Vulvar pain

　　The etiology of vulvar pain is a group of heterogeneous diseases, the etiology may be multifactorial, and there are many studies on vulvovaginitis, while there are fewer reports on circumvallate vulvitis and dysesthetic vulvar pain. The common causes of vulvar pain include the following several types:

　　1. Candidiasis infection:A history of vulvovaginal candidiasis is the only most constant feature in patients with vestibulitis, but inappropriate multiple applications of antifungal drugs can also cause these symptoms. In addition, the colonization rate of Candida in patients with vestibulitis is not higher than that in the control group. The etiology of circumvallate vulvitis is unknown, but Candida albicans may be a potential etiology, and antifungal treatment is usually effective.

　　2. Iatrogenic factors:Patients with vulvar pain often have a history of multiple applications of topical medications. Since the protective barrier function of the vulvar skin's stratum corneum is not as good as that of other parts of the skin, vulvar irritation caused by topical medications is common. Stimulation is unlikely to be the cause of the initial symptoms, but it may prolong the symptoms related to vulvar pain. The incidence of sensitization should not increase due to this lesion, and there is no histological evidence to confirm or exclude the occurrence of allergic contact dermatitis.

　　3. Psychological and sexual psychological factors:Patients with vaginal pain have明显的 psychological and sexual psychological pathologies, but whether they can cause symptoms is controversial. Insufficient sexual arousal during intercourse can lead to reduced lubrication and cause vaginal and vaginal irritation, and cyclic vaginal irritation symptoms can produce vaginal pain. However, several studies have not shown that patients have more unpleasant experiences or a higher incidence of sexual promiscuity than the control group, and their sexual partners also do not have明显的 sexual psychological disorders.

　　4. Genetic predisposition:Vaginal pain is more common in whites and rare in blacks and Asians, but whether this is a true genetic predisposition or a factor of social demography is yet to be determined.

　　5. Dietary factors:Some scholars speculate that vaginal pain is associated with hyperoxaluria, with sharp oxalate crystals contacting the epithelial surface and causing severe burning pain. However, the 24-hour urinary excretion of oxalate in patients is not higher than that in the control group, and only 10% of cases were cured after 3 months of treatment with calcium citrate combined with a low-oxalate diet. Therefore, urinary oxalate is unlikely to be the cause of vaginal pain, but it can act as a non-specific irritant to exacerbate vaginal pain.

　　6. Estrogen influence:

　　(1) Many patients experience worsening of symptoms during their menstrual period.

　　(2) Lower serum estrogen levels, which often occur postpartum (when estrogen is relatively deficient), even in cesarean sections.

　　(3) Oral contraceptives increase the relative risk of developing vaginal pain by 11 times. Although estrogen may contribute to symptom onset, its role needs further evaluation. There is no controlled study showing that estrogen replacement therapy (topical or oral) is effective.

　　(4) Human papillomavirus infection: It is currently believed that the association between vaginal pain and human papillomavirus is coincidental, as its infection rate is not significantly higher than that in the control group, and human papillomavirus is not a neurotropic virus.

　　(5) Pelvic floor muscle tension: Most patients with vestibulitis have instability of the levator ani muscles, poor recovery after muscle contraction, and increased resting baseline tension. Although it is yet to be elucidated whether pelvic floor muscle tension is the cause of symptom persistence, biofeedback therapy to overcome excessive levator ani tension is indeed a promising treatment.

　　(6) Nerve factors: Vaginal pain is similar to reflexive sympathetic dystrophy, which presents with persistent pain in the absence of tissue damage. Animal experiments show that repeated activation of cutaneous nociceptors (C fibers) leads to changes in the peripheral and central nervous systems. The increased sensitivity of cutaneous nociceptors is due to the release of neuropeptides such as substance P, calcitonin gene-related peptide, endorphins, serotonin, and other catecholamines; these neuropeptides have vestibulitis effects and can increase the inflammatory process. The level of substance P in the vestibule of patients with vestibulitis is higher than that in the control group, and the density of epidermal nerve fibers has also increased significantly. Sensitivity of the central and peripheral nerves may be the reason why symptoms persist after the initial tissue trauma has subsided.

