Gynecology of Traditional Chinese MedicineIt is a clinical discipline that uses the theory of traditional Chinese medicine to study women's physiological and pathological characteristics and prevent and treat women's specific diseases.
chinese medicineGynecologyThe research scope includes irregular menstruationMetrorrhagia、Belt down, offspring, pregnancy, parturition, postpartum, breast disease° L, diseases of the anterior yin andMiscellaneous diseasesEtc.
Female internal genitalia
Gynecology of traditional Chinese medicine is one of the important components of traditional Chinese medicine, which is gradually formed, developed and enriched.The development history of TCM gynecology and obstetrics is divided into ten stages:
Traditional Chinese Medicine in Xia, Shang and Zhou Dynasties
(2197-770BC) Chinaremote dateOur ancestors accumulated medicine andmedical technologyBy the Xia, Shang and Zhou dynasties, there had been theoretical records on dystocia, seeds and prenatal education.For example, in the Records of the Historian, the Chu Aristocratic Family, there is a record of dystocia that "a contract was born after chest dissection".There is a record of taking "Gurong" for contraception in the "Mountain and Sea Sutra · Xishan Sutra".There are records of prenatal education in Biography of Martyrs.
(770-221 BC) Famous doctors in this periodFlat magpieBecause he was once specialized in the medical work of gynecology and obstetrics, he was called "taking care of doctors" (gynecologist) at that time.There are also theoretical records on gynecology in Neijing, which lays a foundation for the development of gynecology and obstetrics in traditional Chinese medicine.《Master Zuo's Spring and Autumn Annals》There is a record of "Zhuang Gongshousheng" having difficult labor.And "men and womenSame surnameIt was clearly put forward that consanguineous marriage is harmful to future generations, which is 2500 years earlier than Darwin's related statement in 1858 in BritainEugenicsThe research is also meaningful.
(221 B.C. - 220 A.D.) In the Qin Dynasty, there were gynecology and obstetricsmedical recordRecords.According to the Records of the Historian, Biographies of Bianque Canggong,TaicangGongfu Yuyi is the first“Diagnostic register”Among them, "Han Nunei's Cold Moon" and "Wang Meiren's PregnancyNo milk”All of the medical records are the earliest in obstetrics and gynecology.
By the Han Dynasty, obstetrics and gynecology had further developed. There were "female doctors" in the medical system, medical abortion, conjoined fetuses, surgical removal of stillborn fetuses and other records were first seen, and a number of obstetrics and gynecology monographs appeared.
Among the cultural relics unearthed from the Han Tomb at Mawangdui are《Fetal birth certificate》It is the earliest existing monograph on obstetrics and gynecology. The book puts forward some opinions on the monthly regimen of pregnancy, reflecting the understanding of pregnancy and fetal health at that time.
The three chapters on women in Synopsis of the Golden Chamber written by Zhang Zhongjing discussedPregnancy vomiting, pregnancy abdominal painPuerperal fever、Hot blood entering room, tape downAmenorrhea, the syndrome and treatment of diseases such as "Dongjia", and put forwardVaginal irrigationAnd drug takingExternal treatment。Many experiences and prescriptions at that time are still effective.Hua Lun, a medical expert of the same generation as Zhang Zhongjing, was a famous surgical expert in ancient China. He not only successfully performed an open operation, but also successfully performed an operation to remove the stillborn fetus.The Book of the Later Han Dynasty, Biography of Hua Tuo, said: "One Lun said: 'Dead fetuses are boring, and can't be self generated.' It was explored (taken from a distance). As a result, dead fetuses can be seen in human form, but their color is already dark. All Lun's unique skills are like this." It can be seen that gynecology and obstetrics at that time have developed to a considerable level.
(220 AD to 618 AD)Pulse scienceAnd the achievements of etiology and syndrome have promoted the development of obstetrics and gynecology.Written by Wang Shuhe of Jin Dynasty《Pulse channel》, according to《Dysmenorrhea》Take Cunkou aloneAnd summarized the pulse science knowledge before the 3rd century ADPulse diagnosisThe theory and method of.
In the field of obstetrics and gynecology, they put forward the theory of "living in the classics" and "avoiding the new year", pointing out that "there is no end to the rule,Fetal pulseFang Zhen and pulse discrimination between men and women describeTime of birth“Depart from meridians”That is, "pregnant women leave menstruation, their pulse is floating, abdominal pain is set to lead to the lumbar spine, so as to live for the present".
There are eight volumes on women's diseases in the book. The first four volumes discuss gynecological diseases, includingmenstruationThe following four volumes discuss obstetric diseases. According to the classification of pregnancy, labor, dystocia and postpartum, the etiologyPathogenesisAnd clinical findings.
(618-907 AD) The Tang Dynasty followed the Sui Dynasty to establish a relatively complete medical system and set up the "Grand Medical Office", which was the highest in the Tang Dynastymedical education Institutions and medical institutions, specialized in training medical talents.The development of medicine is characterized by a gradual trend towards specialization.
At this time, an important feature of the development of obstetrics and gynecology was the emergence of the existing monograph on obstetrics in China with relatively complete theories, namely, the "Chanbao" written by Yin.
