According to traditional Chinese medicine, genital herpes is considered an early stage of heat syndrome, a real syndrome, caused by damp-heat and toxic heat blocking the liver meridian. In the later stage, it is often accompanied by deficiency of the liver and kidneys. Treatment is mainly based on symptoms, signs, tongue and pulse diagnosis, and the disease is generally divided into three types: damp-heat descending, toxic heat stagnation, and deficiency of kidney qi, each requiring different treatment methods.
1. Genital herpes belonging to the damp-heat descending syndrome is characterized by clustered vesicles on the genital area, with redness around and possible ulceration. It may cause mild itching, yellowish urine, bitter taste in the mouth, thirst, red tongue with yellow greasy coating, and wiry slippery pulse. This is usually caused by a diet high in greasy and sweet foods, spicy foods, or excessive smoking and alcohol consumption, which damages the spleen and stomach, leading to dampness accumulation and subsequent transformation into heat. The damp-heat then descends along the liver meridian to the genital area, resulting in genital herpes. The treatment principle is to clear heat and eliminate dampness. The commonly used formula is Long Dan Xie Gan Tang with modifications: Gentiana 10g, Gardenia 10g, Scutellaria 10g, Bupleurum 10g, Desmodium styracifolium 10g (packaged), Rehmannia 10g, Angelica sinensis 10g, Akebia 10g, and Radix Glycyrrhizae 10g. Gentiana clears heat and drains dampness from the liver meridian; Gardenia, Scutellaria, and Bupleurum work together with Gentiana to clear the liver and promote bile flow; Desmodium styracifolium and Akebia clear heat and promote diuresis; Rehmannia and Angelica sinensis cool the blood and promote blood circulation; Radix Glycyrrhizae harmonizes the other herbs. If there are large blisters or oozing, add Coix seed 30g and Artemisia scoparia 10g; if there is constipation, add Rhubarb 6g (taken afterwards). There are also ready-to-use Chinese patent medicines, such as Long Dan Xie Gan Wan, 6-8g each time, 3 times a day, taken with warm water.
2. Genital herpes belonging to the toxic heat stagnation syndrome is characterized by large and red blisters in the genital area, local swelling, significant pain, enlarged inguinal lymph nodes, low-grade fever, difficulty urinating, red tongue, and slippery rapid pulse. This is usually caused by unclean sexual intercourse and infection with venereal diseases, resulting in the accumulation of toxic heat in the genital area. The treatment principle is to clear heat and resolve toxins. The commonly used formula is Qing Du Shen Sheng Tang with modifications: Lonicera 30g, Dandelion 30g, Artemisia argyi 30g, Angelica sinensis 15g, Radix Glycyrrhizae 10g, and Isatis root 30g. Lonicera clears heat and resolves toxins; Dandelion and Isatis root eliminate toxins and resolve putrefaction; Artemisia argyi and Artemisia argyi enhance the therapeutic effect of the main herbs; Angelica sinensis and Radix Glycyrrhizae nourish the blood, promote blood circulation, and harmonize the other herbs. If there is yellowish urine and painful urination, add Herba Epimedii 15g, Semen Euphorbiae 10g, and Folium Eriobotryae 10g; if there is lymphadenopathy with pain, add Herba Aristolochiae 30g and Herba Elsholtzia 10g.
3. Genital herpes belonging to the deficiency of kidney qi syndrome is often seen in recurrent cases with small and dry blisters that are asymptomatic but frequently recur. This is usually caused by deficiency of kidney qi, which fails to eliminate the residual pathogenic factors. The kidney governs the anterior and posterior yin, and excessive sexual activity or long-term stagnation of damp-heat and venereal toxins can deplete kidney yin and yang. Kidney yin and yang are the most precious substances in the human body, governing the balance of yin and yang throughout the body. When kidney yin and yang are damaged, the balance is disrupted, and diseases are more likely to recur. Symptoms of deficiency of kidney qi often include lumbosacral soreness and weakness. Yin deficiency is often accompanied by restlessness, insomnia, nocturnal emission, premature ejaculation, red tongue with little coating, and thin rapid pulse. Yang deficiency often presents with cold hands and feet, lower abdominal pain and urgency, pale tongue with thin coating, and deep thin pulse. The treatment principle is to tonify the kidney and resolve toxins and dampness. The commonly used formula is Liu Wei Di Huang Wan with modifications: Raw and prepared Rehmannia 10g each, Dioscorea 15g, Cornus officinalis 10g, Lycium fruit 10g, Poria 15g, Alisma 10g, Cortex Moutan 10g, and Isatis root 10g. Raw and prepared Rehmannia nourish kidney yin; Dioscorea, Cornus officinalis, and Lycium fruit nourish the liver, spleen, and kidney yin; Poria, Alisma, and Cortex Moutan nourish the middle and promote diuresis; Isatis root clears heat and resolves toxins. If there is fire due to yin deficiency, add Ligustrum lucidum 10g and Anemarrhena 10g; if there is yang deficiency, add Epimedium 10g, Cinnamon bark 10g, and Psoralea 10g.
For patients with yin deficiency and internal heat, characterized by recurrent genital herpes with little exudation, accompanied by dry throat and lips, and restlessness and heat sensation in the five hearts, the tongue is red, the coating is peeled and the pulse is thin and rapid. The following Chinese patent medicines can be used: ① Zhibai Dihuang Wan, 9g each time, twice a day, taken on an empty stomach with warm water. ② Dabu Yin Wan, 9g each time, 2-3 times a day, taken with diluted saltwater or warm water.
It has been proven that some commonly used Chinese herbal external washes or treatments can relieve the pain and symptoms of genital herpes. Combining internal and external treatments can improve efficacy. The following are commonly used Chinese herbal external washes and treatments.
(1) Portulaca oleracea 30g, Wild Chrysanthemum 30g, Phellodendron amurense 30g. Decoction of about 200mL for external wash, 2 times a day, 15 minutes each time.
(2) Lycopodium clavatum 30g, Isatis root 30g. Decoction of about 200mL for external wash, 2 times a day, 30 minutes each time.
(3) Borax 100g dissolved in 300mL boiling water, cooled for external wash.
(4) Take fresh half a lotus, wash and mash into a paste, apply to the affected area, cover with gauze, and change the dressing 1-2 times a day.
(5) Take appropriate amount of indigo naturalis powder, add sesame oil to make a paste, apply to the affected area, and change the dressing once a day.
It is recommended that patients with genital herpes follow necessary dietary restrictions to prevent recurrence. Avoid consuming spicy and stimulating foods, and quit smoking and alcohol consumption.
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