　　Vulvar pain is usually characterized by chronic vulvar discomfort caused by burning, tingling, tenderness, or irritation due to gynecological inflammation. Long-term vulvar pain in women may lead to certain psychological diseases.

　　List some common symptoms of gynecological diseases that cause vulvar pain:
　　1. Vestibulitis

　　It is characterized by pain in the vestibular area after pressure, with a history of irritative pain, such as superficial sexual pain, intolerance to menstrual cotton塞, and pain during gynecological examination, or pain when wearing tight clothes or riding a bicycle, the history lasts for several months to several years, and patients are often women before menopause. Pain may occur during the first sexual intercourse or after normal sexual activity, often acute exacerbation under some triggering factors (such as surgery, childbirth, infection), with varying degrees of erythema in the vestibular area, mild touch can cause acute pain; hyperesthesia is located in the entire vestibular area, or limited to the opening of the vestibular gland or the labial frenulum, generally the most obvious tenderness is near the opening of the vestibular gland, about 30% of cases resolve spontaneously, half of which occur within one year.

　　2. Annular vulvitis

　　The symptoms of annular vulvitis are intermittent and related to the menstrual cycle, often occurring during the menstrual period, post-coital pain, and many patients have obvious erythema and mild desquamation during physical examination.

　　3. Sensory abnormal vulvar pain

　　Also known as idiopathic vulvar pain, it often occurs in women during menopause, with no sexual pain, symptoms are persistent, non-irritative vulvar pain and dull pain, occasionally involving the perianal, perineum, and inner thigh, the characteristics of pain are often similar to other neuralgia syndromes such as post-herpetic neuralgia. The vulva is normal, and occasional erythema may be a normal anatomical variation, without obvious tenderness or pressure pain. It is not uncommon for patients with a history of other chronic pain (such as glossodynia) to have accompanying symptoms.

　　Vulvar itching and redness are mostly caused by vaginal gynecological inflammation, especially vulvovaginitis caused by trichomoniasis or fungal infection. The large amount of abnormal leukorrhea discharged stimulates the vulva, causing redness and itching. Not paying attention to cleanliness and hygiene during the menstrual period, or using rubber or plastic menstrual belts, and not frequently cleaning the vulva may cause menstrual blood or vaginal secretions to accumulate in the vulva for a long time. Or wearing synthetic fiber underwear regularly may keep the vulva in a humid environment, often causing vulvar itching. Common preventive measures for vulvar pain include:

　　1. Pay close attention to personal hygiene, keep the vulva clean and dry, and wear loose and comfortable pants. Avoid wearing tight pants for a long time.

　　2. Change your underwear frequently, and it is best to choose cotton underwear, as it is soft, comfortable, and has good ventilation; it is not recommended to wear synthetic fiber underwear that does not breathe, as this may cause prolonged local dampness and exacerbate the condition.

　　3. It is strictly prohibited to scratch the vulva with hands when it is locally itchy, and it is never advisable to use irritant drugs or soap to wash. After vulvar ulceration occurs, secondary infection should be prevented, and soft and sterile perineal pads can be used after medication to reduce the opportunities for friction and mixed infection.

　　Patients with vulvar pain have obvious symptoms, and the clinical treatment mainly focuses on the examination of the primary disease. The main examination methods include: 1. Gynecological examination. 2. Vaginal secretion examination. 3. HPV can be tested.

　　What foods are good for vulvar pain?

　　1. Eat foods rich in vitamin B: Such as wheat, sorghum, euryale, honey, tofu, chicken, chives, milk, etc.; eat more fruits and fresh vegetables.

　　2. Eat cool blood and detoxifying foods. Green beans, glutinous rice, cucumbers, bitter melon, portulaca, green tea, etc.

　　What foods should vulvar pain patients avoid?

　　Avoid spicy foods: Eating too much spicy food can produce dryness and heat, causing internal heat and toxicity to accumulate, leading to symptoms such as itching and pain in the anterior and posterior vulva, thereby exacerbating the symptoms of the disease.

　　Dietary remedies for vulvar pain

　　Angelica Dendrobium Egg Soup: 30g of angelica, 30g of dendrobium, and 30g of fructus lycii. Add 1000ml of water, boil to 300ml, then crack 2 eggs and pour them into the herbal juice and cook until soft. Add an appropriate amount of rock sugar for seasoning, eat in the morning and evening.

