Chlamydial urinary tract infection

　　The cause of chlamydia urinary tract infection is the infection of chlamydia in susceptible populations. The main route of transmission is sexual contact, and unprotected sexual intercourse, early onset of sexual life, and not using condoms are particularly prone to infection. In a few cases, newborns may become infected by infection from the mother during childbirth through vaginal infection.

　　After chlamydia infection, it mainly invades the mucosa, and it has an affinity for the mucosa formed by single-layer columnar epithelium and transitional epithelium, so it adheres to the surface of columnar epithelial cells for reproduction, and ascends along the reproductive tract. It enters the cell for reproduction through the phagocytic action of columnar epithelial cells, causing cell lysis and rupture, leading to local acute inflammation, with symptoms such as congestion, edema, suppuration, and pain.

　　If chlamydia urinary tract infection is not treated or treated incompletely, male patients may develop acute epididymitis, prostatitis, and urethral stricture. Male homosexuals may develop proctitis or pharyngitis. Female patients may develop acute salpingitis, endometritis, and pelvic inflammatory disease, leading to infertility and ectopic pregnancy. The bacteria can also be transmitted from pregnant women to the fetus, causing infection of the fetus's eyes or lungs.

　　Chlamydia urinary tract infection generally has an incubation period of 1 to 3 weeks. Males often experience urethral itching and varying degrees of dysuria and burning sensation, the pain is milder than that of gonorrhea, the urethral orifice is slightly red and swollen, and there are often serous or seropurulent urethral secretions, which are thinner and less than those of gonococcal urethritis, or only white membranes are found at the urethral orifice in the morning. Some patients have no obvious symptoms or any symptoms at all, and are often misdiagnosed. Female patients are mainly infected at the cervix, and the symptoms of urethritis are not obvious, often表现为 acute and chronic cervicitis and cervical erosion, increased leukorrhea, or mild difficulty in urination and frequent urination, and can also be completely asymptomatic.

　　Patients with clinical symptoms and a history of unprotected sexual intercourse should be highly suspected of this disease. The diagnosis of this disease requires etiological examination, and currently, the examination of urethral secretion smears is commonly used. If there are more than 10 white blood cells in the high-power field, and there are no Gram-negative diplococci, this disease should be highly suspected. The positive rate can reach more than 90% by using specific monoclonal antibody staining of secretion smears and observing with immunofluorescence or immunoenzyme labeling techniques.

　　Chlamydia has weak resistance to physical and chemical factors, only survives for a short time outside the human body, and sexual transmission between people is its main way of survival. The prevention of chlamydial infection mainly involves avoiding sexual promiscuity and actively treating carriers, and both partners should be treated at the same time to prevent further transmission.

　　The main clinical examination methods for chlamydial urinary tract infection are urine secretion smear microscopy and pathogenic examination, as follows:

　　1. Urine secretion smear microscopy

　　(Male patients can gently press the urethra from the root of the penis to the urethral orifice to obtain more secretions; for patients without secretions, collect morning urine and centrifuge to take the sediment for microscopic examination), under high-power microscopy (400×), there are more than 10 white blood cells, and under oil immersion microscopy (1000×), there are more than 5 white blood cells, no Gram-negative diplococcus, and this disease should be highly suspected.

　　2. Pathogenic examination

　　Cultivation of chlamydia trachomatis requires special experimental conditions, which are difficult to apply widely. Now, it is mostly used to stain secretions with specific monoclonal antibodies and observe by immunofluorescence or immunoenzyme labeling technology, with a positive rate of over 90%. Nucleic acid amplification methods such as polymerase chain reaction (PCR) and ligase chain reaction (LCR) have excellent sensitivity. However, PCR is not recommended for diagnosing whether the patient has been cured, at least not for patients within 2 weeks of treatment, because for fully treated cases, the duration of PCR positivity is longer than that of culture methods.

　　Chlamydial urinary tract infection patients should follow a light diet, eat more vegetables and fruits, properly match the diet, and ensure adequate nutrition. Eat antibacterial and anti-inflammatory,清热解毒, and enhance immunity foods; avoid eating cold and difficult-to-digest foods, such as glutinous rice, rice cakes, and rice cakes; avoid eating spicy and irritating foods, such as chili, Sichuan pepper, and pepper; 3. Avoid eating foods with high fat content, such as lard and lard.

　　The etiology of chlamydial urinary tract infection is mainly damp-heat, in the early stage, it is mostly characterized by evil reality, and with long illness, it turns from reality to deficiency. If the evil is not exhausted and the body's resistance is injured, it will manifest as a mixed syndrome of deficiency and excess.

