External genital schistosomiasis

　　外阴血吸虫病多由身体其他部位感染而合并外阴感染。寄生在人体的血吸虫有埃及血吸虫、间插血吸虫、湄公血吸虫、曼氏血吸虫、日本血吸虫5种，在中国仅有日本血吸虫。此虫1904年日本人桂田在日本首先报道，故名日本血吸虫。除寄生在人体的血吸虫外，尚有禽类和畜类血吸虫，种类繁多。实际禽畜类血吸虫尾蚴皮炎在中国流行的范围可能还更广泛。

　　血吸虫的完整生活史是人或其他哺乳动物与自然环境和钉螺之间的一个大循环。血吸虫的生活史包括卵、毛蚴、母胞蚴、子胞蚴、尾蚴、童虫、成虫等7个时期。被血吸虫感染的人或动物的粪便中含有大量的血吸虫虫卵，虫卵在水中孵化出毛蚴。毛蚴遇到钉螺便钻入螺体，并在其体内发育成尾蚴。钉螺遇水，尾蚴便钻出来，分布在水的表层，此时人接触疫水，尾蚴钻入皮肤，引起尾蚴皮炎。伺机钻入人或哺乳动物体内，发育成成虫。成虫在人或动物肠壁的小血管中产卵，虫卵再次随粪便排出。人体血吸虫钻入皮肤的尾蚴脱去尾部及体部的皮质发育为童虫，随血流或淋巴液到右心、肺，再到左心，然后到达肠系膜静脉、门静脉发育为成虫，开始产卵，虫卵主要沉积在肝和结肠，是引起血吸虫病的主要因素，虫卵随大便排出体外，又开始新一代繁殖，周而复始。血吸虫在人体内的寿命可以长达30～40年。

　　动物的血吸虫是禽、畜等动物的粪便排出虫卵入水，孵出毛蚴钻入水田、河溪中的锥实螺(萝卜螺)体内繁殖，经1～2个月产生大量的尾蚴，浮游水中，此时人若下水尾蚴可借助腹部的吸盘附着人的皮肤，引起局部炎症反应。动物血吸虫的尾蚴钻入皮肤是一种误入，它不会再继续发育寄生在人体。

　　早期出现真皮水肿，有淋巴细胞和嗜中性粒细胞浸润，后期有嗜酸性粒细胞浸润。在尾蚴侵入皮肤后24h内，尤其2～3h内常可在皮内查到尾蚴。

　　外阴血吸虫病是血吸虫病全身病变的一部分。儿童或青少年感染血吸虫病后还会出现生长发育障碍，如身体矮小、器官不健康发育或没有生育能力。晚期血吸虫病患者常并发消化道出血和肝性脑病。

　　外阴血吸虫病是外阴皮肤出现炎症性改变，可见针头大红丘疹或丘疱疹。中央有小淤点，散在或密集分布，继发感染可形成脓疱。在血吸虫病流行区，可见到外阴部的血吸虫肉芽肿性湿疣或瘘管。主要的症状有局部剧痒，夜间尤甚。有时可伴有发热、腹泻、关节痛、淋巴结肿大等全身症状。

　　The prevention of perineal schistosomiasis mainly involves treating schistosomiasis patients, conducting health searches, and eliminating the source of infection. Strengthening the management of feces and personal protection, as well as post-disaster epidemic prevention measures. The Ministry of Health formulated the 'Emergency Plan for Major Schistosomiasis Epidemics (Trial Implementation)' in 2003, which requires weekly and zero reports for acute infections in heavy epidemic areas. The emergency plan requires that when an outbreak of schistosomiasis or a major sudden outbreak occurs, the local epidemic situation can be reported according to the trend of the epidemic and the need to control the outbreak. The health administration department (schistosomiasis prevention department) should establish a working group for emergency epidemic response, with technical guidance groups consisting of schistosomiasis prevention, health supervision, and other related medical institutions. When an outbreak of acute schistosomiasis or the first confirmed case in an area without previous cases is found, the personnel responsible for schistosomiasis prevention, medical care, and health prevention should report to the local schistosomiasis (disease control) agency as soon as possible, who will then report to the higher authorities. In the 6-10 months of the peak schistosomiasis infection period, a daily report system for acute patients and a weekly report system for scattered patients should be established.

　　Based on the flood tide and the peak season of schistosomiasis infection, follow-up should be conducted for those in contact with epidemic water, and early treatment should be carried out. When the flood recedes to the point where snails are present, the larvae should be eliminated promptly. Conduct snail surveys and disease surveys to understand the post-disaster epidemic situation, and at the same time, carry out chemotherapy for humans and animals.

