从“治未病”理论探析阴道炎的中医预防与体质调护策略

Analysis of Traditional Chinese Medicine Prevention and Constitution‑Regulating Strategies for Vaginitis Based on the Theory of “Treating Disease before Its Onset”

摘要: 阴道炎是妇科临床发病率最高、复发性极强的带下病，西医多以抗菌消炎、调节阴道菌群为主要治疗手段，但存在治标不治本、复发率高、易产生耐药性等弊端。中医“治未病”理论涵盖未病先防、既病防变、瘥后防复三大核心内涵，契合阴道炎隐匿发病、反复发作、体质为本的发病特点。本病归属于中医“带下病”范畴，核心病机为肝脾肾三脏功能失调，湿浊、湿热、寒湿之邪下注冲任胞宫所致，而偏颇体质是疾病发生、迁延、复发的根本内因。文章立足于中医治未病思想，结合九种体质辨识体系，系统探析阴道炎的发病体质基础，从饮食、起居、情志、运动、外治干预等维度，构建全方位、个体化的中医预防与体质调护方案，旨在从根源调节脏腑功能、纠正偏颇体质、祛除内生邪气，降低阴道炎发病率与复发率，为妇科炎性疾病的中医防治提供新思路与临床参考。

Abstract: Vaginitis is a highly prevalent and recurrent disease of vaginal discharge in gynecological clinical practice. Western medicine mainly adopts antibacterial‑anti‑inflammatory therapy and vaginal flora regulation for treatment, which, however, has limitations such as treating symptoms rather than root causes, a high recurrence rate, and a tendency to induce drug resistance. The TCM theory of “treating disease before its onset” consists of three core connotations: preventing disease before its onset, preventing deterioration after disease onset, and preventing relapse after recovery. It is consistent with the clinical characteristics of vaginitis, including insidious onset, frequent recurrence, and constitution‑oriented pathogenesis. Classified as “Dai‑Xia Bing” (disease of vaginal discharge) in traditional Chinese medicine, vaginitis is mainly caused by dysfunction of the liver, spleen, and kidney, as well as downward invasion of the Chong and Ren meridians by pathogenic dampness, damp‑heat, or cold‑dampness. Biased constitutions serve as the fundamental internal cause for the onset, progression, and recurrence of the disease. Based on the TCM theory of “treating disease before its onset” and the nine‑constitution identification system, this paper systematically explores the constitutional basis of vaginitis. A comprehensive and individualized TCM prevention and constitution‑regulating scheme is constructed from the perspectives of diet, daily living, emotion regulation, physical exercise, and external therapeutic intervention. It aims to regulate visceral functions, correct biased constitutions, and eliminate endogenous pathogenic factors fundamentally, so as to reduce the incidence and recurrence rate of vaginitis, and provide new ideas and clinical references for the TCM prevention and treatment of gynecological inflammatory diseases.