Uterine hypertrophy

　　The occurrence of uterine hypertrophy is closely related to ovarian dysfunction, inflammation, pelvic stasis, and other factors, and its specific pathogenic causes are described as follows.

　　I. Uterine cause

　　1. The elastic fiber tissue in the uterine muscle layer of multiparous women increases between smooth muscle and around blood vessels, leading to uterine hypertrophy.

　　2. Primary uterine vascular lesions lead to uterine hypertrophy.

　　II. Ovarian dysfunction

　　Continuous stimulation by estrogen can make the uterine muscle layer thickened. Clinically, patients with functional uterine bleeding, especially those with a long course of disease, all have varying degrees of uterine enlargement.

　　III. Inflammation causes

　　Chronic adnexitis, pelvic connective tissue inflammation, and chronic myositis of the uterus can all cause hyperplasia of collagen fibers in the uterine muscle layer, leading to fibrosis of the uterus.

　　IV. Pelvic stasis

　　Stasis can cause hyperplasia of uterine connective tissue, and can also lead to uterine hypertrophy.

　　V. Pathogens causing cervical hypertrophy

　　Mycoplasma, Chlamydia, bacteria, and viruses can all cause the occurrence of this disease.

　　Uterine hypertrophy can be complicated with cervical erosion. Cervical erosion is a phenomenon of chronic cervicitis, characterized by bright red or pink spots around the cervical os. The main symptoms are increased leukorrhea, often purulent. There may be lower abdominal and lumbar sacral pain and bladder irritation symptoms; patients with severe erosion may have varying degrees of pale bloody discharge, and typical cases may have bloody discharge after sexual intercourse, thick, purulent cervical mucus, which is unfavorable for sperm passage, thus causing infertility.

　　The main symptoms of uterine hypertrophy are excessive menstrual blood volume and prolonged duration; there are also cases where the cycle is shortened to about 20 days, with no obvious change in blood volume and duration; or the menstrual period is prolonged, but the amount of blood is not much.

　　Most patients are multiparous, and most have three deliveries or more. The disease duration is long, and those with excessive bleeding show anemia. Gynecological examination shows a uniformly enlarged uterus, generally the size of a 6-week pregnancy, with a few exceeding 8 weeks of pregnancy, and a relatively firm texture. The ovaries on both sides may be slightly enlarged, with multiple follicular cysts.

　　The prevention of uterine hypertrophy is mainly for the prevention of the cause, including avoiding infection, appropriate exercise after childbirth, actively treating ovarian dysfunction, etc. The specific preventive control measures and daily care precautions for patients are described as follows.

　　First, prevention

　　1, Do family planning and prevent infection.

　　2, Patients should go to regular hospitals for examination and treatment to prevent inadequate sterilization.

　　3, Prevent postpartum infection, and timely give uterine contraction drugs to patients with poor uterine contraction after childbirth.

　　4, After childbirth, appropriate prone or kneeling chest position and postpartum exercise should be taken to prevent the uterus from falling backward and reduce pelvic congestion.

　　5, Actively treat ovarian dysfunction, avoid continuous stimulation of estrogen, etc.

　　Second, nursing

　　The daily care of patients with uterine hypertrophy mainly includes the following aspects that need to be paid attention to:

　　1, Prevent infection. It is advisable for patients to rinse the vagina once a week to avoid dysbacteriosis and bacterial infection. Pay close attention to whether there is other parts of the mold infection, actively control the primary disease, and improve the body's resistance.

　　2, Stop sexual life.

　　3, Patients should change their underwear frequently, and the underwear should be loose, do not wear nylon and other non-cotton products.

　　4, Pay attention to hygiene. Use hot water to boil and disinfect underwear, bathtubs, towels, etc.

　　5, Eat a balanced diet and pay attention to nutritional matching.

　　The examination for uterine hypertrophy can be diagnostic curettage to explore the uterine cavity and B-ultrasound examination, but there are still a few cases that need laparotomy. Diagnostic curettage is abbreviated as DCG, and its purpose is to scrape the uterine cavity contents for pathological examination to assist in diagnosis. If there is a suspicion of cervical lesions, it needs to be done step by step for the cervical canal and uterine cavity, called step-by-step diagnostic curettage. DCG is divided into general DCG and step-by-step DCG.

