TREATMENT OF WHITE LESION OF VULVA BASED ON THE DIFFERENTIATION OF SYNDROMES ACCORDING TO THE THEORY OF MERIDIANS AND COLLATERALS

Yan Rimming, Nan Shuzhen, Meng Guiyue, Wang Fangni

(Department of Acupuncture, Xiyuan Hospital. Academy of TCM, Beijing)

White lesion of vulva may be classified under the categories of vulva itching and vulva ulceration in traditional Chinese medicine which holds that the diseases are mostly associated with excessive strain resulting in damage of meridians and collaterals, or mental depression turning into endogenous "Fire" causing impairment of liver and spleen accompanied with harmful dampness and heat factors descending downward. Since the meridians of liver, spleen and kidney are all connected with the vulva, any damage to these meridians by the harmful dampness and heat factors will be manifested as vulva itching, leukoplakia, leukoderma, swelling and atrophy.

Clinical Data

Among the 71 patients treated, the youngest was 21 years old. the oldest 65, with an average of 42. The course of disease varied from 3 months to 21 years. Pathological examination in 37 cases revealed leukoderma of vulva in 22 cases with atypical epithelial hyperplasia in 5 cases, sclerosing lichen in 11 cases and non-specific inflammation in 4 cases.

Criteria for Diagnosis

Diagnosis was made according to the following items: itching or burning pain in the vulva was accompanied with white dermal or mucosal lesions of the vulva and around the anus. and local thickening, rhagades or ulcer. Vitiligo and malignant tumor were excluded by pathological examination.

Treatment

The patients were divided into two groups.

1. Acupuncture group is Included 44 cases. The chief points applied were Shcnshu Henggu, Zhiyang (itching-stopped point. Extra), SanyinJiao or Ligou. They were alternatively applied. For patients with atrophy of vulva, Pishu and Xuehai were added; while for itching, Yinlian and Zuogu (ischiadic point. Extra) were added.

2. Point injection group: 27 cases were included in this group. Two couples of points-Shenshu, Yinlian and Pishu, Zuogu point were applied alternatively. 1-2 ml of Radix Saliviae Miltiorrhizae Solution was injected into each point. Zhiyang (itching-stopped point, Extra) should be added in case there is itching.

The above mentioned therapies were given once a day or every other day and interrupted during menstrual period. Each course consisted of 10-15 times of treatment. Therapeutic Effect

1. Criteria

Clinical cure: Disappearance of itching, pain and atrophy, the color and elasticity of the involved skin completely recovered.

Markedly improved: Disappearance of itching and pain, atrophy and elasticity of affected skin improved obviously, and the skin turned pinkish,

Effective: the symptoms and signs improved.

Ineffective: the symptoms and signs remained unchanged.

2. Efficacy: Varying degrees of therapeutic effect were obtained in 68 cases. Out of the 71 cases, 13 were clinically cured, 26 markedly improved, 29 effective. Only 3 cases showed no improvement. The total effective rate was 95.77%. The effective rates of acupuncture and point injection groups were 100% and 88.89% respectively, showing no significant statistically difference (P>0.05).