　　Polygonatum Bone Marrow Paste: 150g of polygonatum, 100g of scutellaria, 100g of ophiopogon. Boil together to get the herbal juice, concentrate it into paste. Use 100g of bone marrow (or pork bone marrow) from cow bones (or pork bones), mix the paste with the marrow, eat 10-15g with yellow wine in the morning, and take for 7-10 days.

　　Cistanche Lamb Soup: 150g of cistanche, 50g of dogwood fruit, 50g of rehmannia, and 100g of lamb. Peel the cistanche, wash it with wine, cut it into thin slices, and cook it with dogwood fruit and lamb in a pot with water until it is soft. After the soup is cooked, add coriander, ginger, garlic, scallion, salt, and monosodium glutamate for seasoning and eat it.

　　Ginger Juice Clam Soup: 5ml of ginger juice, 30ml of rice wine, and 200g of clam meat. Appropriate amounts of cooking oil and salt. Clean and cut the clam meat, then fry it with peanut oil and add rice wine, ginger juice, and a sufficient amount of water to cook. After the meat is cooked, add salt for seasoning, eat the meat and drink the soup, twice a day, and take for 7 days. Winter Melon Brown Sugar Drink: 30g of winter melon (use 90% of fresh winter melon), 50g of brown sugar. First, clean the winter melon, add two and a half bowls of water, boil until one bowl remains, remove the residue, and then add brown sugar to cook until it is soft and warm. Eat once a day, and take 3-5 times. Motherwort and Rehmannia Lotus Juice Porridge: 50g of motherwort, 50g of rehmannia. Boil to get 50ml of juice, 15ml of fresh lotus juice, and an appropriate amount of honey. First, cook the glutinous rice into porridge, then add the above various herbal juices and honey and cook for a moment. Eat while hot, twice a day in the morning and evening, and take for 7 days.

　　Rose Cherry Porridge: 15g of rose petals, 30g of cherries, 50g of sugar, and 100g of glutinous rice. Pick the unopened roses, peel off the petals, wash them clean with cold water and set aside. Rinse the glutinous rice clean, cook it into porridge with an appropriate amount of water in a pot. When the porridge is cooked, add the rose petals, cherries, and sugar and cook until thickened. It can be eaten once a day, and 7 days of continuous administration is one course.

　　Liver Qi Stagnation: Patients often experience intermittent pain in the vagina during sexual intercourse, which may radiate to the lower abdomen and the inner side of the lower limbs. It is often accompanied by symptoms such as irritability, chest and hypochondriac distension, dizziness, headache, insomnia, dizziness, red tongue with thin white fur, and wiry and tight pulse. Treatment should be aimed at soothing the liver and regulating qi, and relieving pain through unblocking the meridians. Dietotherapy and medicated cuisine can be chosen such as:

　　Ju络 Danggui Rice Porridge: 10g of Ju peel, 20g of丝瓜络, 15g of Aiye, 15g of Danggui. Boil the herbs to remove the dregs and collect the juice. Wash the粳米 and add appropriate amounts of water, cook over high heat until soft. Mix the medicine juice with the porridge, then cook over low heat until thickened and season for consumption, once a day.

　　Jinju Dazao Drink: 10g of Jinju peel, 10g of Lishizhi core, 10g of Dazao, 5g of Gancao, appropriate amounts of rock sugar. Boil with water to remove the dregs and drink the juice, once a day, for 10-15 consecutive days.

　　Foshou Erhua Ganpi Soup: 10g of Foshou, 10g of Hehuanhua, 5g of Meihua, 100g of pork liver. Wash the pork liver and cut into slices, mix with a little flour, and then put Foshou, Hehuanhua, and Meihua in the pot with water to boil for 10 minutes to remove the dregs. Put the liver slices in the pot and cook for a few minutes, then add ginger, pepper, salt, and scallion for seasoning and serve, once a day.

