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Abstract: A 29-year-old woman, Ms. Feng, reported recurrent vulvar pruritus for 1 month, especially at night, accompanied by increased leucorrhea with tofu-like consistency, exudate and odor from the vulva, which is a manifestation of Candida vaginitis. After discussing with the patient, she agreed to take regular medication, and the itching disappeared and the leucorrhea routine returned to normal.
Basic information】Female, 29 years old
Disease Type】TCM Diagnosis: Dysbiosis (Damp-Heat type); Western Medicine Diagnosis: Candida Vaginitis
Hospital】The First Affiliated Hospital of Henan University of Traditional Chinese Medicine
Date of Consultation】January 2022
Treatment plan】Medication (Chuan Bai anti-itch lotion, miconazole nitrate suppository) + general care
[Treatment Period] 7 days of medication treatment, review on day 7 and 14 respectively
Treatment effect] The vulvar itching disappeared, and the routine leucorrhea examination returned to normal.
I. Initial consultation
When we first saw the patient, we could see that she was panic-stricken, anxious and full of sadness. She reported that she had symptoms of vulvar itching 2 months ago, which were more obvious at night, and her symptoms were not relieved after rinsing with warm water, accompanied by bean curd-like leucorrhea with high volume. The symptoms were relieved after 1-2 weeks of continuous rinsing with drugs purchased from a pharmacy, but the vulvar itching still existed after stopping the drugs, and there was no obvious effect after using the drugs again. After questioning, the patient reported that she liked to eat spicy and stimulating food, occasionally stayed up late, had regular menstruation with a cycle of 28 days and a period of 7 days, the volume was medium, the clot was small and bright red, and her last menstruation was 1 week ago. The patient’s consent was obtained and a gynecological examination was performed. It was found that there was exudate in the vulva, with more tofu-like secretion and odor, and the vaginal mucosa and cervix were congested and red.
II. Treatment history
The patient was given further bacterial culture examination, which showed the presence of Candida albicans. Combined with the patient’s clinical manifestations and ancillary examinations, the patient was diagnosed with Candida vaginitis, also known in Chinese medicine as Takashita disease. After discussion with the patient, local medication was ordered. Firstly, Chuan Bai anti-itch lotion was used to wash the vulva area daily to relieve itching, while miconazole nitrate suppositories were given vaginally to effectively kill Candida albicans, and the combined medication was administered for 7 days along with general care, i.e., daily cleanliness and hygiene of the vulva and a light diet to effectively promote relief of the discomfort. The patient reported that the symptoms of vulvar itching improved after the 7th day of medication, but the leucorrhea was still more frequent, and the symptoms of vulvar itching disappeared completely on the 14th day, suggesting that the disease treatment effect was good.
III. Treatment effect
After the patient was treated with regular medication and general care, the symptoms of vulvar itching disappeared completely, the amount of leucorrhea returned to normal, and the routine examination of leucorrhea did not show any abnormality. After 1 week of regular medication and general care, the nature of leucorrhea was normal but the amount was still high, and the diet, sleep and urine and stool were normal. After the review, the patient was instructed to continue to use the medication. After 2 weeks of medication, the symptoms of vulvar itching completely disappeared, the leucorrhea returned to normal, and the diet, sleep and urine and stool were all normal.
IV. Precautions
As the patient has standardized the medication, the treatment effect is good and the symptoms have been relieved, I am also sincerely happy for the patient, but still recommend the patient to pay attention to the following matters: 1.
1, daily need to pay attention to ensure a light diet, eat more vegetables, fruits, such as spinach, apples, etc., avoid eating spicy and stimulating food, such as chili peppers, so as not to stimulate the local.
2, usually need to pay attention to ensure that the vulva area hygiene, diligent washing vulva, diligent change of underwear, intimate items need to be given sterilization, disinfection treatment and avoid sharing with others to avoid cross-infection.
3, avoid overwork, pay attention to rest and avoid staying up late, so as not to reduce the body’s ability to resist disease, resulting in recurrent infections of pathogenic bacteria.
4.After the recurrence of symptoms, you should go to the hospital in time to avoid self-medication.
V. Personal insight
Candida vaginitis is one of the common inflammatory diseases in gynecology, such as the patient in this case, who often becomes infected when her body resistance decreases such as staying up late or eating improperly, manifesting as vulvar itching and abnormal leucorrhea. The disease is relatively easy to cure and the treatment process is relatively short, but it is easy to recur when the body’s resistance is low, so it is recommended to go to the hospital promptly when symptoms appear and give appropriate treatment to promote the return of the disease.