　　Patients with uterine hypertrophy should avoid spicy foods, hot foods, coagulant foods, and foods containing hormone ingredients; patients with bleeding should eat sheep's blood,螺蛳, and conch, etc.; for infection, eat eel, whelk, celery, sesame, etc. The specific therapeutic diet and dietary precautions are described as follows.

　　First, therapeutic diet for uterine hypertrophy

　　1, Black chicken soup

　　Composition: 1 chicken, 9 grams of Angelica Sinensis, Astragalus, and Poria.

　　Usage: Clean the chicken, remove the internal organs, put the medicine in the chicken's abdomen and sew it up with thread, cook it in a pot, remove the medicine residue, add seasonings after cooking, eat the meat and drink the soup, and take it in 2-3 servings.

　　Function: Strengthening the spleen and nourishing the heart, benefiting the qi and nourishing the blood; suitable for insufficient qi and blood causing excessive menstrual bleeding, thin menstrual color, dizziness, blurred vision, palpitations, pale yellow complexion, empty and sinking lower abdomen, pale red tongue, and thin pulse.

　　2, Braised mutton with Angelica Sinensis and raw earth

　　Composition: 500 grams of mutton, 15 grams of Angelica Sinensis, 15 grams of raw earth, 10 grams of dried ginger.

　　Usage: Clean the mutton, cut into pieces, put it in a pot, add the cleaned medicine and appropriate amount of soy sauce, salt, sugar, cooking wine, and clear water, and cook until the meat is tender, which can be taken regularly.

　　Function: Warming the middle and reinforcing deficiency, benefiting the qi and controlling the blood; suitable for excessive menstrual bleeding due to qi deficiency, with pale and thin menstrual blood, pale complexion, fatigue, shortness of breath, lack of words, pale tongue, and weak pulse.

　　3. Shenghua Honey Paste

　　Composition: 30 grams of angelica sinensis, 30 grams of motherwort, 10 grams of chuanxiong, 10 grams of peach kernel, 10 grams of licorice, 10 grams of moutan bark, 5 grams of prepared ginger, and 50 milliliters of white honey.

　　Usage: Boil the first seven ingredients with 500 milliliters of water, then strain and add white honey to make a paste. Take 30 milliliters, three times a day.

　　Function: Promote blood circulation and remove blood stasis, warm the meridians and regulate menstruation; suitable for scanty menstruation caused by blood stasis, purple and black menstrual blood, blood clots, distension and pain in the lower abdomen that is difficult to press, normal or purple and dark tongue, or ecchymosis, thin and wiry pulse.

　　4. Mother Hen and Mugwort Decoction

　　Composition: 1 old hen, 15 grams of mugwort leaves.

　　Usage: Clean the old hen, cut it into pieces, and boil it with mugwort leaves. Eat in 2 to 3 servings. Take 2 to 3 doses during the menstrual period.

　　Function: Strengthen the body and control bleeding, invigorate the spleen and calm the mind; suitable for excessive menstruation caused by body weakness and inability to control bleeding, palpitations, insomnia, frequent dreams, cold pain in the lower abdomen, pale tongue, and thin pulse.

　　5. Earth Yellow Boiled Wine

　　Composition: 6 grams of raw earth, 10 grams of motherwort, and 200 milliliters of yellow wine.

　　Usage: Pour yellow wine into a porcelain bottle (or cup), add raw earth and motherwort, steam over water for about 20 minutes, take 50 milliliters each time, twice a day.

　　Function: Promote blood circulation and stop bleeding; suitable for excessive menstruation caused by blood stasis, purple and black menstrual blood, blood clots, or accompanied by lower abdominal pain that is difficult to press, purple and dark tongue, or ecchymosis, thin and涩 pulse.

　　6. Diliang Paste

　　Composition: 30 grams of raw earth, 30 grams of earth bone skin, 15 grams of peony root, 15 grams of ophiopogon, 15 grams of white peony, 30 grams of ejiao, and 40 milliliters of white honey.

　　Usage: Boil the first five ingredients to get a concentrated juice of 300 milliliters, then dissolve ejiao in 60 milliliters of boiling water and mix it with the medicine juice. Add white honey, adjust over a low flame, wait until cool, and pour into a bottle. Take 20 milliliters, three times a day.

　　Function: Nourish yin and blood; suitable for excessive menstruation caused by liver and kidney yin deficiency, internal disturbance of虚 heat, with red menstrual blood, dizziness, irritability, thirst, red tongue, and thin and wiry pulse.

