Genital herpes is a sexually transmitted disease caused mainly by herpes simplex virus type II. The main clinical manifestations are clusters of small blisters on the pubic or perianal area, followed by erosion and superficial ulceration. Primary genital herpes is painful and is often accompanied by systemic symptoms such as enlarged inguinal lymph nodes, tenderness, fever, headache, and malaise. Recurrent genital herpes has milder systemic symptoms and rash, shorter duration, and mild localized burning, pins and needles sensation or abnormal sensation before rash emergence. According to the different clinical manifestations, there are three clinical types of genital herpes: primary, recurrent and subclinical. Primary genital herpes is the first infection; recurrent genital herpes is called recurrent genital herpes if the primary genital herpes rash recedes within 1 to 4 months; asymptomatic or atypical rash that produces only minor fissures and ulcers in the genital area is called subclinical genital herpes, and this type accounts for 50% to 80% of the incidence of genital herpes. In recent years, the incidence of genital herpes has been increasing year by year, and in Western countries, genital herpes is the 3rd most common sexually transmitted disease after non-gonococcal urethritis and gonorrhea. Because of the immunity of the body and the difficulty of drugs to eradicate the herpes simplex virus, the disease is prone to recurrence, and some scholars call it a hard-to-cure sexually transmitted disease. Genital herpes caused by herpes simplex virus type II is closely related to the occurrence of genital tumors such as cervical cancer, and can increase the chance of HIV infection, and newborns can be infected through the placenta and the birth canal, so it should be actively prevented. The aim of treatment is to relieve symptoms, reduce pain, shorten the course of the disease, reduce viral emissions, and prevent complications and secondary infections. The treatment of genital herpes is mainly antiviral therapy, combined with immunotherapy and local medication is expected to improve the efficacy; Chinese medicine also has certain advantages in the prevention and treatment of genital herpes. (a) systemic therapy 1, antiviral therapy acyclic guanosine (also known as acyclovir) is recognized as the drug of choice for the treatment of genital herpes, the drug can inhibit the DNA synthesis of the herpes virus and has less impact on the DNA synthesis of the host cell, the drug has few adverse reactions, long-term application has not been found to be significantly accumulation of toxic effects. For primary genital herpes, acycloguanosine 0.2g can be taken orally every 4 hours, 5 times a day for 7-10 days, or vancomycin 0.3, orally, twice a day, or famciclovir 0.25, orally, 3 times a day, both for 7-10 days. Treatment of recurrent genital herpes can be divided into episodic treatment and daily suppressive therapy. Treatment in the flare-up phase is best started within 24 hours of the onset of prodromal symptoms or damage, with acyclovir, vancomycin, or famciclovir, all taken for 5 days at the same dose as above. Daily suppressive therapy can be tried for cases with severe prodromal symptoms and for those who relapse more than 6 times a year with psychiatric symptoms. (Daily suppressive therapy should be avoided in many patients with more frequent relapses in the first few months after the primary infection within 1 year after the initial onset. Acyclovir 0.4g, orally, twice daily, or vancomycin 0.3g, orally, once daily, or famciclovir 0.25g, orally, twice daily, for 4 months to 1 year, and after 1 year stop treatment and give observation, it is reported that the application of daily suppressive therapy can reduce the number of relapses by more than 75% during the treatment period, and no long-term use of the above drugs has been found Toxic side effects of long-term use of the above drugs have not been found, but the blood picture and liver and kidney functions should be checked regularly. It is reassuring to know that as the immunity of the body improves, the number of relapses will decrease year by year, and there is no need for patients to spend their lives with antiviral drugs. If the symptoms of primary infection are severe or the rash is extensive, acyclovir 5-10mg/kg body weight can be used as an IV every 8 hours for 5-7 days or until the clinical symptoms subside; those who are resistant to acyclovir and other lovir drugs and immunocompromised can use sodium phosphonate injection 3.0g as an IV once