I. Definition
Acute epididymitis is an acute infection caused by retrograde infection of the seminal tract, as well as urethral instrumentation and long-term indwelling urinary catheter, etc. The pathogenic bacteria enter the epididymis retrograde through the vas deferens.
Diagnosis basis
1. Symptoms: Rapid onset, pain and pressure in the epididymis, radiating to the inguinal region and lumbar region, and rapid progress of swelling. Body temperature is high.
2.Signs: enlarged scrotum, red and swollen skin.
3.Blood routine: leukocytosis and left shift of nucleus. Urinalysis and urine culture results often show the presence of pathogenic bacteria.
4. Doppler ultrasound shows increased blood flow in the lesion.
Classification of symptoms
1.Damp-heat injection: swelling of one or both sides of the epididymis, pain and refusal to press, pain leading to the abdomen, cold and fever, thirst, red tongue, yellow and greasy coating, and stringy pulse.
2.Heat toxin congestion: The main manifestations are swelling of the epididymis, which cannot be divided from the testicles, hard and tough, accompanied by severe pain, sometimes with throbbing pain, redness and burning of the scrotum, or a fluctuating feeling. The tongue is red, the coating is yellow, and the pulse is counted.
3.Qi stagnation and blood stasis: testicular pain is heavier, traction on the abdomen, the whole or part of the epididymis is enlarged, with hard and tough texture, obvious pressure pain, dark red tongue, greasy moss, string pulse.
IV. Indications for admission
1. Scrotal pain and fever.
2. Scrotal swelling is obvious.
3. Increased white blood cell count and left shift of nucleus in blood routine.
V. Treatment routine
1.Living habits and dietary regimen
Acute epididymitis should be treated with bed rest, scrotum elevation, light diet, no spicy and stimulating food, and attention to emotional regulation; keep bowel movement smooth.
2.Application of broad-spectrum antibacterial agents, select sensitive antibiotics according to the results of TH analysis of urethral secretion.
3.Treatment by evidence
Internal treatment
Damp-heat injection: The basic treatment is to clear heat and dampness, detoxify and eliminate swelling. Soup: Bazheng san or gentian diarrhea liver soup with addition: gentian herb, scutellaria baicalensis, gardenia, Chai hu, psyllium, zedoary, neem, yuan hu, tong cao, q cun, slippery stone. Traditional Chinese medicine: Ermiao Wan (San) 9g, 3 times a day, taken orally; Gentian and Liver Pill 9g, 3 times a day, taken orally.
Heat toxin congestion: The basic treatment is to clear heat and detoxify pus. Soup: Xianfang Livestrong Drink with addition and subtraction: honeysuckle, angelica, red peony, frankincense, myrrh, dahurica, mother-of-pearl, perforated gourd, septoria, dandelion.
Qi stagnation and blood stasis: the basic treatment is to activate blood circulation and resolve blood stasis, soften hardness and disperse knots. Ligustrum lucidum with addition and subtraction: Salvia miltiorrhiza, Angelica sinensis, Boswellia serrata, Myrrh, Curcuma longa, Tangerine kernel, Lychee kernel, Neem, Yanhuzo, Seaweed, Kunbu.
External treatment
1. External application: use Ruyi Jinhuang Paste, once a day.
VI. Rehabilitation guidance
After the disease is healed, eat less spicy and greasy food, keep the bowels open, keep the perineum clean, and if necessary, both husband and wife should visit the doctor at the same time. Avoid the history of smuggling.