(960-1279 AD) Gynecology and obstetrics in the Song Dynasty has developed into an independent specialty.Obstetrics is one of the nine departments set up according to the national medical education regulations.For example, Yuan Feng Bei Pai recorded: "There are 300 students in nine departments of the Imperial College of Medicine... 10 in obstetrics..." During this period, there were some important monographs on obstetrics and gynecology.As written by Yang Zijian《Ten industries theory》，Chen ZimingOf《A good prescription for women》, Zhu Ruizhang's《Maternity Essentials of Health Jiabao》, Li Shisheng's《Production theory》, Guo Jizhong's《Woman side》Etc.In this issue, Chen Ziming and his book "Women's Complete Prescriptions" made the greatest achievements in obstetrics and gynecology.The book systematically discusses the common diseases in gynecology and obstetrics, especially the treatment of dystocia.It is a famous monograph on obstetrics and gynecology in China. It was an outstanding work at that time. It has been popular for more than 300 years and has great influence on later generations of physicians.
(1115~1234 AD; 1271~1368 AD) The Jin and Yuan Dynasties was a period of contention of a hundred schools of medicine, and medical schools began to rise. Liu, Zhang, Li, and Zhu made contributions to obstetrics and gynecology from different perspectives.There were 13 medical departments in the Yuan Dynasty, including one obstetric department.
Jin Yuan Four MastersThe academic development of the Department of Obstetrics and Gynecology has broadened the idea of diagnosis and treatment of gynecological diseases.asLiu WansuBy《A collection of simple questions about pathogenesis, qi and life》The theory of fetal birth: "When a child is young, all of them belong to Shaoyin; when Tiangui is active, all of them are based on Jueyin; when Tiangui is inactive, they belong to the Taiyin meridian."RegularityIt is expounded that as a young girl, we should focus on tonifying the kidney, middle-aged people should focus on regulating the liverMenopauseEmphasize the theoretical basis of regulating the spleen.
Zhang Zihe's "Confucian Family Affairs" believes that "health preservation should be based on food tonic, and treatment should be based on medicine attack". He is good at using the three methods of sweat, vomiting and prostration to drive away diseases, which is also commonly used in gynecology.The book also recorded successful cases of hooking dead fetuses. The internal injuries in Volume 7 of the book said: "Another woman was in labor... her son died in her abdomen... she took the weight hook urgently, continued with the strong rope... hooking the dead fetuses..." It created a precedent for the operation of obstetric instruments in traditional Chinese medicine.Li Guo believed that "internal injury to the spleen and stomach is the beginning of all diseases", and the method of invigorating the spleen, promoting yang and removing dampness was mainly applied to treat diseases, which was also widely used in gynecology and received good results.According to his "Orchid Room Secrets", "WomenBlood avalanche, YesRenal fluidYin deficiency can not guard the envelope phase fire, so the blood flows away and collapses. "For today's menstrual disease (mainly“Dysfunctional uterine bleeding”）It is instructive to treat the disease.Zhu Zhenheng"Yang is often more than enough, and yin is often insufficient". In treatment, attention is paid to the preservation of yin essence, which has certain reference value in clinical practice for some treatment principles proposed by gynecology department for prenatal and postpartum diseases.Zhu Zhenheng is here《Ge zhi yu theory》In the conception theory, it is said that "when Yin and Yang copulate, the embryo pregnancy is coagulated. The place is called the uterus, which is connected at the bottom and has two sides at the top. One side reaches to the left and the other side reaches to the right." It clearly describes the shape of the uterus for the first time.
the Qing dynastyNearThere are more than ten kinds of monographs on gynecology and obstetrics, which have great influence in theory and practice, such as Fu Qing's Mastering Women's Medicine, Da Sheng Pian, Yi Zong Jin Jian · Tips for Gynecology and Shen's Collection of Women's Medicine.
(After 1949 AD) After the founding of the People's Republic of China, the cause of traditional Chinese medicine has been greatly developed, and the gynecology of traditional Chinese medicine has been further consolidated and improved.After 1956, all provinces and cities establishedCollege of Traditional Chinese MedicineWe have compiled five editions of the unified teaching material of Gynecology of Traditional Chinese Medicine, published the Encyclopedia of Chinese Medicine · Gynecology of Traditional Chinese Medicine, and published the teaching reference series Gynecology of Traditional Chinese Medicine. We have also compiled a number of internal teaching materials and monographs on gynecology.We have carried out medical education at different levels for doctors and masters, and trained a large number of gynecological talents of traditional Chinese medicine.
Four diagnostic methods of traditional Chinese medicine
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brief introduction
Observing, inquiring, smelling, cutting, and four diagnostic methods are the basis of gynecology in traditional Chinese medicineDiagnostic method。Women's physiological and pathological characteristics determine that they also have special features in diagnosis. If necessary, they can cooperate with gynecological examination and laboratory examination.
2. HopeLingual colorBright red tongue color is blood heat;Light red indicates blood deficiency;Pale white or fragrant moss with fat edgeTooth markbyLoss of both life and blood。Scanty mossOr peeling or cracking is yin deficiency,root of the tongueYellow and greasy furDamp heatIn the lower focus.Blood stasis refers to dark red tongue or purple spots on the edge of the tongue.
3. Lip colorRed purpleIt is blood heat, bright red and dry split, which is yin deficiency and fluid injury;Color light isSpleen astheniaanaemia;Dark cyan is the main pain;Pale cyan color indicates cold.
⑴ Quantity: too much belongs to qi deficiency or blood heat;Too little is blood deficiency or cold coagulation;More often, less oftenQi depressionorKidney asthenia。
⑵ Color: bright red or dark red belongs to blood heat;Pale red means blood deficiency or deficiency of both qi and blood;ColouronBlood stasis。
⑶ Quality: viscous is hot;Thin is empty cold;Blood clot is blood stasis.