daily, the IV time should not be less than 1 hour and 30 minutes for 7-14 days, and the patient is advised to Drink more water. The use of this drug should prevent its nephrotoxicity and the occurrence of hypokalemia and hypocalcemia. Avoid concomitant use with other nephrotoxic drugs. Pregnant women and children should not use this drug, and elderly patients over 65 years old should use this drug with caution. Immunotherapy There is a lot of information proving that the recurrence of genital herpes is closely related to immune deficiency, and the application of drugs to improve the immune function of patients can reduce the recurrence of genital herpes. The following immune-enhancing drugs are often used clinically: BCG polysaccharide nucleic acid injection 0.5mg, intramuscular injection, once every other day, 18 for a course of treatment, generally applied for 1~2 courses; glycyrrhetinic acid diamine injection 0.15g~0.2g added to 10% glucose 250ml IV for 3 weeks; thymidine for injection 10mg intramuscular injection, once every other day, 1 month for a course of treatment, used for 1~2 courses. 1~2 courses of treatment. Mannopeptide tablets 10mg can also be used orally 3 times a day for 1 month for 2-3 months. The treatment of genital herpes with interferon is not yet advocated. The main reason for this is that it is not easy to get rid of herpes. The formula is based on the different etiology of primary and recurrent genital herpes, primary genital herpes is based on the method of clearing heat and dampness, drying dampness and detoxifying dampness, and the formula is based on the addition and subtraction of gentian diarrhea liver soup; recurrent genital herpes is based on the method of benefiting qi and nourishing yin, clearing heat and dampness, and the medicine is based on Huangqi 30g, prunus ginseng 15g, Zhi Mu 12g, Huang Bai 12g, Sheng Di 30g, Da Qing Ye 30g, Pan Lan Gen 30g, Silphium 30g, Tu Fu Ling 30g, Dioscorea Z 15g, Glycyrrhiza glabra 3g, decoction in water, 1 dose daily. (B) Local treatment The principle is to keep the area clean and dry to prevent secondary infection. The rash can be applied topically with the following drugs: 3% acyclovir cream, 1% penciclovir cream, phthalbutamide application, recombinant human interferon a-2b cream, etc. Local corticosteroid preparations are contraindicated, and 0.1% Levanox solution can be used with wet compresses for lesions with a little exudate. (c) Treatment of genital herpes during pregnancy There is a lot of controversy about the treatment of genital herpes in pregnant women, the focus of the controversy is whether Lowe’s drugs can be used in pregnant women and whether they can achieve the purpose of controlling recurrence, so the medical profession does not yet advocate the use of Lowe’s drugs to treat genital herpes during pregnancy. According to foreign data, pregnant women with primary genital herpes have a 20% to 50% incidence of mother-to-child transmission during delivery via the birth canal because of the long duration of viral discharge, frequent involvement of the cervix, large damage area, and the absence of protective antibodies in the body, so a cesarean section is needed to prevent mother-to-child transmission. For pregnant women with recurrent genital herpes, the probability of mother-to-child transmission is 0%-8% when delivering via the birth canal because of the short duration of virus emission, small damage area, and protective antibodies in the body, etc. If there is no active genital herpes at the time of delivery, a cesarean section is not required; if there is active genital herpes at the time of delivery, a cesarean section is required; at the end of pregnancy (last 3 months), although there is a short recurrence, there is no active damage at the time of delivery Vaginal delivery is still possible. To avoid the occurrence of genital herpes, the best prevention and control measure is to be clean and to stop having unclean sex. Patients with genital herpes should avoid sexual intercourse during the onset of the disease; if they have sex with others during the non-onset period, they must use condoms. Women with recurrent genital herpes need to have regular gynecological examinations to exclude cervical cancer. Patients with genital herpes should usually pay attention to rest, avoid strain, maintain emotional stability, quit smoking, alcohol and spicy stimulating food, these measures will help reduce the number of recurrences of genital herpes, once the recurrence, should be promptly to the regular hospital dermatology consultation.