How Effective Is Azithromycin for Gonorrhea?

The pathogen of gonorrhea is Neisseria gonorrhoeae, which belongs to the genus Neisseria. In 1879, Neisser isolated Neisseria gonorrhoeae for the first time, so Neisseria gonorrhoeae was also called Neisseria Gonorrhoeae. It is the pathogen that causes gonorrhea, commonly known as Neisseria gonorrhoeae. The bacterium has the ability to regulate itself, can acquire resistance through mutation, or at least reduce the effectiveness of the drug, and it is developing this immunity to more and more types of antibiotics. First penicillin failed, then tetracycline, ciprofloxacin, and now cefixime. In 1885, Bamm successfully cultured Neisseria gonorrhoeae on coagulated serum medium.

Gonorrhea

The pathogen of gonorrhea is Neisseria gonorrhoeae, which belongs to the genus Neisseria. In 1879, Neisser isolated Neisseria gonorrhoeae for the first time, so Neisseria gonorrhoeae was also called Neisseria Gonorrhoeae. It is the pathogen that causes gonorrhea, commonly known as Neisseria gonorrhoeae. The bacterium has the ability to regulate itself, can acquire resistance through mutation, or at least reduce the effectiveness of the drug, and it is developing this immunity to more and more types of antibiotics. First penicillin failed, then tetracycline, ciprofloxacin, and now cefixime. In 1885, Bamm successfully cultured Neisseria gonorrhoeae on coagulated serum medium.

Chinese name

Gonorrhea

Time

1897

Subject

biology

discoverer

Neisser

In 1879, Neisser isolated gonorrhea from 35 patients with acute urethritis, vaginitis, and neonatal acute conjunctivitis. In 1885, Bumm successfully cultured Neisseria gonorrhoeae on human, bovine or sheep coagulated serum culture medium. Inoculation of the strain into the urethra of healthy people can also produce the same symptoms. At this point, the conclusion that gonococcus is the pathogen of gonorrhea has come to fruition.

Morphology and staining of Neisseria gonorrhoeae are oval or bean-shaped. The length of the fungus is 0.6 0.8 & micro; m, and the width is about 0.5 & micro; m. Often arranged in pairs, the adjacent faces are flat or slightly concave, like two beans paired together. No flagella and no spores. In the body of acute infection, its morphology is more typical, mostly located in the cytoplasm. The chronic phase is extracellular. N. gonorrhoeae gram staining was negative. When stained with alkaline beauty blue, the cells were blue. When stained with Pappehheim Saathof, the bacteria were red and the background was sky blue, which was very clear.

The pathogenicity of Neisseria gonorrhoeae is closely related to the structure outside the bacteria. The outer structure of Neisseria gonorrhoeae is the outer membrane, and the main components of the outer membrane are membrane proteins, lipopolysaccharides and pili. Membrane proteins can make N. gonorrhoeae adhere to the human mucosa, enter human cells through cell phagocytosis, and multiply in the cells, causing the cells to disintegrate. N. gonorrhoeae spread to the submucosa and cause infection. Pili are easily adhered to the surface of uterine cavity and oral epithelial cells, and are pathogenic and infectious.

Neisseria gonorrhoeae is relatively delicate and is most afraid of drying. It is suitable for growth under humid conditions at a temperature of 35 to 36 ° C and containing 2.5% to 5.0% carbon dioxide. The optimum pH for its growth is 7.0 to 7.5. Neisseria gonorrhoeae has a very poor resistance to external physical and chemical factors. It will die in 1 to 2 hours in a completely dry environment, but if it is attached to clothes and bedding, it can survive for 18 to 24 hours. It can be in thick pus or wet objects. Can survive for several days. It can only survive 5 minutes at 50 ° C. Neisseria gonorrhoeae is weakly resistant to commonly used mucosal fungicides. The Chinese Academy of Sciences Weisheng commonly used the Jieyin lotion for testing. N. gonorrhoeae was killed within 1 minute under the action of Jieyin lotion. N. gonorrhoeae was also very sensitive to soluble silver salts. Died within 2 min of N. gonorrhoeae in the pus. A 1% phenol (carbonic acid) solution can kill it in 3 minutes. Except for resistant strains, N. gonorrhoeae is sensitive to antibiotics, but the minimum inhibitory concentration of antibiotics has gradually increased.

Neisseria gonorrhoeae has high culture requirements and is generally not easy to culture. It is necessary to add ascites or blood to the medium. It is aerobic bacteria with carbon dioxide growth. It grows rapidly in the environment of RH6.5-7.5, temperature 35-37 , and containing 5% -10% carbon dioxide. Weak resistance, not resistant to dryness and cold, survive 20 minutes at 42 , only 5 minutes at 50 , all died immediately at 100 , sensitive to general disinfectants, sensitive to sulfa and penicillin, but prone to drug resistance. Domestic use of chocolate agar or blood agar medium, which contain antibiotics, can selectively inhibit the growth of many other bacteria. Incubate at 36 ° C, 70% humidity, and 5% -10% CO2 (candle jar). Observe the results for 24-48 hours. After cultivation, colony morphology, Gram staining, oxidase test and sugar fermentation test are also required for identification.