　　1. Treatment of acute urinary tract infection by dialectical medicine

　　Acute stage, including acute urinary tract infection and acute onset of chronic urinary tract infection, characterized by frequent urination, urgency, dysuria, cloudy urine, or fever and aversion to cold, occasionally hematuria.

　　1. Bladder damp-heat

　　Chief symptoms: Frequent urination, short and涩痛，dribbling, urgent burning, urine color yellow and red, lower abdomen contraction and pain, or fever and aversion to cold, bitter taste and nausea, or abdominal pain, resistance to palpation, constipation, red tongue, greasy yellow fur, slippery and rapid pulse.

　　Treatment method: Clear heat and purgative, benefit dampness and unblock the淋。

　　Herbal medicine: Bay zheng san with Dandelion and Shishui. Wood vinegar 6g, Xu麦10g, Cheqiancao 15g, Piexu 10g, Huashi 30g, Shanzhi 10g, Dahuang 6g (added later), Dengxincao 10g, Shenggancao 6g, Shishui 30g, Dandelion 30g

　　2. Liver and Gallbladder Stagnant Heat

　　Main Symptoms: Alternating chills and fever, bitter taste in the mouth and dry throat, restlessness and desire to vomit, loss of appetite, frequent urination with pain, yellow and red urine, lower abdominal pain, red tongue with yellow or greasy coating, wiry and rapid pulse.

　　Therapeutic Method: Clear heat and drain dampness in the liver and gallbladder.

　　Herbal Formula: Longdan Xiegan Decoction. Gentiana 10g, Bupleurum 12g, Alisma 12g, Plantago 15g, Coptis 6g, Raw Rehmannia 12g, Angelica 15g, Gardenia 10g, Scutellaria 10g, Licorice 6g.

　　3. Sanjiao Damp-Heat

　　Symptoms: Chills and high fever, fever increases in the afternoon, bodyweight and pain, chest tightness and no hunger, dry mouth without desire for drink, epigastric and abdominal stuffiness, occasional nausea and vomiting, cloudy urine, yellow and thick coating, soft and rapid pulse or slippery and rapid pulse.

　　Therapeutic Method: Promote the Sanjiao and clear dampness and heat.

　　Herbal Formula: Sanren Decoction with additions. Almond 10g, Raw Coix Seed 30g, Alpinia katsumadai 12g, Magnolia officinalis 10g, Prepared Pinellia 12g, Alpinia oxyphylla 6g, Talcum 30g, Bamboo Leaf 9g.

　　Second, Differential Treatment of Urinary Tract Infection in the Convalescent Period

　　The convalescent period is when the acute symptoms have been relieved, the course of the disease is more than 6 months, the涩 pain in urination is not very significant, on and off, feeling sore lower back, fatigue and weakness, often caused by overwork or cold.

　　1. Spleen and Kidney Qi Deficiency

　　Main Symptoms: Lethargy and fatigue, poor appetite and abdominal distension, sore lower back and pain, frequent urination with clear urine or frequent night urination, loose and soft stools, occasional涩 sensation in urination, on and off, pale tongue with thin white coating, deep and fine pulse with weakness.

　　Therapeutic Method: Invigorate Qi, strengthen the spleen, and补肾, with assistance of diuretic properties.

　　Herbal Formula: Qingquan Drink (self-prescribed formula). Codonopsis 15g, Astragalus 15g, Schisandra 15g, Poria 15g, Lycium 15g, Cuscuta 12g, Coix Seed 30g, Plantago 15g (wrapped in cloth), Pteris 30g, Licorice 3g.

　　2. Liver and Kidney Yin Deficiency

　　Main Symptoms: Dizziness and tinnitus, severe headache, intermittent fever and night sweats, dry mouth and chapped lips, sore lower back, short and yellow urine, tongue with redish coating and thin yellow or little coating, deep and fine pulse or wiry and fine pulse.

　　Therapeutic Method: Nourish Yin and clear heat to benefit moisture.

　　Herbal Formula: Zhizi Dihuang Soup combined with Erzhi Pill, with additions. Anemarrhena 9g, Phellodendron 9g, Raw Rehmannia 12g, Schisandra 15g, Schisandra chinensis 9g, Moutan Cortex 12g, Poria 15g, Alisma 12g, Schisandra chinensis 12g, Eclipta 12g, Plantago 15g (wrapped in cloth), Leonurus 18g.