⒍Look downSpleen deficiency due to thin color and white matter;It is yellow and thickDamp heat bet。Mixed colors and foul smell are mostly malignant tumors of reproductive tract.
7. It is expected that the amount of lochia will continue to be large, and the bright red color and thick substance will be blood heat;Dark, thick and smelly is damp and hot;Blood clots in purple darkness are blood stasis and cold.
Inquire
1. Ask the age, gynecological diseases are closely related to age.Kidney qi is at the beginning of puberty, and Chong Ren function is not yet perfect, which is prone to occurMenstruation is irregular, dysmenorrhea andDysfunctional uterine bleedingEtc.During the childbearing period, due to fetal birth and lactation, it is easy to consume qi and blood, which can cause menstrual disordersamenorrhoea, abortion, etc.the menopauseDue to the gradual decline of kidney qi, yin and yang are out of balance, which often leads to menstrual disordersMetrorrhagia、Postmenopausal and Postmenopausal SyndromeIt is also a period of high incidence of tumors, which should be paid attention to.
3. Ask about menstruationMenarcheAnd menopausal age, menstrual cycle, menstrual period, and menstrual volume, color and quality,Last menstruationDate, symptoms before and after menstruation, etc.In addition, askcontraception measuresAnd whether it affects menstruation.
⒋Ask and leadAsk about the color, quality, quantity and smell of the tapeYin itchingAnd other accompanying symptoms, gynecological examination, experimental examination, etc.
5. Ask the pregnancy about the last menstrual date, nausea and vomitingEdema, fetal movementVaginal bleeding、Abdominal painandLumbar acidEtc.Ask about the birth history, delivery situation, delivery mode, whether there is a history of massive hemorrhage after delivery, and what kind of family planning measures should be taken.
6. Ask about the amount, color, quality and smell of postpartum lochia, and whether there is fever, sweating, abdominal pain and other symptoms.In addition, the quantity and quality of milk should also be inquired.
8. Ask about professional life to understand the occupation, life and hobbies, and also ask whether there is a history of exposure to chemical poisons, and whether the work or room is wet or dry,eating habits, sexual condition and whether there is a history of cold in the rain during menstruation.
Auscultation
⒈Listen to the soundThe low and thin voice is a sign of qi deficiency, and the sigh from time to time is a sign of qi depression.Low voice or inability to speak during pregnancyPregnancy aphonia。Yawning constantly during childbirth is a sign of blood loss and qi exhaustion.
⒉SmellThose with blood filthy odor are hot, vaginal bleeding or with strange odor can be malignant tumors.Those with foul smell are mostly damp and hot.Cachexia of pregnancyThose who smell rotten apples at the mouth areAcidosis。After pregnancythe fetal movementIt disappears, the abdomen does not increase, and the fetuses with bad breath are often stillborn.
2. With lower pulsePulse stringNumber or slip number, which is damp and hotBelt down；The pulse is thin or weakNephrasthenia；String and slippery veins are often found in° LInflammation.
⒊Pregnancy pulseCunkou pulseSlippery is the pulse of early pregnancy. There is a feeling of gliding, counting and moving under the fingers.The weak can see all six channels,Ulnar veinThose who do not stop are alsoPregnant pulse。After pregnancy, the six pulse is thin, short and astringent, or the two chi pulse is weak and uneven intermittently, mostly due to weak qi;After pregnancyGliding pulseIf it disappears with a large amount of vaginal bleeding, it is possible for the fetus to die.
4. The parturient pulse has been pregnant for a full term, and the ulnar pulse turns as fast as cutting ropes, rotating beads, or the floating number of pulse is scattered.Or the pulse on both sides of the middle finger gradually reaches from the first phalanx to the middle of the finger tip.
5. The postpartum pulse should be weak and gentle, such aspostpartum hemorrhageMore than that, you can see the detailsAstringent pulse, postpartumnight sweatThe pulse can be seen in thin numbers.
[Abdominal diagnosis]
Focus on the lower abdomen.If you press it hard and hard, it will not disperse after pushing it. Most of the pain is blood stasis;If there is no lump or pain, it is blood deficiency;There are blocks according to them, and they will be scattered after pushingQi stagnation。
Mainly identify the menstrual cycle, menstrual period, menstrual volumeWarp color、MeridianAnd various symptoms associated with the menstrual cycle (Table 2).
It is mainly used to identify the quantity, color, quality and smell of the band, and the associated local or systemic symptoms (Table 3).
In addition, the semen of the five internal organs is depleted, and even the semen is withered,AzoospermiaThe fluid is weak and withered with veins, so there is no secretion under the belt,Vaginal dryness , orBurning pain, apathy,Oligomenorrhea，InfertilityEtc.
After the parturient gives birth, the residual blood turbid liquid of the uterus is discharged from the vagina, which is called lochia.The syndrome differentiation of lochia mainly refers to the abnormalities in quantity, color, quality, blood clots and abdominal pain (Table 4).
The syndrome differentiation of gynecological lower abdominal pain should be based on the time, nature, location and degree of abdominal pain, combined with meridians, bands, lochia, moss, pulse, etc. (Table 5).
The zang fu organs, qi and blood are closely related to gynecological diseases. Among the zang fu organs, the liver, spleen and kidney are most closely related to gynecological diseases.The differentiation of viscera and qi and blood is gynecologydisease diagnosis Common methods in (Table 6, Table 7).
