中医治疗带下病的最新进展

The Latest Progress of Traditional Chinese Medicine in the Treatment of Leukorrheal Diseases

摘要: 带下病是妇科临床高发病、常见病，对应西医阴道炎、慢性宫颈炎、人乳头瘤病毒持续感染、盆腔炎等生殖道炎症类疾病，以带下量、色、质、气味异常，伴外阴瘙痒、灼痛、小腹坠胀、腰骶酸痛为核心临床表现，严重影响女性的身心健康与生活质量。本病病机以湿邪为主，兼夹热、毒、瘀、虚，肝、脾、肾三脏功能失调与任、带二脉失固为发病根本。近年来中医治疗采用中药口服、中药制剂外用、针灸、艾灸、中药联合中药熏洗/针灸/穴位埋线/中药灌肠等内外联合方案论治带下病，多靶点改善阴道微生态、下调促炎因子、提升机体局部与全身免疫，复发率显著低于单纯西药治疗。本文综述了近5年来带下病中医治疗的最新进展，总结现有研究不足并展望今后研究方向，为临床辨证施治提供参考依据。

Abstract: Leukorrheal disease is a high incidence and common disease in gynecology. It corresponds to the inflammatory diseases of reproductive tract such as vaginitis, chronic cervicitis, HPV persistent infection and pelvic inflammatory disease in western medicine. The core clinical manifestations are abnormal amount, color, quality and smell of vaginal discharge, accompanied by pruritus of vulva, burning pain, abdominal distension and lumbosacral pain, which seriously affect women’s physical and mental health and quality of life. The pathogenesis of this disease is mainly dampness, accompanied by heat, toxin, stasis and deficiency. The dysfunction of liver, spleen and kidney and the failure of Ren and Dai meridians are the root of the disease. In recent years, traditional Chinese medicine treatment has adopted internal and external combined schemes such as oral administration of traditional Chinese medicine, external use of traditional Chinese medicine preparations, acupuncture, moxibustion, traditional Chinese medicine combined with traditional Chinese medicine fumigation/acupuncture/acupoint catgut embedding traditional Chinese medicine enema to treat leukorrheal diseases. Multi-targets improve vaginal microecology, down-regulate pro-inflammatory factors, and enhance local and systemic immunity of the body. The recurrence rate is significantly lower than that of western medicine alone. This paper reviews the latest progress of traditional Chinese medicine treatment of leukorrheal diseases in the past five years, summarizes the shortcomings of existing research and looks forward to the future research direction, so as to provide reference for clinical syndrome differentiation and treatment.