四妙丸合萆薢分清饮加减治疗淋病1例  

Simiao pills combined with modified Bixie Fenqing decoction in tr eating gonorrhea:A case report

作　　者：郑义 李焱风 张春和 

机构地区：[1]云南中医药大学第一附属医院/云南省中医医院,云南昆明650021

出　　处：《中医临床研究》2024年第27期107-109,共3页Clinical Journal Of Chinese Medicine

基　　金：国家中医药管理局重点研究室建设项目[国中医药函(2009)95号];国家中医药管理局重点学科建设项目[国中医药发(2009)30号];云南省中医临床优秀人才研修项目(第一批)[云财社(2024)103号]。

摘　　要：淋病是由淋病奈瑟菌引起的以泌尿生殖系统化脓性感染为主要表现的性传播疾病,是中国重点监测和防控的性传播疾病之一。由于目前尚无针对淋球菌的有效疫苗上市,抗菌药物治疗仍是淋病防治的主要手段。抗生素的早期使用虽然可有效降低感染的严重程度和减少并发症的发生,但同时也会增加淋病奈瑟菌的耐药风险。近年来,临床医生不规范的使用抗生素使得淋病的耐药性逐渐上升,导致可使用的针对性抗生素越来越少。对于药敏培养结果存在多种抗生素耐药的患者,抗生素类药物将面临无法使用、需要寻找研发新的抗生素类药物的局面。不仅需要投入巨大的人力、物力和财力,同时耗时较长。淋病属中医学中的“毒淋”“膏淋”“精浊”“淋浊”等范畴。《杂病源流犀烛》有“其茎中如刀割火灼,窍端有秽物,如米泪……如目眵。”近代中医学将淋病称为“花柳病”或“毒淋”。中医学通过几千年临床经验的不断总结,针对淋病的治疗具有明显优势。通过临床跟诊发现,导师使用四妙丸合萆薢分清饮加减治疗淋病效果显著,为临床医生治疗针对抗生素有耐药及过敏的淋病患者提供一种治疗思路,也同时减少滥用抗生素的可能。Gonorrhea is a sexually transmitted disease caused by Neisseria gonorrhoeae,which is mainly characterized by suppurative Ginfection of genitourinary system,and it is one of the sexually transmitted diseases that are mainly monitored,prevented and controlled in China.As there is no effective vaccine against Neisseria gonorrhoeae on the market at present,antimicrobial therapy is still the main means of prevention and treatment of gonorrhea.Although the early use of antibiotics can effectively reduce the severity of infection and reduce the occurrence of complications,it also increases the risk of drug resistance of Neisseria gonorrhoeae.In recent years,the irregular use of antibi-otics by clinicians has led to a gradual increase in drug resistance to gonorrhea,resulting in fewer and fewer targeted antibiotics available.For pa-tients with multiple antibiotic resistance as a result of drug sensitivity culture,antibiotics will be unable to be used,so it is necessary to find and de-velop new antibiotics.Gonorrhea belongs to the categories of“toxic gonorrhea”,“plaster gonorrhea”,“seminal fluid turbidity”,“turbid gonorrhea”and so on in traditional Chinese medicine.Incisive Light on the Source of Miscellaneous Diseases records that“Its stem is burning like being cut by a knife,and there is filth at the orifice,which is like rice tears…like the open eyes”.It is close to gonorrhea in modern medicine.In modern Chinese medicine,gonorrhea is called“syphilis”or“poison gonorrhea.Through the continuous summary of thousands of years of clinical experi-ence,Chinese medicine has obvious advantages in the treatment of gonorrhea.Through clinical follow-up,it is found that Simiao pills(四妙丸)combined with modified Bixie Fenqing decoction(萆薢分清饮加减)is effective in the treatment of gonorrhea,which provides a treatment idea for future clinicians to treat patients with antibiotic resistance and allergy,and also reduces the possibility of abuse of antibiotics.

关 键 词：中药 淋病 经验总结 

分 类 号：R759.2[医药卫生—皮肤病学与性病学]