Western Gynecology
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Summary of Western Gynecology
The treatment of gynecological diseases by Western medicine is called Western Gynecology. Gynecological diseases are common and frequently occurring among women.However, many people lack proper understanding of gynecological diseases, lack of health care for the body, andBad living habitsAnd so on, making the physical health worse and worse, leading to someFemale diseasesEntangled and incurable, it brings great inconvenience to normal life and work.
Pathological Introduction
Gynecological diseasesGynecological diseases, YesFemale reproductive systemA general term for common diseases. Major gynecological diseases include vulva diseases, vaginal diseasesUterine diseases、Fallopian tubeDiseases, ovarian diseases, and gynecological diseases are common and frequently occurring among women, which gradually reduce their physical health.
Internal cellar of medical history collection
⒈General itemsIncluding the patient's name, gender, age, native place, occupation, nationality, address, admission date, medical history record date, and medical history narrator.If it is not the patient's statement, the relationship between the narrator and the patient should be noted.
⒉Chief complaintThe main symptoms and course of disease should be listed clearly and simply.It is required to preliminarily estimate the general scope of the disease through the chief complaint.The common clinical symptoms of gynecology includePruritus of vulva、Vaginal bleeding、Leukorrhea, amenorrhea, lowerabdominal pain、Lower abdominal massas well asInfertilityEtc.If the patient has three main symptoms of menopause, vaginal bleeding and abdominal pain, the chief complaint should also be written in the order of its occurrence time as: x x days after menopause, x days after vaginal bleeding and x days after abdominal pain.If the patient has no conscious discomfort.Series onlyGynecological censusEarly son found atcervical carcinoma, the chief complaint should be truthfully written as: "cervical cancer" was found in the general survey × days.
3. The current medical history is the main part of the medical history, which should be described in detail.History of Present IllnessIt includes the whole process of occurrence, development and treatment of the disease from the earliest onset to this hospitalization.Generally, the main complaint symptoms should be the core and described in chronological order.First, ask whether there is an inducement for the onset, the specific time and priority of the onset, and the location, nature, duration and severity of the main symptoms;Then understand the development and evolution of the disease, whether it is continuous or intermittent, whether it is progressive or gradually alleviated, and the diagnosis and treatment process, treatment effect andside reactionEtc.In addition to the main symptoms, it is also necessary to ask in detail whether there are accompanying symptoms and their occurrence time, characteristics and evolution process, especially the relationship with the main symptoms.In addition, the general situation of the patient, such as appetite, urine and urine, weight change, and whether there isshiver、feverShall be inquired and recorded.Relevant symptoms with differential significance, even if they are negative, should be written in the current medical history.
⒋Menstrual historyMenarcheAge,menstruationPeriod and duration of period.For example, at the age of 14, menarche comes every 28 to 30 days and lasts for 5 days each time. It can be abbreviated as 14 Lei -!noodles;How much is your menstrual volume each time (you can ask to change it every daytamponTimes), Yes Noclot, whether there is any discomfort before menstruation (such asbreast tenderness , edema, depression orhotbedEtc.), Yes NodysmenorrheaAnd the location, nature and degree of pain, as well as the onset and disappearance time of dysmenorrhea.Regularly ask about the date (groan), volume and duration of menstruation. If the bleeding is different from the previous normal menstruation, ask againPrevious menstruationDate (PMP).Postmenopausal patients should ask about their menopausal age.Whether there is vaginal bleeding after menopauseLeukorrheaOr other discomfort.
5. Marriage history, number of marriages and age of each marriage, whether close relatives are married（Lineal relativeandThird generation collateral relatives）, the man's health condition. Yes NoHistory of metallurgy and tourismSTD history and cohabitation of both parties.Term birth, the number of premature births and abortions, and the number of existing children.If there are 3 full term births, no premature delivery, 1 abortion, and 2 existing children, it can be abbreviated as 3-0.1_2 or pregnancy only.3 (G4b).Delivery mode, with or withoutdystociaHistory, birth status of the newborn, and whether there is a history of massive hemorrhage or infection after delivery.spontaneous abortionOr induced abortion.Date of last delivery or abortion.What kind of family planning measures are adopted and their effects.
6. Personal history, life and residence, place of birth and area of former residence.Have hobbies such as smoking and drinking.
uterusmyomayesFemale reproductive systemMost commonBenign tumorMost of them are 35~50 years old.According to statistics, about 20% of women over 35 years oldfibroidHowever, most patients reported myoma clinically because of small and asymptomatic myomaincidence rateFar lower than it really is.Symptoms of hysteromyomaIrregular menstruation、Abdominal mass, compression symptoms, etc., uterine fibroids are often complicated with ovarian and ovarian diseases, and are also very easy to interact with the uterine bodyAdenocarcinomaIt also exists with cervical cancer. In winter, you should drink more boiled water and eat a certain amount of fruit every day to prevent uterine fibroids.
