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Introduction
When body resistance is lowered or external genitalia hygiene is neglected, various types of vaginitis are brought on by pathogenic microbes that easily can invade from outside the body through the vagina. Various kinds of vaginitis include nonspecific vaginitis, mycotic vaginitis, trichomonal vaginitis, amebic vaginitis, senile vaginitis, and infantile vaginitis. In traditional Chinese medicine, this disease belongs to the category of damp-heat in Chong and Ren Channels, weakness in the Belt Channel, and gynecological diseases.
Etiology/Pathogenesis
According to Chinese Medicine, the Chong and Ren Channels circulate through the pelvic region. The mechanism of this disease lies in imbalances in the Chong and Ren Channels and is induced by stagnant damp-heat and external pathogenic toxins lodged in the internal and external genitalia. Wang Lin Ming investigated the mechanism of senile vaginitis. He suggested that although the disease is seated in the vagina and is manifested as a full syndrome, it is a deficiency disease in origin. The pathogenesis is deficiency in kidney-qi, which causes excessive dryness in the vagina. The treatment of vaginitis should focus on restoring qi and restraining the pathogen. (1)
Primary Treatments with Chinese Medicinal Herbs
Wang Ya Juan treated mycotic vaginitis with a Ku Shen decoction. This decoction used the following herbs: Ku Shen (Sophora), Tu Fu Ling (Smilax), She Chuang Zi (Cnidium Fruit), Zi Cao (Lithospermum); Di Fu Zi (Kochia), Bai Xian Pi (Dittany Bark), Chi Shao (Red Peony), Cang Zhu (Atractylodes), and Huang Bo (Phellodendron). 300 ml water was used to decoct these herbs to a final volume of 150 ml. The decoction was used to steam and soak the affected area for 30 minutes each session, twice a day. After the local soaking, dyclonine was applied. One dyclonine suppository was placed into the vagina. The results showed that all 120 cases recovered. (2)
Other Treatments with Chinese Medicinal Herbs
Mei’s Vaginitis Formula
Cheng Xin Mei observed the clinical effects of treating mycotic vaginitis with Chinese herbs. The herbs included Huang Bo (Phellodendron), Huang Lian (Coptis), Huang Qin (Scutellaria), Chi Shao (Red Peony), Mu Dan Pi (Moutan), Tu Fu Ling (Smilax), Ku Shen (Sophora), She Chuang Zi (Cnidium Fruit), Bai Xian Pi (Dittany Bark), and Fang Feng (Siler). The herbs were decocted in water to a final volume of 500 ml. The decoction was used for bathing the vagina once a day. One course of treatment consisted of 6 days. After 1 to 2 courses of treatment, 28 cases were resolved, 2 cases showed some improvement, and 1 case had no improvement. The total effectiveness rate was 96.8%. (3)
Bei Xie Shen She Tang
Yang Cui Ru observed the clinical effects of treatment of mycotic vaginitis. For damp-heat type, modified Bei Xie Shen She Tang (a decoction for removing moisture) was used. The decoction consisted of Bei Xie (Tokoro), Cang Zhu (Atractylodes), Yi Ren (Coix), Huang Bo (Phellodendron), Ze Xie (Alism), Bai Xian Pi (Dittany Bark), Bai Shao (White Peony Root), Chen Pi (Citrus), Fu Ling (Poria), and Gan Cao (Licorice). For hypofunction of the spleen with stagnation of damp type, modified Si Jun Zi Tang (Four Noblemen Decoction) was used. The herbs used were
Dang Shen (Codonopsis), Bai Zhu (White Atractylodes), Shan Yao (Dioscorea), Bai Shao (White Peony), Fu Ling (Poria), Gan Cao (Licorice), Chai Hu (Bupleurum), Bai Bu (Stemona), She Chuang Zi (Cnidium Fruit), Bai Xian Pi (Dittany Bark), and Chen Pi (Citrus). For yin deficiency of the liver and kidney type, modified Zhi Bai Di Huang decoction was used. These herbs included Sheng Di (Rehmannia), Fu Ling (Poria), Shan Yao (Dioscorea), Shan Zhu Yu (Cornus), Ze Xie (Alisma), Zhi Mu (Anemarrhena), Huang Bo (Phellodendron), Bai Xian Pi (Dittany Bark), Mu Dan Pi (Moutan), and Bai Bu (Stemona). One dose of a decoction was taken each day. The formula for external bathing used Bai Bu (Stemona), Ku Shen (Sophora), Huang Bo (Phellodendron), Bai Xian Pi (Dittany Bark), and Pu Gong Yin (Dandelion). One dose was made into a decoction for external bathing 15 minutes twice a day. 10 days constituted one course of treatment. The results showed that among the 46 cases treated, 38 cases were resolved, 6 cases were improved, and 2 cases had no improvement. The total effectiveness rate was 95.6%.