　　Gancao Baidou Drink: 30g of dried ginger, 50g of Dazao, 30g of rock sugar. Wash the dried ginger and cut into slices, remove the seeds from the Dazao, put them in a pot with rock sugar and appropriate amounts of water, and boil for 20-30 minutes. Eat the Dazao and drink the soup, twice a day, for 3-5 consecutive days.

　　Aiye Wudou Egg Soup: 10g of Aiye, 30g of Wudou, 2 eggs. Put them in a pot with water and cook until the Wudou is soft, remove the dregs and keep the juice. Then beat the eggs into the juice and cook for a few minutes. Consume once a day, for 2-3 consecutive days.

　　Chuanxiong Celery Egg Soup: 9g of Chuanxiong, 50g of celery, 2 eggs. Cut Chuanxiong and celery into fine pieces. Put them in a pot with eggs and cook for 15-20 minutes. Take out the eggs, peel them, pierce a few holes with a needle, and put them back into the soup to cook for a few minutes. Season with monosodium glutamate, salt, ginger, and scallion, eat the eggs and drink the soup, once a day, for 7 consecutive days.

　　Jicai Shitake Rice Porridge: 50g of Jicai, 20g of dried Shitake, 20g of shrimp, 20g of cooked bamboo shoots, 20g of pork, 100g of粳米, pork oil, salt, and monosodium glutamate as needed. Wash and chop the above ingredients. Heat the oil in a pot, stir-fry the Jicai for a while, then add the other ingredients and rice, add 1500ml of water, and cook into porridge. Season with scallion, monosodium glutamate, and salt, and consume once or twice a day.

　　Liver depression transforming into fire: Patients often present with symptoms such as burning and pricking pain in the vagina, yellow and dark urine, dry mouth and bitter taste, red face and eyes, irritability, distension and pain in the hypochondria, red tongue with thin yellow fur, and thready and rapid pulse. Treatment should focus on clearing the liver and expelling heat, and soothing the liver and regulating the qi. Dietetic medicine can be chosen such as:

　　Jieyu Xiangchen Wine: 50g of Xiangfu, 5 liang of Chuanxiong, 30g of Chenpi, 1000ml of Baijiu. Soak for 7 days before taking, 2-3 times a day, 10-20ml each time. Shizi Shitake Lean Pork Soup: 150g of lean pork, 50g of mushrooms, 50g of Gouqizi. Cut the lean pork into slices, wash the mushrooms and Gouqizi, and put them in a pot with appropriate amounts of salt, ginger, and pepper to cook. Season with scallion, monosodium glutamate, and salt, and consume the soup and meat, once or twice a day, for 3-7 consecutive days.

　　Foshou Anxiang: 12g of Foshou, 12g of Yujin, 12g of Xiaohuixiang, 200g of粳米. First, boil Foshou, Yujin, and Xiaohuixiang to remove the dregs and collect the juice of 150ml. Cook the rice into porridge, then add the medicine juice and cook for a few minutes. Add appropriate amounts of salt, monosodium glutamate, pepper, and ginger for seasoning and consume, once a day.

　　Chinese arborvitae and Cornus officinalis pork liver soup: Chinese arborvitae 9g, Cornus officinalis 10g, pork liver 200g, yellow wine 50ml. Cut Chinese arborvitae and Cornus officinalis into pieces, slice the pork liver, and cook with Chinese arborvitae and Cornus officinalis in a pot. Steam-braise and serve with warm yellow wine. Take twice daily, for 3-5 consecutive days.

　　Bovine kidney and pigeon meat braised: Bovine kidney 30g, pigeon meat 200g, a little rice wine. Remove the feathers and internal organs of the pigeon, crush the bovine kidney, and place it in the pigeon's abdominal cavity. Add ginger, pepper, scallion, an appropriate amount of water, and rice wine, mix well, and steam-braise in a pot. Season and eat. Take once daily, for 3-5 consecutive days.

　　Cuttlefish and bamboo shoot meat congee: Dry cuttlefish 1 piece about 100g (debone and soak in warm water to swell), dried bamboo shoots 50g, lean pork 10g, glutinous rice 100g. Clean the soaked cuttlefish and cut into strips, chop pork and bamboo shoots into strips for later use; clean the glutinous rice, add an appropriate amount of water in a pot, add the pork strips, cuttlefish, and bamboo shoots, and cook until tender. Season with salt, monosodium glutamate, and pepper, and serve warm. Take 1-2 times daily.

