Prevention and treatment of trichomonas vaginalis and mold infection   (draft)

Appendix II: by Pan, Yaogui

Prevention and treatment of trichomonas vaginalis and mold infection   

Physiology mechanism 生理 of vaginal channel: 

The vaginal mucosa epithelial cells of adult healthy women contain animal starch, and the vagina contains gram-negative bacilli, the so-called vaginal bacillus (Doderlein’s bacilli), which can decompose starch into lactic acid to maintain a certain acidity (PH=4.5) in the vagina, to prevent pathogenic bacteria from multiplying in the vagina, thereby maintaining biological characteristics and self-defense function in the vagina. 




1 Trichomonas vaginitis

1.1. Etiology

Trichomonas vaginalis, a whipworm strain, is pear-shaped and slightly larger than neutrophils; it has four flagella at the top, a fluctuating membrane at the body, and an axial column at the tail, with the activities rotating along a straight axis and fluctuating forwards. 

Optimum PH5.5-6.0 for growth: PH<4.5>7.5 for poor growth. The optimum growth temperature is 35 C-37 C, but it can survive 7-9 hours at a temperature of 10 C and 38-40 C. While from 25 to 27. degree. C. to 120 to 150 hour (generally about 30. degree. C. in bath water); Normal well water can live for 5 days, 9 hours in soapy water and 12-20 hours in a dry environment. Apparently, it can widely exist in nature and is easy to get spreaded. 

1.2 Method of dissemination: 

1.2.1  Direct transmission: sexual transmission is dominant. 

1.2.2  Indirect infection: via bath, bath utensils, underwear and personal feces, urine infection, toilet, medical equipment, etc. 

1.3 Pathogenesis

Although there are different theories, it is mostly believed that trichomonas is not pathogenic.  It mainly consumes glycogen in vagina and hinders the formation of lactic acid, thus reducing the acidity in vagina and destroying the defense function of vagina.  Pathogenic bacteria are then easy to propagate and cause inflammatory reaction. Trichomonas does not invade tissues to cause pathological changes. 

1.4  Incidence rate: 

In China, the incidence of minor illnesses is about 20% (20–25%) 小发病牵国国内统计为20%左右 in the United States and 10%-25% in the Soviet Union) and 16.7%-32.36% in factories.  It is higher among married women than among unmarried women; the rate is higher for pregnant women than other women. 


1.5  Symptoms and Signs: 

Symptoms usually begin one week after infection. 

1.5.1 Vaginal vulva is itchy and has the sensation of insect crawling, but does not affect sleep and activity, only triggered by secretion stimulation. A few cases evolve to dermatitis. 

1.5.2 Vaginal secretions increased, a yellowish foam (due to decomposition of carbon water compounds and discharge gas), thin, with a bad smell or hemorrhagic, purulent, stimulate the pudendal skin and cause discomfort and pain. 


1.5.3  Infertility:  trichomonas can devour sperm, vaginitis can affect sperm survival so as to interfere with pregnancy. 

1.5.4 Urinary system symptoms: urethritis symptoms such as frequent micturition, urgency urination, and urinary pain. 

1.5.5  Examination of vaginal speculum: red granules are observed on the vaginal wall, in the shape of waxberry fruit. 

1.6 Diagnosis: 

According to medical history, pruritus and foamy leucorrhea can be diagnosed. The diagnosis requires suspension for the detection of active trichomonas, as well as smear and culture methods. 

1.7 Treatment: 

1.7.1  General treatment: pay attention to personal health, avoid sex life, reduce local stimulation, keep local dry. 

1.7.2 Local treatment: 



  1. Vaginal acidification to restore its biological characteristics and self purification. Commonly used 0.5% acetic acid solution or 1% lactic acid solution washing, once a day, 10 days as a course of treatment, pay attention to the pregnant women can only be swabbed, unmarried with catheter washing. Decocting garlic in soup and fumigating and washing are also effective. 
  2. deworming treatment: one tablet was stuffed into the vagina every night for metronidazole, diweijing, and carboprost, with 10 days as a course of treatment. The quantity of tricitabine was 100,000 units. One tablet was used to plug the vagina every night, and 14 days constituted a course of treatment. 