　　7. Goji and Lamb Stew

　　Composition: 1000 grams of lamb shank, 50 grams of goji, and appropriate amount of seasoning.

　　Usage: Boil the whole piece of lamb with boiling water, then rinse it clean with cold water and cut it into pieces; when the oil in the pot is hot, add the whole piece of lamb, boil with boiling water, stir-fry with ginger slices, add cooking wine to flavor the pot, stir-fry, then add goji berries, soup (2000 milliliters), salt, and scallion, bring to a boil, skim the foam, and simmer over low heat for 1 to 1.5 hours until the lamb is tender. Remove scallion and ginger, add monosodium glutamate, and drink the meat and soup.

　　Function: Kidney and blood nourishing; suitable for menstrual disorders caused by kidney-yang deficiency, such as scanty menstruation or unclean menstrual blood, pale red or dark red, thin quality, soreness in the lower back and knees, dizziness and tinnitus, or cold feeling in the lower abdomen, frequent urination at night, pale tongue, and slow and delayed pulse.

　　Two, what foods are good for uterine hypertrophy

　　For bleeding, eat goat blood, snails, clam, cuttlefish, shepherd's purse, lotus root, mushrooms, malan tou, shi er, bizi, persimmon cake; for infection, eat eel, clam, water snake, needlefish, carp, kumquat seaweed, celery, sesame, buckwheat, rapeseed, xiangchun, red bean, mung bean.

　　Three, it is best not to eat certain foods for uterine hypertrophy

　　1. Avoid spicy foods such as chili, Sichuan pepper, raw scallion, garlic, alcohol, and frozen drinks.

　　2. Avoid eating foods with hot properties, blood coagulation, and hormone ingredients such as longan, jujube, ejiao, royal jelly, etc.

　　For uterine hypertrophy, conservative physical therapy or minimally invasive surgery with LEEP knife is generally considered; androgen therapy can reduce blood loss. For those who have no effect from conservative treatment, total hysterectomy can be considered. For those under 50 years old with normal ovaries, they should be preserved.

　　1. Drug Treatment

　　It is suitable for mild ulcers, the method is as follows:

　　1. 10-30% silver nitrate solution or 10% iodine alcohol Use a cotton swab to apply the medicine gently to the affected area, after applying silver nitrate, apply physiological saline to make the excess silver nitrate become non-corrosive silver chloride. Apply twice a week, 4 to 6 times as a course of treatment, and repeat as necessary.

　　2. Potassium Dichromate Solution Use a cotton swab to gently apply the medicine to the affected area, apply once after the menstrual period is clean, and repeat once after the next period. For those with large ulcerated surfaces, the effect is sometimes better. Before applying the medicine, first use 0.1% new germicide to clean the cervical mucus, place two cotton balls in the posterior fornix to prevent the medicine from flowing down and burning the vaginal mucosa. After the cotton balls are removed, use a 75% alcohol cotton swab to wipe the medicine area (formula: potassium dichromate 10g, concentrated sulfuric acid 75ml, add water to 100ml).

　　2. Surgery

　　For those with hypertrophy of the cervix, deep and extensive ulcerated surfaces involving the cervical canal, and (or) suspected of having malignant changes, cervical cone resection can be performed. The excised tissue is sent for pathological examination. This method has smaller scars and the cervix can be maintained in its original state after surgery.

　　3. Minimally Invasive Treatment

　　Physical therapy is suitable for moderate and severe ulcers, with good efficacy and the shortest course of treatment.

　　1. Laser Treatment Laser causes the ulcerated tissue to carbonize and scab.

　　2. Cryotherapy Use a rapid cooling device with liquid nitrogen, place the probe on the ulcerated surface for 1 to 3 minutes, remove it after natural warming, and cause the pathological tissue to freeze and necrose. After treatment, a large amount of watery secretion can be discharged in 2 to 3 weeks. The advantage is that bleeding and cervical stenosis occur less frequently.

　　3. Ironing Technique Use an ironing iron to contact the ulcerated surface, causing tissue to coagulate and form a scab, which usually starts to fall off after about two weeks. The wound healing usually takes 6 to 8 weeks. The operation should be performed 3 to 5 days after the menstrual period ends. Avoid using it for those with appendicitis. After treatment, the leukorrhea may temporarily increase or bleed. If there is a lot of bleeding, use disinfected gauze to compress and stop the bleeding, and remove it after 24 hours. The disadvantage is that sometimes the cervix may become narrow due to scar contraction.