　　Polygonum multiflorum and Cornus officinalis cooked eggs: Polygonum multiflorum 30g, Cornus officinalis 10g, eggs 2, first decoct Polygonum multiflorum and Cornus officinalis in water, remove the dregs and keep the juice, beat the eggs and cook them, season with scallion, salt, and monosodium glutamate, eat the eggs and drink the soup. Take once in the morning and evening, for 5-7 consecutive days.

　　Yin deficiency of liver and kidney: Patients often have symptoms such as vaginal dryness and pain, or even a burning sensation in the vagina, dizziness and tinnitus, dry mouth and throat, yellow urine and dry stools, red tongue with little fur, and wiry and thin pulse. Treatment should be tonifying the kidney and nourishing the liver, and moistening dryness. Dietary therapy can be chosen such as:

　　Cordyceps sinensis, Chinese wolfberry, and Angelica sinensis braised sea cucumber: Chinese yam 30g, Chinese wolfberry 30g, Angelica sinensis 15g, Cistanche deserticola 15g, Chinese cordyceps 1 piece, sea cucumber 100g. Clean the herbs, cut the sea cucumber into pieces, add an appropriate amount of rock sugar, and steam-braise together in a steaming bowl. Eat the meat and drink the soup. Take once daily, for 7 consecutive days.

　　Sparrow millet congee: 2-3 sparrows, kill and pluck feathers and internal organs, chop them, clean 200g of millet, and cook with the sparrow meat in a pot with water. Boil until thick, add scallion, ginger, a little salt, and pepper for seasoning. Take once daily.

　　Polygonatum sibiricum and duck egg soup: Polygonatum sibiricum 30g, Polygonatum 30g, Angelica sinensis 15g, Chinese wolfberry 30g, raw rehmannia 30g, add 1000ml of water and boil to 300ml. Then add 2 duck eggs, beat and pour into the soup, add table salt, ginger, scallion, and a little monosodium glutamate for seasoning. Take twice daily, for 3-5 consecutive days.

　　Eucommia bark braised large intestine: Eucommia bark 50g, Chinese wolfberry 30g, pork large intestine 300g. Clean the large intestine, finely chop Eucommia bark and Chinese wolfberry, stuff them into the large intestine, add an appropriate amount of water, steam-braise until the pork large intestine is tender, season with ginger, pepper, scallion, monosodium glutamate, and table salt, eat the intestine and drink the soup. Take once daily, for 10-15 consecutive days.

　　Astragalus, Ginseng, and Polygonum multiflorum chicken: Astragalus 15g, Ginseng 5g, Polygonum multiflorum 15g, young female chicken 1 (about 500g), scallion slices, fine salt, and cooking wine as needed. After the chicken is slaughtered, remove the feathers and internal organs, place it in a pot, add Polygonum multiflorum, Ginseng, and Astragalus slices inside the chicken, add a little water, steam-braise until the chicken meat separates from the bone. Remove Polygonum multiflorum and Astragalus, add oil, salt, ginger, scallion, and cooking wine, mix well, and continue to braise for 10-12 minutes before serving the meat and soup. Take once daily.

　　Turtle and goji glutinous rice porridge: 150g of turtle meat, 30g of goji, 200g of glutinous rice. First, chop the turtle meat and goji, wash the glutinous rice, and cook together in a pot with water. When the porridge is thick, add ginger, dried tangerine peel powder, chopped scallion, monosodium glutamate, and salt for seasoning. Eat once in the morning and once in the evening, for 3-5 consecutive days.

　　Sea cucumber and rosehip soup: 50g of sea cucumber, 15g of rosehip, 20g of astragalus. First, slice the rosehip and astragalus, cut the sea cucumber into strips, and cook together in a pot with pepper, ginger, and salt for 30 minutes. Eat the sea cucumber and drink the soup, once a day for 7 consecutive days.

