"A headline with a mission"
Author/Dr. Miao
Itching refers to the itching symptoms of the vulvar area, which is common in various gynecological diseases, such as vaginitis, vulvitis, etc. The causes of itching are complex and diverse, and traditional Chinese medicine believes that the formation of itching is related to various factors such as dampness and heat, liver and gallbladder fire, blood deficiency and dryness. In this article, we will discuss the pathological characteristics and treatment experience of pruritus based on the theory of traditional Chinese medicine and classic works such as "Treatise on Typhoid Fever", and attach clinical cases for reference.
Etiology and pathogenesis of itching
In the theory of traditional Chinese medicine, the etiology and pathogenesis of itching are considered to be complex and involve a variety of internal and external factors. The following are the main causes and pathogenesis:
Damp heat build-up
Damp heat is one of the main causes of itching. When the evil of dampness and heat invades the human body and accumulates in the lower coke area, it will cause local dampness and heat, which in turn will cause itching. It is mentioned in the "Neijing": "The damp and hot qi bet on the bladder, and the damp and hot fight is itchy." This sentence clearly points out the direct effect of the evil of dampness and heat on the itching of the genitals.
The liver and gallbladder are hot
Liver and gallbladder fire can also lead to itching. Traditional Chinese medicine believes that if the liver qi is stagnant or the liver is inflamed, it will cause the liver meridian to be damp and hot, and bet on the genitals, thus causing itching. In addition, it is mentioned in the "Su Wen: Yin and Yang Imagery Treatise": "All pains, itching and sores belong to the fire of the heart. This implies that when the heart is hot, it may also trigger the liver fire, which indirectly leads to itching.
Blood deficiency and dryness
Blood deficiency and dryness are another cause of itching. When the human body is deficient in blood, the skin loses its nourishment, and it is easy to produce the evil of wind dryness, which leads to itching. It is clearly pointed out in "Lingshu Wuyu Jinjie Liquid Farewell": "Those who itch are also deficient in blood." This sentence emphasizes the direct connection between blood deficiency and yin itching.
2. Dialectical treatment of itching
The treatment of itching should be treated according to different etiologies and pathogenesis. It is mainly divided into damp heat betting, liver and gallbladder fire, blood deficiency and wind dryness.
1. Damp heat betting certificate
Syndrome: itching of the vulva, burning sensation, large amount of subband, thick xanthin, foul smell, yellow urine, red tongue and yellow greasy, and slippery pulse.
Treatment: clear away heat and dampness, kill insects and relieve itching.
Prescription medicine: Gentian laxative liver decoction plus or minus. Fangzhong gentian, skullcap, gardenia clear heat and relieve fire; Raw land, angelica nourishes yin and nourishes blood; psyllium, zexiao and dampness; Bupleurum soothes the liver and relieves depression; Licorice blends medicines.
Addition and subtraction: If the dampness and heat are heavier, you can add cork, sophora ginseng, and white fresh skin to strengthen the power of clearing heat and dampness; If the itching is severe, you can add Dihuzi, white moss skin, and Cnidium monnieri to enhance the anti-itching effect.
2. Hepatobiliary fire syndrome
Syndrome: itching of the vulva, accompanied by burning sensation, irritability, bitter mouth, yellow urine, red and yellow tongue, and number of pulses.
Treatment: Cleanse the liver and relieve fire, soothe the liver and relieves the gallbladder.
Prescription medicine: Gentian laxative liver decoction. Fangzhong gentian, skullcap, gardenia clear heat and relieve fire; psyllium, zexiao and dampness; Bupleurum soothes the liver and relieves depression; Angelica, the raw land nourishes yin and nourishes blood; Licorice blends medicines.
Addition and subtraction: If the upset and insomnia are obvious, you can add Coptis chinensis and lotus seeds to clear the heart and calm the nerves; If the mouth is bitter and the throat is dry, you can add gypsum and Zhimu to clear heat and moisten dryness.
3. Blood deficiency and dryness
Syndrome: itching of the vulva, dryness and desquamation, low menstrual flow, pale color, fatigue, yellowish complexion, thin tongue, weak pulse.
Treatment: nourish blood and moisten dryness, dispel wind and relieve itching.