The surface of the normal cervix is covered by a layer of squamous epithelium, which is smooth and pink.Cervical deep tissue occurs due to infectionchronic inflammation , make the surface epitheliumNutritional disordersThe desquamated surface of epithelium is graduallycervixTubularColumnar epitheliumThe covered columnar epithelium is very thin, and the lower blood vessels and red stroma can be seen through, so the surface is red, which is cervical erosion.Cervical erosion ischronic cervicitis A common pathological change is that the columnar epithelium of the cervical mucosa grows slowly, the epithelium is flat, and the appearance is smooth, which is simple erosion due to different degrees of irritation of inflammation;The columnar epithelium grows fast and forms glandular erosion when glandular hyperplasia is formed.If the gland is dilated, it can beFolliclesType I erosion, accompanied by interstitial hyperplasia, forms small protuberances, and is covered with columnar epithelium unevenlypapillaLike erosion.These types can often be mixed.Cervical erosion is one of the most common gynecological diseases.
Cervical polyp is one of the manifestations of chronic cervicitis, which is more common in married women.Cervical polyps arecervixOne or several pedunculated pimples grow at the site of.The roots of small pimples are mostly attached toExternal orifice of cervixOnly a few grow in the cervical canal.The polyp is like a water drop, with a diameter of less than 1cm. Its pedicel is thin, bright red, soft and brittle, and it is easy to bleed after contact.Most cervical polyps arechronic cervicitis It is a manifestation of cervical mucosa hyperplasia under the stimulation of inflammation.
4. Cervical hypertrophy:
Hypertrophy of cervix Yeschronic cervicitis One of.Due to the long-term stimulation of chronic inflammation,CervixHistogenesisCongestion, edema, hyperplasia of cervical glands and stroma, and extrusion of glandular ducts by surrounding proliferative tissues make it difficult to discharge mucus produced by glands, which formsRetention cystThe superficial glandular cysts protrude to the surface of the cervix, which is easy to observe, while the deep glandular cysts often lead to the thickening and enlargement of the cervix to varying degrees, which is commonly calledCervical hypertrophy。
In the following pagesmenstruationThe term "amenorrhea" is used for all missing periods.There are two types of amenorrhea: primary amenorrhea andSecondary amenorrhea。We will introduce the two most common causes of amenorrhea elsewhere, pregnancy and menopause.
Secondary amenorrhea is defined as the absence of a menstrual cycle of more than 90 days (3 menstrual cycles disappear) in previously normal individuals.Menstruation disappeared more than 3 months must be checked.
The primary amenorrhea occurred at the age when the girl should have menstruation, but still not.For the first time, different peoplemenstruationMost people have menstruation at the age of 16.If a young girl has menstruation and her peers have not menstruated yet, she must go for an examination.
The causes of primary amenorrhea will be discussed later.
The following organs are related to the occurrence of normal menstrual cycle
⑷hypothalamus(One of the brainSpecial area）1. Endometrium The endometrium is usually either thick (stimulated by estrogen) or thin (decreased estrogen secretion).Also called "female reproductive organs" and "standard menstrual period".
2. Ovary
The menstrual period depends on the secretion of ovarian hormones.Menstrual deficiency usually occursAnovulationThe ovary does not emit anyEgg cell）。It is also called "standard ovary".
There are several possibilities:
⑴ No follicles are formed and no estrogen is produced.In this case, the endometrium will be thin.
⑵ It forms follicles but cannot divide, and also produces estrogen but does not interact withProgesteroneRelatively resistant to production.In this case, the endometrium will be thick.In the latter case, there is usually one or moreestrogenRelevant follicles exist.
Acoustic Navigation andranging system The inspection can show the presence of follicles,Blood testIt can show the level of estrogen in the blood.
3. Pituitary gland
The pituitary gland can secrete many hormones to control ourBody function。Three of these hormones are important for menstruation.They are follicle stimulating hormone（FSH）、Luteinizing bodyProduction hormone（LH）AndProlactin。The levels of these three hormones can be known through blood tests.It is also called "pituitary cycle and menstrual cycle".
If FSH and LH levels increase and estrogen levels decrease, then the problem usually lies in the ovary.The ovary can not cause the response of FSH and LH, but the continuous increase of FSH and LH levels can cause the response of the ovary.
If the FSH level is normal and the estrogen and LH levels are increased, the diagnosis of polycystic ovary disease can be excluded (see polycystic ovary).
Increased prolactin levels also require further examination.
Blood testing combined with endometrial microscopic diagnosis can provide medical practitioners with accurate information about the causes of amenorrhea.
The treatment of amenorrhea depends on the needs of pregnancy.If you want to have a child, you should do ovulation induction therapy and other hormone therapy to regulate the menstrual cycle.Endometrial thickeningThe most important thing for women is to regulate their menstrual cycle and prevent endometrial cancer in the future. Please remember: if your endometrium is thick, you do notcancerHowever, after many years (more than ten years), it may develop into incurable cancer.
pituitary tumor It is important to remember that only a few people with high prolactin levels can develop intoPituitary tumor。
Vaginal bleeding
Vaginal bleedingyesfemale organOne of the most common symptoms of gynecological diseases, the etiology is multifaceted. In addition to normal menstruation, when genital inflammationPathologicalPregnancy, endocrine disease, traumatumourVaginal bleeding can occur in such cases.So if female friends have vaginal abnormalitiesWhen bleeding, immediately go to the hospital to check and find out the cause of bleeding.clinical manifestationAnd its identification points:
1. Periodic vaginal bleeding
(1) Increased menstruation: the main manifestation is that the menstrual cycle is normal, but the amount of menstruation is high orProlonged menstruation。This type of bleeding is mostly associated with uterine fibroidsAdenomyosisOr placeIntrauterine deviceof
(2) Bleeding during menstruation: twiceMenstruationIt usually lasts for 3 to 4 days, and the amount of bleeding is generally less thanMenstrual blood volume, occasionally accompanied by lower abdominal pain or discomfort.This type of bleeding is caused byFollicle rupture, temporarily decreased estrogen level, also known asOvulatory hemorrhage。
⑶ Pre menstrual or post menstrual drip bleeding: a small amount of vaginal bleeding continues several days before and after menstruation, often dripping.Visible inOvulatory menstrual dysfunction Or side effects of IUD placement.EndometriosisA similar situation may occur.