Xia’s Vaginitis Formula
Ren Ming Xia et al. studied the clinical therapeutic effects of treating monilial vaginitis with Chinese herbs. The herbs used were: Ku Shen (Sophora), Bai Hua She She Cao (Oldenlandia), Huang Bo (Phellodendron), She Chuang Zi (Cnidium Fruit), Di Fu Zi (Kochia), Chi Shao (Red Peony), and Hua Jiao (Zanthoxylum Peel). These herbs were decocted in water. The decoction was then used for washing the external genitalia region. First, a cotton ball was soaked in the decoction and then was used to gently clean the region and the vagina. After removing all of the secretion, a second cotton ball was soaked in the decoction, and was placed inside the vagina. After 5 minutes, it was removed. This treatment was administered once a day, and 7 days constituted one course of treatment. Two courses were separated by a 5-day interval. At the same time, the patient’s partner was treated with the oral administration of anti-fungal herbs or by bathing with Chinese herbs. The results showed that after 1 to 3 courses, among the 50 cases treated, 46 were resolved and 4 showed effectiveness. (4)
Yi’s Vaginitis Formula
Lee Shou Yi studied the clinical therapeutic effects of external use of Chinese herbs on treatment for monilial vaginitis. The herbs used were: Chuan Lian Zi (Szechwan Chinaberry Fruit), Huang Bo (Phellodendron), Huang Qin (Scutellaria), and Da Huang (Rhubarb). One dose of the decoction was used every day. The decoction was used to douche the vulva-vagina twice a day, with an irrigator. The results showed that after 1 to 2 courses of treatment, symptoms subsided in all 23 cases with negative bacteriological tests. (5)
Wu Wei Xiao Du Yin
Wu Jin E observed therapeutic effects of modified Wu Wei Xiao Du Yin (an anti-inflammatory decoction with five herbs) on gonorrheal vaginitis. Patients were randomly divided into control and treatment groups. The treatment group consisted of 76 cases. The formula contained the following herbs: Jin Yin Hua (Lonicera Flower), Ye Ju Hua (Wild Chrysanthemum), Pu Gong Yin (Dandelion), Zi Hua Di Ding (Viola), Ze Xie (Alisma), Huang Bo (Phellodendron), Shi Hu (Dendrobium), Yu Jin (Curcuma Root), and Tu Fu Ling (Smilax). One dose of this decoction was used a day. 10 days constituted one therapeutic course of treatment. The decoction’s residual was decocted a second time. The resulting decoction was used to douche the vagina. The treatment was administered once a day. 60 cases in the control group took amoxicillin 0.5g twice a day and the vagina was douched with potassium permanganate once a day. The results for the treatment and control groups were, respectively: 57 and 33 cases were resolved and 19 and 27 cases had no improvement. The therapeutic effects were better in the treated group. (6)
Lang Du Tang
Qiu Mei studied the clinical effects of the external application of Lang Du Tang (a decoction of Chinese stellera root) on trichomonal vaginitis. The herbs used were Lang Du (Chinese Stellera Root), She Chuang Zi (Cnidium Fruit), Di Fu Zi (Kochia), Jin Yin Hua (Lonicera Flower), and Huang Bo (Phellodendron). These herbs were decocted in 1500 to 3000 ml of water. The treatment consisted of steaming and bathing with the fluid for 30 to 40 minutes in the morning and the night. One course of treatment consisted of 7 days. After 5 to 21 days of treatment, among 325 cases treated, 312 cases were resolved, 10 cases improved, and 4 cases had no improvement. (7)
Guan’s Vaginitis Formula
Zhang Zhu Guan treated trichomonal vaginitis with bathing solutions. The herbs used were: She Chuang Zi (Cnidium Fruit), Huang Bo (Phellodendron), Ku Shen (Sophora), Huang Bo (Phellodendron), Long Dan Cao (Gentiana Root), Bian Xu (Polygonum), Da Suan (Garlic), Cong Bai (Fistular Onion Bulb), and Sheng Giang (Ginger). The herbs were decocted and concentrated to a final volume of 150 ml. It was cooled to 37 to 39 degrees before it was used. After washing the external genitalia region, the herbal bathing solution was used to douche repeatedly. Otherwise, external genitalia and vagina was washed with a cotton ball soaked with the decoction. The treatment was applied once a day. 10 consecutive days constituted one course of treatment. The treatment was discontinued during the menstrual cycle and 3 days before and after menstruation. The results showed that after 2 to 3 courses of treatment, among 87 cases treated, 84 cases were resolved and 3 cases showed effectiveness. The total effectiveness rate was 100%. (8)