1.7.3 Systemic treatment: 

  1. Oral anthelmintic; (for ordinary couples), metronidazole 0258/ day, 10 days as a course of treatment. Or 2 g (0.25×8), the cure rate is 95% and the side effects are not more than 10 days therapy. (1-HI) 
  2. Treatment of comorbidity: the treatment of genital inflammation can restore the biological characteristics of the vagina, which is not conducive to the growth of trichomonas. 
  3. Complications of treatment: for example, symptomatic treatment of urinary tract infection, antibiotic treatment of vaginitis (chloramphenicol 0.25 for vagina), and repeated treatment if there were still symptoms after one course of treatment. 





1.8  Prevention: 

Strengthen health education, do a good job in personal health, ban pool bath, transform public toilets from sitting to squatting, bath isolation (with individual towels and basins), medical equipment disinfection, treatment and strict management of the patients carrying worms.   


    六、诊   断:


2 Mycotic vaginitis (candidal vaginitis) 

Mycotic vaginitis is vaginal inflammation caused by Candidaalbicans. Its incidence rate is second only to trichomonas vaginitis, and it is more common in pregnant women, patients with diabetes and those who have long-term application of antibiotics. And is often complicated with other inflammation. Candida can be parasitic in the vagina at ordinary times, and whenever glycogen in the vagina increases: when the acidity increases, it can rapidly proliferate and cause symptoms. First, the mode of infection: mainly indirect. 

                2 霉菌性阴道炎(念珠菌阴道炎)









    三、治   疗:  










II. Clinical manifestations and characteristics: 

  1. Abnormal vulva itching: The symptoms that begin on the inner side of the labia minora and spread to the outside are very significant. 
  2. Vaginal discharge: it is often reduced in the acute phase, with a white discharge like curds or bean dregs. 
  3. Examination of vaginal speculum; Vulva and vaginal mucosa were often covered with a layer of white membrane, and the uncovered mucosa showed mild swelling. 
  4. Excreta smears and suspensions may be cultured if pathogenic bacteria are detected. III. Therapies: 1 Vaginal irrigation: 2-4% soda water or Radix Gentianae liquid (decocted into 500cc water in 4 pairs) was usually used for 3/ day, and a course of treatment lasted for 10 days. Set education 2. Nystatin, 500,000 units once every night, vaginal plug, 10 days of treatment. 3. Qugu mycin ointment is applied externally (on the ulcer surface) or 0.5% gentian violet is applied to the vulva and vaginal wall. 4. Take 8 Zhidai Jing tablets orally, 8/ day. IV. Prevention: 1 to strengthen health publicity and education, that the disease transmission. 2. treating primary diseases such as diabetes. Avoid abuse of antibiotics. 3. Eliminate the source of infection: improve the bath, bath, toilet, etc., and closely disinfect the medical devices to eliminate cross infection.   Comparison of trichomonas vaginitis and mycotic vaginitis      









以直接为主: 性交等方式

以间接为主; 通过浴具、浴池等。





1. 外阴,阴道痒,不影响工作和睡眠。

2. 白带多、灰黄色、或伴有血性及脓性,呈泡沫状


4. 或有尿道炎症状并存。

5. 悬液检查见活毛滴虫。

1. 外阴奇痒,重者可影响睡眠及工作。

2. 白带多少不一,呈乳凝块或豆渣样。

3. 阴道粘膜被一层由膜覆盖,揭除后可见粘膜红肿。

4. 无泌尿系炎症情况。

5. 悬液检查可见白色念球菌。


1. 常用酸性液冲洗阴道,如0.5%醋酸或1%乳酸、大蒜头液熏洗。

2. 驱虫治疗: 灭滴灵、滴维净、卡巴肿、曲古霉素等塞人阴道内或口服灭滴灵。


4. 治疗并发病,泌尿系炎症 (呋喃坦啶)

5.  治疗、管理带虫者。

1. 常用碱性液冲洗阴道,如2-4%苏打水。

2. 制霉菌素,曲古霉素,阴道内用药。

3. 一 般不用抗菌素。


4. 病因治疗: 如糖尿病的治疗等。

5. 不需要治疗带菌者(因为正常阴道内有霉菌存在)

By Yaogui Pan, Gynaecology and Obstetrics Department

Nanling Medicine, 1979; 1:45-47



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