　　Downward flowing damp-heat: Common symptoms include pain during sexual intercourse, with excessive leucorrhea, yellow and脓-like or foamy like rice gruel, foul smell, irritability, insomnia, bitter and sticky mouth, jaundice, burning sensation in the urinary tract, yellow tongue coating, and slippery and rapid pulse. Treatment should focus on clearing heat and removing dampness. Dietary therapy can be chosen:

　　Chinese toad lily with celery: Wash equal amounts of fresh Chinese toad lily, fish mucus root (houttuynia), and celery, blanch in boiling water, season with salt, sugar, vinegar, garlic, monosodium glutamate, and sesame oil, and eat as a side dish.

　　Mung bean and yam paste: 100g of mung bean, 50g of rock sugar, 50g of yam. Boil together in a pot to form a paste, then add 10g of ginger juice, stir well, and take it on an empty stomach with boiling water, 15-20g each time, for 7 consecutive days.

　　Jujube and bamboo eight-precious porridge: 10g each of jujube, mung bean, bamboo shoot, poria, coix seed, Chinese yam, lotus seed, and euryale seed, 250g of glutinous rice. Cook together to make porridge, add a little rock sugar for seasoning after the porridge is thick, and eat once in the morning and once in the evening.

　　Steamed pork liver with horsewhip grass: 60g of fresh horsewhip grass, 100g of pork liver, a little salt. Wash the fresh horsewhip grass and cut into small pieces, slice the pork liver, mix them in a bowl, add an appropriate amount of water, ginger, salt, starch, monosodium glutamate, and scallion, and steam until done. Eat the pork liver and drink the soup, once a day for 5-7 consecutive days.

　　Bitter mustard and Chinese chive rice porridge: 50g of amaranth, 50g of bitter mustard, 30g of garlic, 200g of glutinous rice. First, chop the bitter mustard, amaranth, and garlic, sauté with lard, wash the glutinous rice, and cook together in a pot with an appropriate amount of water. When the porridge is thick, add salt, chopped scallion, and monosodium glutamate for seasoning. Eat once in the morning and once in the evening, and for 7 consecutive days.

　　Chrysanthemum and lily pork liver soup: 10g of chrysanthemum, 15g of lily, 100g of pork liver. First, slice the pork liver, soak the chrysanthemum and lily in water for 30 minutes, then cook in a pot for 20 minutes. Add pork liver, ginger, scallion, salt, and monosodium glutamate, and boil for another 5 minutes. Eat once a day for 3-7 consecutive days.

　　Steamed crucian carp with amomum and jujube: 50g of amomum, 10g of jujube seeds, 1 crucian carp (about 100g), 3 slices of ginger. First, clean and scale the crucian carp, grind the amomum and jujube seeds into powder, mix evenly with salt and ginger, and stuff into the fish belly. Then place the fish in a large plate, cover with another plate or bowl, and steam until the crucian carp is tender and warm. Eat once a day for 7 consecutive days.

　　Wind invasion: Patients often present with pain in the vagina accompanied by fever, aversion to cold, headache, nasal congestion, fatigue, sore limbs, thin white tongue coating, floating pulse, etc.: Treatment should be to disperse cold, relieve the exterior, and nourish blood. Dietary therapy and medicated cuisine can be chosen:

　　Suzao ginger sugar drink: Suzao leaves, ginger, scallion whites, sugar each 10g, pour boiling water over them, cover and steep for 10 minutes, drink while hot, several times a day.

　　Danggui Niubang porridge: ginger 10g, Danggui 10g, Niubangzi 15g. scallion whites 20g, decoct the above herbs, remove the dregs, and add 200g of glutinous rice to cook porridge, add a suitable amount of sugar to season and eat when the porridge is thick.

　　Lugen Zhuru ginger tea: fresh lugen 150g, Zhuru 20g, ginger 10g (sliced), sugar to taste. Put the above herbs into a pot, add a little water, soak for 20 minutes, simmer over low heat for 10-20 minutes, strain the juice for tea, drink it several times a day, warm and hot.

　　Tofu Xiangru soup: scallion whites 20g, tofu 150g, Xiangru 20g, ginger 3 slices. Cut the above herbs into fine pieces, cut the tofu into blocks, and put them into a pot, simmer for 30 minutes over low heat. Season with salt, monosodium glutamate, and pepper, eat the vegetables and drink the soup, once a day, for 3 days in a row.

