a long time. Personal experience is the main treatment methods and the selection of drugs, treatment and other related.
Candida is a kind of conditional pathogenic bacteria, whether the incidence of invasion of the human body depends on the level of human immunity and the number of infectious bacteria, virulence. When the body is in pregnancy, diabetes, oral contraceptives, long-term use of broad-spectrum antibiotics, corticosteroids and immunosuppressive agents make the body immunity, change vaginal environment, easy to cause the infection of candida.
The pathogenicity of Candida associated with the following factors: the adhesion; adhesion and virulence is proportional to the Candida albicans adhesion in the strongest; type two forms: when infection, Candida albicans often showed hyphae type. The virulence of hyphae type than yeast virulence type; the toxin: polysaccharide toxin cell surface and the other one is called "Candida toxin" may be pathogenic factors; the cell surface composition; the extracellular enzyme: Candida albicans can produce secretion of some enzymes, such as blood, soluble phospholipase phospholipase and extracellular acid protease (CAP) etc.. Which is the most important CAP. CAP not only hydrolyzed protein, but also hydrolyzed keratin and collagen, which could promote the adhesion of Candida albicans.
Candida albicans infection, the first is adherent to the host's epithelial cells, and then formed in the above Candida albicans pathogenic factors. Adhesion in epithelial cells because the membrane of the host cell adhesion receptor on the surface of Candida albicans, namely fucose and N- acetyl glucosamine; with a variety of adhesion mediated Candida albicans cell wall, which is more important with mannan (M-P) - protein complexes and chitin. Chitin is (1-3, 1-6) beta glucan and N- acetyl glucose by compound and a three-dimensional space polymer; Candida albicans cell wall with fibrinogen, fibronectin adhesion receptor components. And these components are widely distributed in the vascular wall, inflammation and wound healing and other parts, strong adhesion, and adhesion of Candida albicans to bridging Candida albicans and host cell adhesion, the Candida albicans adhesion and invasion of the host more easily.
1, the traditional Chinese medicine wash side, has a very good effect, I used in the clinical side repeated repeated effect, the role of strong.
2, Nifuratel nystatin soft capsules, topical.
3, miconazole, ketoconazole, itraconazole, clotrimazole suppositories, can choose one.
4, proprietary Chinese medicine: such as Sophora flavescens suppository, Funing suppository and so on, can choose one.
5, external preparations do not have to be too complex, choose a can;
1, medication time: the first 6 days, after the net after 6 days, the most critical of these two periods;
2, general medication must be through 3 menstrual cycles.
3, excessive use of antibiotics, estrogen, glucocorticoid or diabetes and other related diseases;
4, there are several kinds of oral drugs, liver and kidney damage and other side effects, commonly used for intestinal infections, general gynecological vaginal infection, external use can be;
5, traditional Chinese medicine lotion lotion, such as various types of traditional Chinese medicine, there are some disadvantages, such as dry after washing, the reason is to reduce compliance.
6, I often use in the clinical experience of their own, very good curative effect, the bacterial vaginosis, fungi, trichomonas, gonococcus has very good effect. Mainly from anti allergy, the formation of vaginal mucosal surface protective film, sterilization, phytoestrogens and other aspects of the role.
The following is a fungal vaginitis and patients to answer:
The patients of recurrent fungal vaginitis.