　　Perineal schistosomiasis is caused by the larvae of schistosoma burrowing into the skin, causing schistosomiasis dermatitis, which occurs in the perineum. The examinations that should be done for perineal schistosomiasis include blood routine, spleen ultrasound examination, and liver ultrasound examination. The blood routine shows an increase in eosinophils in white blood cells, and serum immune reactions such as blood coagulation, enzyme labeling, and latex are positive. Eggs can be found in secretions, urine, and feces. Ultrasound examination shows enlargement of the liver and spleen.

　　The larvae of schistosoma burrow into the skin to cause schistosomiasis dermatitis. When it occurs in the perineum, it is known as perineal schistosomiasis. Based on the specific symptoms of perineal schistosomiasis, the following dietary methods can be adopted:

　　1. Acute schistosomiasis

      50 grams of pumpkin seeds, shelled and left with the kernel, ground into powder, mixed with boiling water, honey, or sugar to form a paste. Take on an empty stomach. This recipe has the effect of detoxifying and killing parasites.

　　2. Acute schistosomiasis with liver and spleen dampness

      1500 grams of Zao'er Binglang, 100 grams of Bizi meat, 300 grams of Radix Rubia, 300 grams of Red Vine, and 10 grams of Processed Realgar. The other four ingredients are ground into fine powder, while the Red Vine is decocted to extract the juice, used to make pills as large as pepper seeds, coated with beeswax. Take 20 grams daily, divided into two doses. This recipe has the effect of clearing heat, removing dampness, and detoxifying.

　　3. Chronic schistosomiasis with symptoms of anorexia and diarrhea

      50 grams of Euryale Seed, 30 grams of Yam, and 20 grams of White Adzuki Bean. The three ingredients are mixed and ground into fine powder, then placed in a pot, with sugar and water added to make a paste. Heat and cook into a thick porridge. This recipe has the effect of invigorating the spleen and removing dampness.

　　4、血吸虫病肝硬化腹水

      绿豆30克，黄花菜20克，大枣10枚。将绿豆、大枣洗净，黄花菜掐去根把，同放入锅内，加水烧开后改用小火煮至绿豆开花，加糖搅匀即可。本方具有清热利水的功效。

　　4, Ascites due to liver cirrhosis in schistosomiasis

      Mung bean 30 grams, chrysanthemum flower 20 grams, jujube 10 pieces. Wash the mung bean and jujube, remove the root of the chrysanthemum flower, put them into the pot, add water, boil, then change to low heat and cook until the mung bean blooms, stir in sugar and mix well. This recipe has the effect of clearing heat and promoting diuresis.

　　Dried root of Pilea cadi 30 grams, lean pork 100 grams. Wash the lean pork and cut into pieces. Add 3 bowls of water and cook with Pilea cadi. When the pork is tender, remove the Pilea cadi, add a little yellow wine and a small amount of salt, monosodium glutamate and other seasonings. This recipe has the effect of soothing the liver, invigorating the spleen and promoting diuresis.

      6, Late-stage ascites of schistosomiasis

　　Red bean 30 grams, crucian carp 1 piece. Kill the crucian carp, remove the gills, scales, and internal organs, cut into pieces, put into the pot, add washed red beans and other spices and water, boil, then change to medium heat and cook until the fish is cooked. Do not add salt, just drink the soup. This recipe has the effect of diuresis and detumescence.

      7, Early schistosomiasis

　　Sour plum skin 9 grams, Yujin 3 grams, grind into fine powder. Take 10 water chestnuts, decoct the soup and take it with the powder. This recipe has the effect of killing worms, soothing the liver, and promoting diuresis.

      8, Nausea and vomiting, dizziness after treatment of schistosomiasis with antimony

　　Conventional methods of Western medicine for the treatment of vulvar schistosomiasisLate-stage formation of skin granuloma can be treated by electrocoagulation, laser surgery or surgery. If there is infection, anti-inflammatory treatment or external application of Shechuangxin, Dandelion, and Huanliancao can be used. Late-stage formed skin granuloma can be treated by electrocoagulation, carbon dioxide laser or surgical resection. If there are symptoms of allergic reactions, antihistamines or corticosteroids can be given. For schistosomiasis caused by infection with cercariae, systemic internal medicine treatment can be carried out with potassium (sodium) tartarate antimony potassium (sodium) furazolidone, hexachloroparaxylene gallate antimony sodium pyrazinamide, Nilitazole (nithiazide) and other drugs..