　　Jiabai Shimen porridge: jiabai 50g, mushrooms 30g, glutinous rice 100g, pork mince 50g. Peel and cut the jiabai into strips, soak the mushrooms and cut them into strips, heat a pan and add oil, stir-fry the pork mince, jiabai, and mushrooms, add a sufficient amount of water, add the rice when the rice grains are almost cooked, cook for a while, add the stir-fried jiabai, mushrooms, and pork mince, and cook for a short while before seasoning and eating, once in the morning and evening.

　　Scallion and tangerine peel spicy beef: cilantro 15g, scallion whites 10g, tangerine peel 5g, dried chili 3g, fresh beef 250g, wash the beef, cut it into extremely thin slices, mix with ginger slices, scallion whites, cooking wine, peanut oil, and salt, heat a wok over high heat with a sufficient amount of peanut oil, stir-fry the ginger slices, chili, tangerine peel, and beef continuously, until the beef is crispy and fragrant, add vinegar and sauce and stir-fry for a moment, then remove from heat for eating or as a side dish, once a day.

　　Danggui Maidong煮莲藕: Danggui 10g, Maidong 12g,莲藕300g, cut the lotus root into sections, chop Danggui and Maidong together and put them into the pot, add ginger, pepper, scallion whites, lard, and simmer until soft, season with salt and monosodium glutamate for eating, once a day, for 3-7 days in a row.

　　1. Medication treatment:
　　The treatment of vulvar pain is not specific, but it is still meaningful. Most patients with vulvar pain will have significant improvement in their symptoms after a detailed and patient examination of the vulva and vagina by a doctor, and after educating the patients.

　　1. Anti-inflammatory treatment:Multiple treatment measures need to be carried out simultaneously, such as using amoxicillin to treat Streptococcus pyogenes infection; taking 150mg of fluconazole weekly to prevent secondary fungal infections, and placing a gel in the vagina to promote the proliferation of lactobacilli and eliminate Streptococcus. Apply 2% lidocaine gel locally during sexual intercourse or when pain occurs.

　　2. Antidepressant treatment:It is necessary to explain to the patient that the drug is used for treating pain rather than depression. Most patients will improve their symptoms after a few weeks or a month after reaching the appropriate dose. Unless a primary disease is found during the examination, such as non-Candida albicans infection, or erosive lichen planus, tricyclic antidepressants such as amitriptyline or desipramine (nortriptyline) can be used, starting with a dose of 10mg, gradually increasing to the level that the patient can tolerate and feel comfortable, or until 150mg.

　　3. Other treatments:Amitriptyline is often effective for treating sensory vulvar pain. About 30% of vestibulitis patients receive local injections. Interferon alpha can provide long-term relief, such as 1 million U, injected 3 times a week for a month, a total of 12 times. The injection site is limited to the vestibular area and covers all damaged areas. Similarly, women with vestibulitis often experience significant improvement after vestibular resection when the pain is limited to the vestibular area, and the resection site includes the inner skin of the labia minora and the inner opening of the hymen, which also improves the vagina. The operation should be decided by an experienced obstetrician-gynecologist, who must fully understand the patient's condition and the steps of the operation.

　　4. Continuous antifungal treatment:May be effective for women with circumvallate vulvitis. The method is to take fluconazole 150mg every 1 to 7 days (fluconazole can be retained in the vagina for 3 days after taking the medicine), to clear Candida albicans, and to avoid exposing the vulva to刺激性乳膏. Alternatively, you can choose external antifungal cream of the azole class, such as nystatin cream or vaginal tablets, applied externally once a day.

　　Second, pelvic physical therapy
　　May also be effective for vestibulitis and other types of vulvar pain. To date, the best therapy is pelvic electromyography biofeedback. It is recommended to have a diet low in oxalates and high in calcium citrate during meals, which is effective for vestibulitis and other types of vulvar pain. Some surgeons have tried to perform excision using carbon dioxide laser, but the results are not yet clear, and even some patients have increased pain as a result. Recently, there have been reports that dye laser therapy activated by flashlights is effective for vulvar pain, but some patients have been found to have increased pain during follow-up. Therefore, laser therapy is not suitable for this group of people.