About mycotic vaginitis
First, about the common knowledge of mycotic vaginitis:
1, mycotic vaginitis is a small problem in general, but in clinical treatment, is not as imagined so simple; many patients with recurrent and difficult to cure;
2, the pain of fungal vaginitis is very obvious, the symptoms of itching is not all people have the degree of itching, sometimes a lot of leucorrhea (before or after menstruation), vaginal mucosa showed inflammation;
3, check leucorrhea is easy to diagnose and eliminate other reasons;
4, the mold is everywhere, mouth, hands and feet, all kinds of appliances, bathroom walls, long drying towel, bath towel;
5, the mold is a pathogenic bacteria, the general bacteria on the inhibition, other bacteria when the weak, the mold growth;
6, the southern humid environment, summer and autumn, especially in cold water bathing season, the most prone to;
Two, on the treatment of mycotic vaginitis:
By 1, the general treatment medication, topical drugs can cure fungal vaginitis, commonly used drugs such as miconazole, Econazole suppository, matrine suppositories, Nifuratel nystatin soft capsule and topical vaginal;
2, use time or time to take effect: general medication in the first 6 days, after 6 days; no other time; must adhere to 3 times before and after menstruation treatment; and the relative sensitive drugs, there are many cases of Daktarin not sensitive;
Take effect time: because the mold proliferation is fast, the tolerance is good, therefore generally needs to use the medicine 3 days to take the effect;
3, oral antifungal drugs: not recommended oral, such as the need to use oral ketoconazole, fluconazole and itraconazole; but these drugs harm liver and kidney and gastrointestinal reactions obviously; I don't clinical oral or injection; because a side effect is too large, treat the disease will not be damage to the body, external use can be cured completely; oral agents such as fluconazole, note taking only once.
4, husband: treatment is very important, mold, often associated with sexual life; contamination factors, such as tap water, bed sheets, towels, beriberi and so on; husband to external medicine for more than 3 weeks of continuous administration suggested interval is not the way (for 3 days to stop, and then next week), continuous medication because easy to hurt men the genital mucosa; male genital medication is very convenient;
5, female oral antibiotics, glucocorticoid, early birth control pills, estrogen preparation, diabetes, liver dysfunction and so on, is easy to mold factors;
6, Chinese medicine treatment, strength is very strong, I used a formula in clinical, the effect is very good, not only mold, all kinds of vaginitis have very good effect, and as long as less taste, can achieve the protective effect of estrogen, bactericidal effect, anti allergic effect, anti itch detoxification effect; compatibility is a very do not follow the routine the prescription;
7, the mold overall is a small problem, such as considering Jiuzhibuyu, urine, liver function, estrogen, beriberi, husband, etc. antibiotics used for a long time;
8, completely curable, but very painful, need time;
The second time：
1, don't use drugs such as miconazole, dressing; the reply to the optional;
2, soda water washing, long wash shoulds not be;
3, find the reasons, such as the above;
4, husband of Tongzhi, very important;
5, do not have to take medicine;
1, the so-called broken root, in fact, is the right conditions, and grew up,
2, to 3 consecutive menstrual cycles, choose sensitive drugs, topical; Nifuratel nystatin soft capsule, I used, the effect is good;
3, fungal treatment, generally for a period of 3 weeks of medication, but due to the female ovulation period leucorrhea, the effect is not good, I usually only in the first 6 days, after the net after 6 days, each menstruation so use; to be continuous for 3 times;
4, the husband is not cured, equal to the white rule;
Get well soon！
A lot of patients cured, the main reason is the medication is not standardized, or medication for too long, the vaginal mucosa is fragile, local resistance decreased, but easy to infection.
Treatment is divided into two steps:
The first step: fully adequate sterilization, a lot of drugs, can choose, such as those listed in the paper. Traditional Chinese medicine lotion is very effective, but the formula must be better.
The second step: to restore the balance of vaginal flora, which is the fundamental treatment, you can use Lacidophilin Vaginal Capsules, a period of time can be gradually restored, and prevent recurrence, restore the vaginal microenvironment.
Leucorrhea stimulation is the cause of vulvar itching, over washing can also cause genital itching, a variety of stimuli sensitive and itchy.
Do not always wash with soda, will increase the local resistance to fall;
Candida vaginitis, vaginitis, the United States has a diagnosis and treatment norms (2006), long-term refractory recurrent cases of pathogenic bacteria identification, drug sensitivity test, antibiotic selection is very important.
The external and oral administration of drugs should be orderly, reasonable and comprehensive treatment. Irregular treatment, or the use of some drugs, often cause liver and kidney damage. It is very important to choose the medicine according to the pharmacology and the specific pathogen and the degree of reproduction.
The high level of integration of traditional Chinese and Western medicine, regardless of the fungal disease, more diseases will bring benefits.