Disease classification
Male genital diseases
Definition of western medicine disease name
Seminoma is an infection of tissues in spermatic cord except vas deferens, including blood vessels, lymphatic vessels and connective tissues. Most of them are acute attacks, and the pathogens are common bacteria or mycobacterium tuberculosis, often accompanied by epididymitis and other diseases.
Etiology of western medicine
The vast majority of spermatic cord inflammation is acute, and the pathogen is often common bacteria or mycobacterium tuberculosis, often accompanied by epididymitis and other diseases; There are also pathogenic pathogens such as filariasis and treponema pallidum.
Pathogenesis of TCM
There is no such disease name in TCM literature. This disease is mostly caused by damp-heat in the liver meridian, accompanied by syndrome of qi stagnation and blood stasis in the later stage. The liver is the main muscle, and the kidney controls the two yin. Indulge yourself, you will be overworked, consume kidney essence, lose kidney essence, and the evil of damp heat will take advantage of it; Or eating spicy and thick taste, hurting the spleen and stomach, endogenous dampness, stagnation of heat, betting along the meridian; Or because of emotional disorder, depressed anger hurts the liver, liver qi is not discharged, qi stagnation, body fluid is abnormal, phlegm and dampness become turbid over time, qi and blood stagnate, and blood stasis blocks, which can thicken and harden the spermatic cord.
Pathological pathogens invade the spermatic cord from lymphatic vessels, causing spermatic cord tissue inflammation, sometimes forming abscess, necrosis, induration, granuloma and other pathological changes.
Traditional Chinese medicine diagnosis
This disease is mostly caused by exogenous diseases, or internal injuries of liver and kidney, and reinfection of exogenous diseases. The disease is located in the liver and kidney meridians; The nature of the disease is virtual and real, or mixed with virtual and real, and the later stage is also a witness of blood stasis.
1. Clinical manifestations: The main symptom of spermatic cord inflammation is pain along the spermatic cord, which is related to scrotum, penis and perineum. It is often accompanied by fever, chills, weakness of waist and knees, sexual dysfunction and other kidney deficiency syndromes; Those with damp-heat liver meridian can see bitter mouth and dry throat, wet scrotum, impatience and irritability, and Huang Chi in urine. The tongue is red, the coating is yellow and greasy, and the pulse is thin and smooth.
2. Syndrome analysis: "Su Wen Taiyin Yangming Chapter" says: "Those who are wet will be injured first." Damp-heat pathogen is most likely to block Qi-flowing and make Qi-flowing rise and fall abnormally. The liver pulse bypasses the yin organs, and the kidney governs the two yin organs. If you always have too much sexual life, you will hurt your liver and kidney, and your liver and kidney will lose their sperm, which is easy to be invaded by external evils. If damp-heat evil invades the liver meridian, you can bet along the meridian. Or emotional disorder, impatience and irritability, stagnation of liver-qi, stagnation of qi and stagnation of liver-qi, and retention of body fluid in this meridian may lead to swelling and pain of spermatic cord after a long time. If it does not heal for a long time, the spermatic cord will become thick, hard and tender. Insufficient liver and kidney, sore waist and knees, and the waist is not nourished; If you don't use tendons, you will have sexual dysfunction. If the liver meridian is damp and hot, you will see bitter taste, dry throat, wet scrotum and Huang Chi in urine. Red tongue with yellow and greasy fur and thready pulse are all symptoms of damp-heat in liver meridian.
symptom
Bacteria and other pathogens invade lymphatic vessels, involving the entire spermatic cord tissue, showing pain along the spermatic cord and radiating to scrotum, penis and perineum. The whole body may be accompanied by fever and chills.
The main symptom of spermatic cord inflammation is pain along the spermatic cord, which radiates to scrotum, penis and perineum. May be accompanied by fever, chills and other systemic symptoms, as well as epididymitis, long-term visible spermatic cord thickening, hardening, tenderness. In addition, there are several quite special spermatic cord inflammation:
(1) Endemic spermatic inflammation: It has local epidemic characteristics and is an acute spermatic infection similar to cellulitis. It is characterized by swelling, thickening, hardening and tenderness of spermatic cord, accompanied by fever, chills and sometimes abscess and necrosis. In some subacute or chronic cases with no sudden onset, fibrous nodules may appear in the spermatic cord. The cause of this disease is not clear, and it may be an epidemic infection of streptococcus.
(2) Filariasis: Filariasis infection, in addition to the common invasion of lower limbs, scrotum, penis lymphatic vessels, sometimes it can also invade spermatic lymphatic vessels, causing filariasis. It is usually a chronic pathological process, in which the spermatic cord thickens and hardens, resulting in local pain. This is caused by chronic inflammation and obstruction of lymphatic vessels in spermatic cord, and live or dead filariasis can be found in pathological tissue.