(2) Postmenopausal vaginal bleeding: if the patient isWomen of childbearing age, with or without lower abdominal pain, nausea and other symptoms, first consider pregnancy related diseases, such as abortionEctopic pregnancyorTrophoblastDisease, etc;If the patient is adolescent Nonesex lifeHistory women or perimenopausal women with other symptoms should consider anovulatoryDysfunctional uterine bleeding。For the latter, malignant tumors of the reproductive tract should be excluded first.
⑶ Postmenopausal vaginal bleeding: generally, the amount of bleeding is small, and it can be continuous or repeated.Occasionally, it may be accompanied by lower abdominal pain.Endometrial cancer should be considered first, which can also be seen in senile vaginitis orendometritisEtc.
⑷ Posttraumatic vaginal bleeding: commonStraddle injuryAfter that, the amount of bleeding may be more or less, accompanied by pain in the external genitals.
electronic colposcopy : It can locate the cervical inflammation, precancerous lesions and cervical cancer before surgery, and enlarge the lesion 10~30 times, which is the most intuitive and importantGynecological examinationEquipment is also a common means of gynecological cancer screening.
gynaecologyUltrasonic examinationIn the field of gynecology and obstetrics, it has been widely used in the diagnosis of pelvic diseases and assisted in targeted treatment.
cough, feverheadacheTake antibiotics?However, antibiotics may inhibit some beneficial flora,mouldWill take the opportunity to breed in large numbers.Therefore, antibiotics should be used with caution.
Clean underwear separately
Mould can multiply on the surface of skin, gastrointestinal tract, nails and other places.If your family or yourself haveTinea pedis、ringworm of the nailsIt is easy to cause cross infection of mold.Therefore, the underwear must be washed separately, and it is best to soak it for a few minutes with special underwear sterilizing solution.
Female care fluid
Frequent use of detergent and disinfectionPadIt is easy to damage the vaginaweak acidThe weak acid environment of the vagina can maintain the self-cleaning function of the vagina. Ph4 weak acid formulaFemale care fluidIt is more suitable for daily cleaning and maintenance.
Pay attention to pregnancy care
During pregnancysex hormoneHorizontal, inside vaginaGlycogenAnd acidity will be increased, easy to be attacked by mold.For pregnant women, oral drugs should not be used, but local prevention andAdjuvant therapyProgramme.
Watch out for washing machines
Almost every washing bucket contains mould!And the more frequently you use the washing machine, the more mold you have!But don't worry, there is a killer weapon against the mold in the washing machine: wash the washing bucket with hot water at about 60 ℃OK！Regularly clean the clothes with disinfectant!
Pay attention to public health
public occasionsThere may be a lot of mold hidden.When going out, don't use the bathtub of the hotel, wear long pajamas, and put toilet paper on the toilet pad.Simultaneous selectionCoquettishOur personal cleaning and care products are easy to carry.
If you are infected with mycotic vaginitis, it is not only you but also you who need to be treated, so that the expected effect can be achieved.You usually use women dailyNursing liquidAt the same time, don't remember to prepare a man's care solution for him.
Wear cotton underwear
Tight fittingchemical fiberThe underpants will increase the temperature and humidity of the vagina, which is a "living" environment where mold can applaud!Choose cotton underwear instead!
Clean the vulva
Female diabetics have high vaginal glycogen content, which is produced by fermentation under the action of glycogenAlkaline substanceTo make a normal vaginaacid valueThe deviation from 4-4.5 is 5.5, which destroys the self-cleaning function of the vagina and is easy to be damaged by mold.Therefore, while controlling blood sugar, we should also pay attention to that when cleaning the vulva every day, it is more suitable to choose the female care solution with Ph4 weak acid formula.
Usage
Sanitary napkins are usedhigh-temperature sterilizationTo achieveAseptic stateAfter the one-time disinfection and sterilization period expires, its hygiene can no longer be guaranteed, and even if it is not opened, it will be polluted.Therefore, sanitary napkins should be bought now.
The sanitary napkin is made of fiber, so bacteria can easily invade and reproduce after being affected with moisture.Therefore, sanitary napkins after unpacking should be kept away from dark and humid places like toilets and placed in dry and clean environments.
Sanitary pad
Leucorrhea is a kind of sticky white liquid flowing out of the vaginaVaginal mucosaOfExudate、 Fallen vaginaepithelial cellsMixed.Normal leucorrhea is colorless or milky white, egg white, slightly fishy or tasteless.
Some women often use a lot ofSanitary padTo control leucorrhea, in fact, doing so will allow bacteria to invade.The sanitary pad on the marketHealth indicatorsSome are unqualified, some of which are oftenEscherichia coli, Streptococcusfungus, which will causeVaginal infection。
Gynecological ultrasound examination item 9:Gynecological tumors: ① Benign: such as uterine fibroids and various typesoophoritic cyst。②Malignancy: such as adenocarcinoma of uterine bodyChoriocarcinomaPrimary or secondary ovaryCancerous tumorEtc.