Prescription medicine: Angelica sinensis drink plus or minus. Angelica sinensis, white peony and Chuanxiong in the recipe nourish blood and invigorate blood; Raw land, Polygonum multiflorum is moist and dry; nepeta, windproof, wind-dispelling and itching; Licorice blends medicines.
Addition and subtraction: If the itching is severe, you can add Dihuzi, white moss skin, and Cnidium monnieri to enhance the anti-itching effect; If the desquamation is obvious, you can add lily and wheat dong to moisten the dryness.
3. Traditional Chinese medicine treatment experience for itching
Based on the theoretical guidance, combined with my years of clinical practice, I would like to share a few experiences about the treatment of pubic itching.
First of all, we should pay special attention to dialectical arguments. When treating itching, it is not possible to generalize, and the treatment plan must be formulated according to the specific symptoms and constitution of the patient. Because different causes can cause different itching symptoms, treatment should be different.
Secondly, holistic conditioning is crucial. The treatment of itching is not only as simple as topical medication, but also focuses on overall conditioning. For example, for patients who bet on dampness and heat, we need to clear away heat and dampness; Patients with strong liver and gallbladder fire need to clear the liver and relieve fire; Patients with blood deficiency and dryness should nourish blood and moisten dryness. At the same time, we should also pay attention to the emotional regulation of patients, improve their living habits, and enhance their overall physical fitness.
In terms of drug compatibility, we should also make reasonable adjustments according to the condition. For example, for patients who bet on dampness and heat, we can add traditional Chinese medicine such as cork, Sophora radix, and white fresh skin to enhance the effect of clearing heat and dampness; For patients with strong liver and gallbladder fire, traditional Chinese medicine such as Coptis chinensis and lotus seed heart can be added to clear the heart and calm the nerves; For patients with blood deficiency and dryness, we can add traditional Chinese medicine such as lily and wheat dong to moisten dryness.
Finally, we cannot ignore the importance of topical treatments. Topical medication is very critical in the treatment of pruritus. We can use methods such as external washing and external application of traditional Chinese medicine, such as external washing of Sophora ginseng decoction and external application of Cnidium monnieri powder, etc., to directly act on the lesion area and achieve the effect of relieving itching.
4. Clinical cases
Case 1: Damp heat betting type itching
Patient: Li, female, 32 years old.
Chief complaint: itching of the vulva for 2 weeks, accompanied by a large amount of subband, and thick xanthin.
History: The patient began to develop itching in the vulva 2 weeks ago, accompanied by a burning sensation, a large amount of lower belt, thick xanthin, foul smell, and yellow urine. He has been treated with antibiotics with no obvious effect.
Tongue and veins: The tongue is red and greasy, and the pulses are slippery.
Diagnosis: damp heat bet type pruritus.
Treatment: clear away heat and dampness, kill insects and relieve itching.
Prescription: Gentian Liver Decoction plus or minus. Gentian herb 10g, skullcap 10g, gardenia 10g, raw ground 15g, angelica sinensis 10g, psyllium 12g, zexiao 10g, bupleurum 6g, licorice 6g. In addition, add 10g of cork, 10g of bitter ginseng, and 10g of white fresh skin.
Treatment process: After taking 3 doses, the itching was significantly reduced, and the amount of subband was reduced. After continuing to take 6 doses of the drug, the symptoms basically disappeared, and the belt was normal.
Press: The patient bets on dampness and heat, resulting in itching in the genitals, a large amount of lower belt, and thick xanthin. The treatment is to clear away heat and dampness, kill insects and relieve itching, and the medicinal gentian laxative liver decoction is added with cork, sophora ginseng, and white fresh skin, and the effect is remarkable.
Case 2: Hepatobiliary fire type itching
Patient: Wang, female, 28 years old.
Complaints: Itching of the vulva for 1 week, accompanied by irritability, bitter mouth.
History: The patient began to develop itching in the vulva 1 week ago, accompanied by a burning sensation, irritability, bitter mouth, and yellow urine. He has been treated with anti-allergic drugs with no obvious effect.
Tongue veins: The tongue is red and yellow, and the number of veins is stringed.