Fang’s Vaginitis Formula
Jiang Shao Fang, et al. observed the clinical effects of Chinese herbs on trichomonal vaginitis. The herbs used were: Ku Shen (Sophora Root), She Chuang Zi (Cnidium Fruit), and Gan Cao (Licorice). A decoction of these herbs was used to steam and wash the external genitalia for 20 to 30 minutes. This treatment was applied twice a day. The patient’s partner was also treated. After 3 to 7 days of treatment, 30 cases were resolved. (9)
Yu’s Vaginitis Formula
Zhao Feng Yu observed the clinical effects of treating trichomonal vaginitis with the external use of Chinese herbs. The herbs used were: Ku Shen (Sophora), She Chuang Zi (Cnidium Fruit), Di Fu Zi (Kochia), Huang Bo (Phellodendron), Bai Bu (Stemona), and Chuan Jiao (Zanthoxylum Peel). The herbs were decocted with 3000 ml of water to a final volume of 2000 ml. The decoction was then used to steam the external genitalia and bathe for 20 to 30 minutes after cooling slightly. One dose was used every other day. 10 days constituted one course of treatment. Among the 50 cases treated, 21 cases were resolved, 19 cases were significantly improved, 6 cases had somewhat improved, and 4 cases had no improvement. The total effectiveness rate was 92%. (10)
Xiao Yang Zhi Tai Jian
Song Yin Bo studied the clinical effects of Chinese herbal treatments on specific vaginitis. Xiao Yang Zhi Tai Jian (an anti-pruritus decoction to help stop leukorrhea) No 1 was used. It contained the following herbs: Bai Zhu (White Atractylodes), Bai Jiang Cao (Thlaspi), Pu Gong Ying (Dandelion), Ku Shen (Sophora), Bai Xian Pi (Dittany Bark), Huang Bo (Phellodendron), Cang Zhu (Atractylodes), Jin Yin Hua (Lonicera Flower), Che Qian Cao (Plantain), Tu Fu Ling (Smilax), Yi Ren (Coix), and Gan Cao (Licorice). For stagnancy in the liver with pain in lower abdomen, Xiang Fu (Cyperus) and Yuan Hu (Corydalis) were added. For kidney deficiency with lumbago, Xu Duan (Dipsacus) and Du Zhong (Eucommia) were added. For qi insufficiency, Huang Qi (Astragalus Root) and Tai Zi Shen (Pseudotellaria Root) were added. For the combination of damp and stagnancy, Dan Shen (Salvia) and Yi Mu Cao (Leonurus) were added. For abnormal menstruation, Wu Ze Gu (Cutle-bone) was added. One dose of the decoction was taken per day and divided into 3 separate administrations. Xiao Yang Zhi Tai Jian No 2 was used for the external treatment. This formula contained the following herbs: Ku Shen (Sophora), Jing Jie (Schizonepeta), Huang Lian (Coptis), Huang Bo (Phellodendron), Jin Yin Hua (Lonicera Flower), She Chuang Zi (Cnidium Fruit), and Bai Xian Pi (Dittany Bark). One dose of the decoction was divided into two administrations to be used a day in a bath for 20 to 30 minutes. For severe pruritus in the vagina, a cotton ball was threaded, soaked with the decoction, and was put into the vagina at night and taken out in the morning. 5 days constituted one course of treatment. The results showed that 32 cases were resolved and 24 cases improved. The total effectiveness rate was 100%. (11)
Bu Shen Zhi Yang Tang
Hu Jian Qiu et al. Bu Shen Zhi Yang Tang (an enforcing kidney and anti-pruritus decoction) was used to treat senile vaginitis. The decoction used the following herbs: Tu Si Zi (Cuscuta), Shan Yao (Dioscorea), Bai Zhu (White Atractylodes), Chai Hu (Bupleurum), Bai Shao (White Peony), Yi Ren (Coix), Xian Mao (Curculigo), Chen Pi (Ailthanus Root), Dang Shen (Codonopsis), Tu Fu Ling (Smilax), Lian Xu (Hindu Lotus Stamen), and Gan Cao (Licorice). One dose of the decoction was divided into 3 portions, taken in one day. 12 consecutive days constituted one course of treatment. Among the 84 cases treated, 37 cases resolved, 18 cases showed marked improvement, 14 cases had some improvement, and 15 cases had no improvement. Symptoms such as pruritus in the genitalia, large quantity leukorrhea, and burning sensations were significantly reduced. (12)
Other Treatments
Combining Chinese traditional medicine and western medicine