Gynecological examination
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afterInquireAfter the partitionTableGo, take off your clothes for gynecological examination.If anyUrination intentionDon't be embarrassed. A full bladder will directly affect the examination.Lying on the examination table with your legs apart, if you feel nervous, in addition to taking a deep breath to adjust yourself, don't forget to tell the doctor that she will help you distract.
Later, a deeper inspection is required, which requires the use of a camera, usually disposable or sealed after disinfection.The doctor will warm it in hot water and then apply itVaseline, and then put theDuckbillReach into the vagina, which makes the examination more bearable.When the duck's beak is opened, the inner wall of the vagina that normally sticks together is stretched open, and the doctor can clearly see the vagina and cervix.
vagina
Examination purpose: check whether the surface of vaginal mucosa is smooth, whether the texture is normal, and whether there isBleeding spot，Vaginal dischargeWhether the character and smell of the product are normal.Normal vagina: the vaginal wall mucosa is pale pink, with folds, no ulcers, vegetationscyst、Congenital malformation, the secretion is egg white like or white paste, no odor, small amount, butperiod of ovulationandPregnancyIncrease.If you want to check leucorrhea, the doctor will take a sample at this time.
Inspection purpose
Observe whether there is tumor, ulcer, erosion and polyp on the cervix, whether the size of the cervix is normal, whether the surface is smooth, whether the texture is too hard, whether there isUterine prolapse。Normal cervix: the periphery bulges, and there is a hole in the middle.NulliparousIt is round, and has been lying in a "one" shape. It is tough, flesh red, and smooth.If you want to do cervical cancer preventionsmearThe doctor will take samples at this time.
Inspection method
The doctor took out the speculum and put on a very thin pairRubber gloves, apply Vaseline, slowly put one or two fingers into the vagina, and put the other hand on the lower abdomen and press down hard. This is an examination of the uterus and accessories.This will make you nervous again, even some pain.No way, relax, keep your eyes onceiling, distract.If you are fat, you should let yourself relax.When the finger touchesFundus uteriYou will feel pain, but the time is not long, about 1 minute.
Uterus and accessories
Purpose: to know the position, activity and texture of the fundus of uterus. IfUterine enlargement. Hard and unsmooth surfaces are abnormal phenomena and need further inspection.Normal uterus: It is inverted pear shaped, 7-8cm long, 4-5cm wide, 2-3cm thick, most of which are in the anteversion and flexion position, with medium hardness and good mobility.The ovary and fallopian tube are collectively called "accessories", which can be moved and feel slightly distended when touched.Normal fallopian tubes cannot be touched.
Inspection points
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oneRoutine gynecological examination: Including the inspection of the size, shape and position of the vulva, vagina, cervix and uterus, as well as the fallopian tubes and ovaries.
fourCervical scraping examination: Cervical scraping is the most convenient and effective way to widely screen cervical cancerdiagnostic method 。TCTIt is a more accurate method than cervical scraping for cancer screening.
fiveMammography: Mammography computerNear infraredX-ray scanning is the latest instrument for breast examination. It uses near-infrared camera method to find many lesions invisible to the naked eye, which is convenient, efficient and painless.
The examination time should avoid menstruation, and it is better to choose the period from the end of menstruation toovulation The previous period was checked.
Take a shower the night before the routine gynecological examination24 hoursIt is not allowed to wash the inside of the vagina, because this will lead to abnormal secretions and some potentialcancer cellWashing off will affect doctors' correct diagnosis.
Don't have sex the night before the examination, because the man's semen andcondomThe spermicide on may appear in the test samples on the next day, interfering with the doctor's judgment.
The night before the routine gynecological examination, do not use any vaginal drugs. Any drug or lubricant used to treat vaginal infection will affect the test samples, cover abnormal cells, and affect the examination results.The leucorrhea specimen shall be retained by the gynecologist and sent for examination immediately without delay.
Preparation before gynecological examination.Find out what you wantGynecologistOn which day is there an outpatient service in the morning or afternoon? Three monthsmenstruationThe end of the day must be remembered.Put one in the bagNotepadThe date, content andDoctor's orderMake a record of everything.Try not to go to the gynecology department for examination during menstruation, and ensure thatpersonal hygieneYou can take a bath, but do not flush the vagina within 24 hours to avoid flushing out abnormal secretions.In addition, if you feel like urinating before the examination, you must gorestroom。The bladder filled with urine will affect the examination.
Complications of disease
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cervicitis
After inflammation of the cervix, there will be increased leucorrhea, local itching, tingling and other symptoms. At the same time, the stimulation of inflammation will also cause waist pain.
Abnormal uterine position
The normal position of the uterus is the anteversion and flexion position. If the uterus appearsRetroflexionWhen the position changes abnormally, the ligaments supporting the uterus in the body are excessively pulled, and at the same time, some nerves are compressed, which can cause low back pain.
Uterine prolapse
The uterus moves downward along the vagina. As the pelvic supporting tissue is weak and the tension is reduced, the pressure of the abdominal cavity increases, resulting in a sense of falling and waist pain due to traction.
If there is a tumor in the pelvic cavity such asfibroid, cervical cancer, ovarian cyst and other compression nerves or cancer cells infiltrating into pelvic connective tissue can cause low back pain, andPainIt will be aggravated with the increase of tumor.
