🌿 Folk Prescriptions

This condition is a common type of vaginitis caused by infection with *Candida albicans*, typically transmitted from the anal region. It is generally unrelated to athlete’s foot. The vaginal pH range of 5.5–6.5 is conducive to *Candida albicans* proliferation. Increased glycogen and acidity in the vagina accelerate fungal growth, triggering inflammation. Thus, it commonly affects pregnant women, diabetics, and those receiving estrogen therapy, as well as individuals on long-term antibiotics. *Candida* can exist asymptomatically in the mouth, intestines, and vaginal mucosa, and can be transferred among these sites. When local conditions are favorable, infection occurs.
Main symptoms include vulvar itching, burning pain, severe cases causing restlessness, urinary frequency, dysuria, and painful intercourse. In acute phases, vaginal discharge increases, appearing curd-like, white, with white membranous deposits on the inner labia minora and vaginal mucosa. After removal, red, swollen mucosal surfaces are revealed. Sometimes erosion or superficial ulcers appear.
Diagnosis requires detailed medical history inquiry: history of high-dose estrogen use, long-term antibiotic use, diabetes, or previous episodes. Confirmation is made by detecting *Candida albicans* in vaginal secretions. Microscopic examination revealing budding yeast and pseudohyphae confirms diagnosis. If symptoms persist but repeated tests are negative, culture testing should be used. For stubborn or elderly cases, blood glucose should be checked.
Treatment of fungal vaginitis can be done with pure Western medicine or integrative Chinese-Western medicine approaches.
(1) General Measures: Actively treat underlying conditions predisposing to fungal vaginitis and eliminate risk factors. Maintain vulvar cleanliness and dryness, avoid scratching. Abstain from sexual activity during treatment. Avoid spicy and stimulating foods.
(2) Adjust Vaginal pH: *Candida* thrives best at pH 5.5. Using alkaline solutions to wash the vulva and vagina alters pH, inhibiting fungal growth. Use 2%–4% sodium bicarbonate solution to rinse the vagina once or twice daily for two weeks per course. After rinsing, dry the vulva thoroughly to maintain dryness and inhibit fungal proliferation.
(3) Vaginal Suppositories: Azole suppositories are highly effective for fungal vaginitis. Clotrimazole suppository: one nightly dose, inserted after rinsing, for 10–14 days. Alternatively, Daktarin suppository: one nightly dose, inserted after rinsing, for 7 days.
(4) Topical Creams: Apply clotrimazole or Daktarin cream externally to treat vulvitis caused by fungal infection, reducing itching and pain. Apply several times daily for two weeks. Yifuqing cream, containing ketoconazole as the main ingredient and a small amount of local steroid, offers excellent anti-itch effects, particularly suitable for women with severe fungal vulvovaginitis. Apply to the vulva twice daily, morning and evening.
(5) Oral Medications: Since fungal infection can be sexually transmitted between partners, oral treatment for both individuals is recommended. Oral drugs also suppress intestinal *Candida*. Fluconazole: 150 mg once, taken as a single dose. Or Sporanox: for initial infection, 200 mg twice daily after breakfast and dinner, taken for one day. For recurrent fungal vaginitis, increase Sporanox dose: 200 mg once daily for three days, or 100 mg twice daily for three days. Take all doses after meals.
(6) Herbal Treatment: Use decoctions of herbs with heat-clearing, detoxifying, insecticidal, and itch-relieving properties to fumigate and wash the vulva. This not only alleviates symptoms but also inhibits and eliminates *Candida*. Due to significant relief of itching and burning after fumigation, it is especially suitable for acute fungal vaginitis, reducing patient discomfort. Additionally, herbs can be made into powders or suppositories for vaginal insertion.
Prescription ①: Bai Xianpi 30g, Huang Bai 30g, Ku Shen 30g, Shechuangzi 30g, Bingpian 3g. Wrap herbs in gauze, boil to extract 2000 ml juice. Steam the vulva while hot, then sit in bath when slightly cooled for 20 minutes. Once daily, 1–2 times. Remove the herb bag after use, air dry for reuse once. One course lasts 7 days. After fumigation, insert clotrimazole or Daktarin suppository into the vagina, and apply the topical cream externally.
Prescription ② (from *Selected Practical Formulas for Skin and Venereal Diseases*): Ding Xiang 12g, Huo Xiang 30g, Huang Lian 15g, Da Huang 30g, Long Dan Cao 20g, Ku Fan 15g, Bo He 15g, Bingpian 1g. This formula clears heat and dries dampness, kills insects, and relieves itching. It strongly inhibits *Candida albicans*, other superficial fungi, and *Neisseria gonorrhoeae*. Usage: one dose daily, decocted and used to wash or soak the vulva 1–2 times daily, each session lasting 30 minutes. Can also be prepared as wash liquid or ointment. Married women may combine with daily vaginal irrigation using the liquid. Continuous use for 12 days constitutes one course.
Prescription ③ (from *Latest Therapies for Sexually Transmitted Diseases*): Ku Shen 30g, Shechuangzi 30g, Long Dan Cao 20g, Sheng Bai Bu 15g, Tu Jin Pi 15g, Huang Bai 15g, Di Fu Zi 15g. Add 2000–3000 ml water, decoct for 30–40 minutes, filter out residue, then fumigate and sit in bath. Once nightly, 20–30 minutes per session.
Prescription ④ (from *Selected Practical Formulas for Skin and Venereal Diseases*): Ku Shen 30g, Shechuangzi 30g, Huang Lian 30g, Huang Bai 30g, Chuan Jiao 10g, Ku Fan 10g, Bingpian 3g. Powdered finely, sterilized for storage. Before use, rinse vulva and vagina with 3% sodium bicarbonate solution, then sprinkle the powder onto the vulva and vagina. One to two times daily. One course consists of five applications.
After using the above methods, patients’ clinical symptoms improve quickly. However, this does not confirm complete cure. Patients must complete the full treatment course, then return to the hospital for follow-up: gynecological examination and vaginal secretion testing. If all results are normal, recent cure is confirmed. Thereafter, check monthly after menstruation ends, continuing for three consecutive months. If all results are negative, the condition is considered fully cured.