Diagnosis: hepatobiliary fire type itching.
Treatment: Cleanse the liver and relieve fire, soothe the liver and relieves the gallbladder.
Prescription: Gentian Liver Decoction plus or minus. Gentian herb 10g, skullcap 10g, gardenia 10g, psyllium 12g, zexiao 10g, bupleurum 6g, angelica sinensis 10g, raw land 15g, licorice 6g. In addition, add 6g of Coptis chinensis and 6g of lotus seed heart.
Treatment process: After taking 3 doses, the itching was significantly reduced, and the symptoms of irritability and bitter mouth were reduced. After continuing to take 6 doses, the symptoms basically disappeared.
Press: The patient's liver and gallbladder are hot, resulting in dampness and heat in the liver meridian, resulting in itching in the genitals. The treatment is to clear the liver and expel the fire, soothe the liver and relieves the gallbladder, and the medicinal gentian laxative liver decoction is added with Coptis chinensis and lotus seed heart, and the effect is remarkable.
Case 3: Blood deficiency and dry itching
Patient: Zhang, female, 35 years old.
Chief complaint: itching of the vulva for 3 weeks with infrequent menstrual flow.
History: The patient began to develop vulvar itching, dryness and scaling, light menstrual bleeding, pale color, and fatigue 3 weeks ago. Moisturizers have been used externally, but there is no obvious effect.
Tongue and veins: The tongue is pale and thin, and the veins are weak.
Diagnosis: blood deficiency and dry itching.
Treatment: nourish blood and moisten dryness, dispel wind and relieve itching.
Prescription: Angelica drink plus or minus. Angelica sinensis 15g, white peony 12g, Chuanxiong 10g, raw land 15g, Polygonum multiflori 10g, nepeta 6g, parsnip 6g, licorice 6g. In addition, 12g of Dihuzi, 10g of white moss bark, and 10g of Cnidium monnieri are added.
Treatment process: After taking 3 doses, the itching was significantly reduced, and the dryness and desquamation were reduced. After continuing to take 6 doses, the symptoms basically disappeared and the menstrual flow returned to normal.
Press: The patient's blood is deficient and dry, and the skin is not nourished, resulting in itching in the genitals. The treatment is to nourish blood and moisten dryness, dispel wind and relieve itching, and the medicinal Angelica sinensis drink is added to the skin seed, white moss skin, and Cnidium monnieri with remarkable effect.
5. Discussion
In the treatment of itching, the theory of traditional Chinese medicine has unique advantages. Through syndrome differentiation and treatment, combined with holistic conditioning and local treatment, it can effectively alleviate patients' symptoms and improve their quality of life. During the course of treatment, the following points should be noted:
1. Take dialectical argumentation as the principle
The etiology of itching is complex and diverse, and the treatment should be based on the principle of syndrome differentiation and treatment. Depending on the patient's specific symptoms and constitution, the appropriate treatment and medication will be selected.
2. Focus on holistic conditioning
The treatment of itching should not only be used topically, but also pay attention to overall conditioning. By clearing away heat and dampness, clearing the liver and purging fire, nourishing blood and moistening dryness, etc., it can effectively alleviate symptoms and improve the curative effect.
3. Emphasize drug compatibility
During the course of treatment, the compatibility of drugs should be adjusted according to the condition. For example, those who bet on dampness and heat can add cork, sophora ginseng, and white fresh skin to enhance the effect of clearing heat and dampness; For those who have a strong liver and gallbladder fire, you can add Coptis chinensis and lotus seed heart to clear the heart and calm the nerves; For those with blood deficiency and dryness, you can add lily and wheat dong to moisten dryness.
4. Pay attention to local treatments
For the treatment of itching, topical medication is also very important. Methods such as external washing and external application of traditional Chinese medicine can be used, such as external washing of Sophora ginseng soup and external application of Cnidium monnieri powder, etc., to achieve the effect of relieving itching.
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I Note: The purpose of this article is to spread the idea of diagnosis and treatment of traditional Chinese medicine, please follow the doctor's instructions for specific treatment and medication! Don't try it blindly! (Thank you for your attention, spread the culture of Chinese medicine, feel the power of Chinese medicine, and let more people benefit~)