Pregnant women
After pregnancy, as the fetus grows month by month, the waistSupport forceIncreasing, long-term mechanical action will lead to gradual relaxation and expansion of ligamentsUterine cavityCompression of pelvic nerves and blood vessels can also lead to low back pain.
After pregnancy, due to the enlargement of the fetus, the lumbar support force increases, leading to the relaxation of the sacrospinal ligament, and the compression of pelvic nerves and blood vessels, causing low back pain.This kind of low back pain usually followsMuscle strengthThe recovery of may gradually disappear.
Abdominal distention and pain
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Female patients with lower abdominal pain, mostly gynecological inflammation, can also have internal diseases andSurgeryIllness.Therefore, once women have lower abdominal pain, they should carefully identify the nature of pain in order to get timely treatment.
frommenstruationPain caused: women's lower abdominal pain and general discomfort during menstruation are mostly physiological phenomena. If the pain is severe, it is dysmenorrhea.Adolescence is mostlyPrimary dysmenorrhea, self-healing;The dysmenorrhea after menstruation is mostly caused by a certain disease, so you should seek medical treatment early instead of usinganodyneTo solve the problem.
Abdominal pain caused by certain gynecological diseases: for example, endometriosis often forms a mass near the ovary, uterus and rectum, which canPremenstrual periodAnd increased abdominal pain during menstruation,Coital painIt is also one of its characteristics.Another example is pelvic hemorrhage orBlood stasis stops, can cause pelvic pain, which is often manifested as the root of one thigh.
Abdominal pain caused by ovulation:period of ovulationAppears insideLower abdomenDistention painThis is becauseFollicle ruptureCaused by.Generally speaking, this kind of pain does not affect health and has no adverse consequences, but very few people suffer from ovulationovarian follicleLarge perforation, resulting in damage to small blood vesselsRupture of ovaryTo make an abdominal cavityInternal hemorrhageIn case of gynecological emergency, you must go to the hospital for treatment.
Disease hazard
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If you have gynecological inflammation, you should arrive in timeRegular hospitalScientific and standardized treatment is carried out because:
First, if inflammation is not treated in time, it may lead to mutual spread and cross infection of inflammation in various physiological parts, and it will also bring manycomplication, and even lead to malignant lesions in some parts.
Second, if inflammation is not treated, the body will be exposed to inflammation for a long timeimmunity, metabolism andendocrine systemWill have adverse effects on health.
Third, some gynecological inflammation not only harms women themselves, but also affects their families. If pregnant women, it can also causeintrauterine infection 、birth canalInfection and other links infected newborns, resulting in abortion, premature delivery, congenital malformations, mental retardation and other serious consequences.
Therefore, women should insist on physical examination. If they are found to have gynecological inflammation or other diseases, they should go to regular hospitals in time for scientific and standardized treatment.
Treatment misunderstanding
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Myth 1: Abuse of antibiotics or use of antibiotics will cause bacteriaDrug resistance, and kill a large number of peopleprobiotics , destroy vaginaFloraAnd lead to vigorous growth of fungi,Gynecological diseasesStubbornness is difficult to deal with, and it is difficult to cure thoroughly.
Misunderstanding 2: Improper cleaning of lower bodycolpitisAs the most commongynaecopathiaMore than 40% of patients are caused by improper cleaning methods.Female vagina isAcidic environmentIt has self-cleaning antibacterial effect, but many women use it for a long timeLotionWashing the lower part of the body will kill the vaginal bacteria that are beneficial to the body, reduce the local resistance and cause infection
Myth 3: Treatment does not follow the course of treatment. When most women are treated withSubjective feeling: When the symptoms are good and the leucorrhea is normal, the disease is considered good, so the drug should be stopped as soon as possible, causing repeated infection.The gynecologist pointed out that:gynecological inflammationThe treatment of gynecological inflammation should be strictly carried out according to the course of treatment. If the treatment is not carried out according to the course of treatment, gynecological inflammation will become chronic and more difficult to treat.
Gynecological health care
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Climacteric womenit is to be noted thatReasonable diet。Menopause women should pay attention to spiritMental healthOutside,Reasonable dietWe should also pay considerable attention.reunite withvitamin BIt can maintain nerve function, promote digestion, prevent headachedizzy, keepmemoryAnd so on.Xiaomioatmeal, corn, etcCoarse grainandMushroom, mushroom, etcMushroomFood is rich in vitamin B. Menopausal women should eat more of these foods appropriately.Water and salt of menopausal womenMetabolic disorder, water and sodium retention is easy to occur, causing edema, and further causing increased blood pressure.Therefore, salt consumption should be limited to half of that of young and middle-aged people.ClimactericCarbohydrate metabolism、Fat metabolismIt is also often disordered and prone to hyperglycemia,blood fatIncrease, body tends to obesity, anddiabetes、atherosclerosis。Therefore, menopausal women should eat lesssweet food, animal fat andAnimal viscera, eat more coarse grains.As we grow older,Basal metabolismIt is easy to cause energy surplus.Therefore, obese women should limit their staple food intake.Ensure thatproteinYes, you can eat morelean meat, chicken, fish, eggs, dairy products andBean Products。commonlyvegetable oilinUnsaturated fatty acidHigh content, such as soybean oilRapeseed oil、Corn oil、Sesame oil、sunflower oilBoth contain high calories, and excessive consumption will lead to energy surplus.It is reported thatPolyunsaturated fatty acidsThe intake of can also increase the incidence of cancer.