Lai Yan Ping treated trichomonal vaginitis by the combination of traditional and western medicine. A Bai She soaking solution was used. It consisted of the following herbs: JinYin Hua (Lonicera Flower), She Chuang Zi (Cnidium Fruit), Ku Shen (Sophora), Huang Bo (Phellodendron), Di Fu Zi (Kochia), Jing Jie (Schizonepeta), and Xian An Ye (Fresh leaf of Eucalyptus). At first, these herbs were decocted in 2200 ml of water for 15 minutes. The decoction was then filtered. After the fluid was cooled, it was divided into several portions of 400 ml each. The vagina was then douched by the decoction with an irrigator. Then it was soaked for 15 to 20 minutes. 1,000,000 units of Nystatin were inserted deeply into the vagina channel. Treatment occurred once every day and 15 days established one course of treatment. In the control group a 2 to 4% warm soda solution was used as an irrigating fluid and Nystatin administered. The results showed that all 16 cases in the treatment group were resolved. In the control group 13 cases were resolved and 3 cases had no improvement. It was concluded that the combination treatment is effective either in removing the heat and detoxification or in drying up the moisture and terminating leukorrhea. (13)
Yan Li Ying treated vaginitis with a combination of traditional Chinese medicine and Western medicine. Patients were divided randomly into two groups, 85 cases in each. For the treatment group, Zhi Yang Ye was used for douching the external genitalia once every day. The formula consisted of the following herbs: Huang Bo (Phellodendron), Ku Shen (Sophora), She Chuang Zi (Cnidium Fruit), Dang Gui (Chinese Angelica Root), Di Fu Zi (Kochia), Ai Ye (Artemesia), Mu Xiang (Saussurea), and Wei Ling Xian (Clematis). One course consisted of 10 sessions. In both the control and herbal treatment group, different antibiotics were placed in the vagina according to different symptoms, such as 0.4g of metronidazole in trichomonal infection, 500,000 units of antifungals for monilial vaginitis, 0.25g of tetracycline and 0.2g of metronidazole for bacterial infection, and 0.5mg of stilbestrol and 0.25g of tetracycline in senile vaginitis. For the control group, 2% sodium bicarbonate was used as a douching solution in monilial vaginitis and a 1:5000 potassium permanganate solution in all other types of vaginitis. The results in the treatment and control groups were, respectively: 84 and 69 cases were resolved and 1 and 16 cases had no improvement. The effectiveness rates were 98.8% and 82%. (14)
References
- Wang Lin Mian. Discussion on senile vaginitis’s mechanism and oral treatment. Shandong Journal of TCM. 1991;0(6):12-13.
- Wang Ya Juan, et al. Treating 120 cases of mycotic vaginitis with Ku Shen Tang. Shaanxi Journal of TCM. 1999;20(1):28.
- Chen Xin Mei. Experience in treating mycotic vaginitis by external treatment with Chinese herbs. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology. 2000; (4):30.
- Ren Ming Xia, et al. Treating monilial vaginitis with Chinese herbs. Journal of Traditional Chinese Medicine Research. 2000;16(4):27.
- Li Shou Yi. Clinical observation on treating monilai vaginitis with by external treatment with Chuan Liang San Huang Tang. Journal of Changchun College of TCM. 1999;15(4):32.
- Wu Jin E. Treating 76 cases of gonorrheal vaginitis with modified Wu Wi Xiao Du Yin- Treating 60 cases in the contrast group with Western medication. Zhejiang Journal of Traditional Chinese Medicine. 2000;35(3):110-111.
- Qiu Mei, et al. Treating 326 cases of trichomonal vaginitis by soaking with Lang Du Tang. Sichuan Journal of TCM. 1999;17(7):30.
- Zhang Zhu Guang, et al. Treating 87 cases trichomonal vaginitis with Ku Shen Ye. Bulletin of Correspondence College of TCM. 1999;18(5):35.
- Jiang, Shao Fang, et al. Treating 30 cases of trichomonal vaginitis with She Chuang Zi Ku Shen Ye. Journal of Folk Chinese Medical Treatment. 1999;7(7):30.
- Zhao Feng Yun, et al. Clinical observation on treating 50 cases of trichomonal vaginitis with external use of Chinese herbs. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology 1999;7(7):30.
- Song Yin Bo, Treating 56 cases of specific vaginitis Xiao Yang Zhi Xie Jian. Sichuan Journal of TCM. 2000;18(12):29-30.
- Hu Jian Jiu, et al. Experience in treating senile vaginitis with Bu Shen Zhi Yang Tang. Journal of Traditional Chinese Medicine Information. 1999;16(5):31-32.
- Lai Yan Ping. Treating 158 cases of tricomonal vaginitis with combination of Chinese and Western treatments. China Journal of Integrated Medicine. 1999;19(2):102.
- Yang Li Yin, et al. Clinical observation on treating vaginitis with combination of Chinese and Western treatments. Journal of Shizhen Medicine. 2001;12(2):181.