(3) Sexually transmitted lymphogranulomatous spermatic inflammation: Sexually transmitted pathogens invade the lymphatic vessels of the spermatic cord from the deep iliac lymph nodes, and sometimes invade the blood vessels of the spermatic cord, causing spermatic pain and lymphogranuloma of the spermatic cord.
(4) Syphilitic spermatic phlebitis: quite rare. Treponema pallidum can invade the spermatic cord, which is often caused by the spread of syphilis lesions in other parts to the spermatic cord, showing local pain in the spermatic cord, thickening, hardening and tenderness of the spermatic cord.
Western medicine differential diagnosis
Seminoma is sometimes distinguished from acute and chronic epididymitis. Spermatogonitis is pain along the spermatic cord, which can affect the scrotum and penis. Peritoneal radiation can be stinging, painful or painful or dull. Acute epididymitis is an acute attack, characterized by sudden pain in scrotum, which can cause spermatic cord to radiate to the waist, which is more intense. The epididymis was obviously swollen and tender, and the surface skin was reddish. Sperm showed no obvious enlargement of testis and epididymis, no tenderness and abdominal tenderness. Chronic epididymitis can have pain similar to spermatic cord inflammation, generally dull pain, but epididymis is generally hard and massive, with mild tenderness and discomfort, which may be accompanied by thickening of spermatic cord and increasing the diameter of vas deferens.
prognosis
Active treatment should be given to orchitis. Most of them are initial acute attacks and can be cured after clinical treatment. The general course of disease is 1 ~ 2 weeks. If the delay becomes chronic, the spermatic cord can be thickened and hardened, which can cause infertility in severe cases.
Western medicine treatment
Choose antibiotics according to different pathogenic causes. Penicillin, ampicillin and gentamicin are commonly used in common bacterial infections. Tuberculosis infection is treated with anti-tuberculosis drugs. Antibiotics should also be used to treat endemic spermatogonitis, and penicillin should be used more. Filariasis needs to be treated with drugs such as haiqunsheng and carbaarsenic. Different drugs should be selected according to different pathogens of sexually transmitted diseases for spermatic cord inflammation of lymphogranuloma. Syphilitic spermatic phlebitis can be treated with penicillin and other drugs.
Traditional therapy in China
First, the treatment is mainly to clear away damp-heat in liver and gallbladder, supplemented by promoting blood circulation and removing blood stasis. According to the pathogenesis characteristics of this disease, it is suggested that clearing away damp-heat in liver and gallbladder, regulating qi and promoting blood circulation and tonifying liver and kidney should be the main methods. The main treatment is clearing away dampness and heat. Kidney deficiency tonifies liver and kidney; Qi stagnation can regulate qi, and drugs for promoting blood circulation and removing blood stasis can be added later. Prescriptions commonly used are Longdan Xiegan Decoction plus Semen Vaccariae, Prunellae Spica, Salvia miltiorrhiza, Achyranthes bidentata and fennel. Radix Gentianae, Fructus Gardeniae and Radix Scutellariae in the prescription can clear liver and purge fire. Akebia stem, plantain seed and Alisma orientalis are used for clearing away damp heat; Radix Angelicae Sinensis, Radix Salviae Miltiorrhizae and Radix Rehmanniae nourish blood, cool blood, promote blood circulation and remove blood stasis; Bupleurum clears liver qi; Achyranthes bidentata, Fructus Foeniculi and Semen Vaccariae promote blood circulation and qi circulation to relieve pain. If abdominal pain is less, Rhizoma Corydalis and Fructus Toosendan are obviously added to promote qi circulation and relieve pain; Astragalus membranaceus is added to patients with qi deficiency syndrome; The waist and knees are sore, and Eucommia ulmoides and Taxilli are added to nourish the liver and kidney: if the spermatic cord thickens and hardens, litchi seeds are added to promote qi circulation and dissipate stagnation.
Second, qigong therapy: you can use Matsui, bodybuilding and standing guard.
Third, external treatment: frankincense and myrrh 15g, Astragalus membranaceus 60g, Notopterygium incisum 15g, fennel 10g, Salvia miltiorrhiza 30g. Decoct with water, and fumigate and wash the part, 20 minutes each time, twice a day.
Fourth, physical therapy: you can choose magnetic therapy and hot compress.
acupuncture and moxibustion
Take Xingjian point, Yinling Spring, Yangling Spring, Hanging Bell and Datun, and use purging method; Supplemented by Sanyinjiao, Guanyuan and Zhongji points, once a day/kloc-0.
prevent
1. Prevent sexually transmitted diseases, abstain from abstinence exercise and enhance physical fitness. 2. Avoid sexual intercourse after illness and have a proper rest. 3. Avoid spicy and greasy things. Step 4 cheer up.