Humans are the only natural host for Neisseria gonorrhoeae, and gonorrhea is mainly transmitted by sexual contact. Neisseria gonorrhoeae invades the urogenital system to reproduce, urethritis occurs in men, and urethritis and cervicitis occur in women. If incomplete, it can spread to the reproductive system. The fetus can cause neonatal gonorrhea acute conjunctivitis through a birth canal infection. Humans have no natural immunity to Neisseria gonorrhoeae, and are all susceptible. After the illness, the immunity is not strong and cannot prevent reinfection.

Pathogenesis

(1) Affinity to epithelium: Neisseria gonorrhoeae has a special affinity for columnar and transitional epithelium. Male and female urethra, female cervix are covered with columnar epithelium and transitional epithelium, so they are susceptible to gonococcus. Male scaphoid fossa and female vagina are covered with stratified flat epithelium. Light, so gonorrhea vaginitis is rare in adult women. Young girls are susceptible to infection because the vaginal mucosa is columnar epithelium. The skin is not susceptible to gonococcal infection, and primary gonococcal skin infections are rare. Humans have no innate immunity to Neisseria gonorrhoeae, and reinfection can occur after recovery.

(2) Adhesion: Specific receptors on N. gonorrhoeae pilus can bind to the corresponding parts of mucosal cells; its outer membrane protein II can mediate the adhesion process; it can also release IgAl degrading enzymes and resist cell rejection. In this way, gonococci quickly adhere to the epithelial cells. The pH in the microenvironment, ion bridges, hydrophobic structures, and sex hormones can also promote the adhesion process.

(3) Invasion and infection: N. gonorrhoeae adsorbs on the microvilli of epithelial cells, and its outer membrane protein I is transferred into the cell membrane, and then N. gonorrhoeae is swallowed by the cells and enters the cells. Neisseria gonorrhoeae pilus can be adsorbed on sperm, and can quickly go up to the cervical canal. The mucus of the cervical canal temporarily prevents gonococci from reaching the uterine cavity, and multiplies in the columnar epithelial cells of the cervix to cause disease. Once N. gonorrhoeae invades cells, it begins to proliferate and damage epithelial cells. After the cells are lysed, Neisseria gonorrhoeae is released into the submucosal space, causing infection in the submucosa.

(4) Lesion formation: Neisseria gonorrhoeae continues to proliferate after invading the submucosa, and breeds within about 36 hours. Through the synergistic effects of its endotoxin lipopolysaccharide, complement and IgM, it forms an inflammatory response and makes the mucosa red and swollen. At the same time, due to the accumulation and death of leukocytes, necrosis and shedding of epithelial cells, pus appeared. The most severe lesions were at the openings of the glands and crypts.

(5) Spread: Inflammation caused by gonococcal infection can spread along the urinary and reproductive tracts. In men, it can spread to the prostate, seminal vesicles, vas deferens and epididymis, and in women it can spread to the uterus, fallopian tubes and pelvic cavity. In severe cases, Neisseria gonorrhoeae can enter the bloodstream and spread to various tissues and organs throughout the body, leading to disseminated infection.

2. Drug resistance mechanism

(1) Types of drug-resistant strains: So far, four drug-resistant Neisseria gonorrhoeae strains have been discovered.

PPNG strain: It is a penicillin-resistant strain mediated by the bacterial plasmid. In recent years, PPNG strains of different plasmid types have been isolated.

CMRNG strain: It is a drug-resistant strain mediated by bacterial chromosome. Its resistance spectrum is extensive, including penicillin, tetracycline, cephalosporin, streptomycin, and spectinomycin.

TRNG strain: a tetracycline-resistant strain mediated by a bacterial plasmid.

Fluoroquinolone-resistant strain: It is a drug-resistant strain mediated by bacterial chromosome. The drug resistance spectrum includes ciprofloxacin, lofloxacin and ofloxacin (floxacin).

(2) Reasons for resistant strains:

PPNG strain: This strain has an extra-chromosomal genetic material, called a plasmid, which is produced by a control enzyme obtained by Haemophilus and can be passed on to offspring. The plasmid mutates the drug-resistant gene R factor in the cytoplasm, thereby carrying the code for -lactamase production. This enzyme can cleave the -lactam ring of penicillin and make it lose its antibacterial effect.

CMRNG strains: Many genetic sites in the chromosomes of N. gonorrhoeae can be genetically mutated, which changes the site of drug action and leads to the development of drug resistance.

TRNG strains: The specific details of the reasons for their resistance are unknown. Fluoroquinolone-resistant strains: Gene mutations involving several genetic loci in the chromosomes of Neisseria gonorrhoeae. The combined mutations at different loci determine the degree and pattern of drug resistance. Three types of drug resistance mechanisms have been reported:

Gonorrhea western medicine treatment method

Treatment principle

Gonorrhea should be treated according to the following principles.

(1) Early diagnosis and timely treatment: First, the diagnosis should be established as soon as possible after the illness, and no random treatment should be made before the diagnosis is confirmed. Secondly, after diagnosis, treatment should be carried out immediately without hesitation, and never miss a chance.

(2) Defining the clinical type: determine whether it is a simple type, a comorbid type, or a disseminated type. Clinical typing is extremely important to properly guide treatment.

(3) To determine whether there is drug resistance: To determine whether it is resistant to penicillin, tetracycline, etc., which will also help guide the treatment correctly.

(4) Determine whether there is a chlamydia or mycoplasma infection: if chlamydia or mycoplasma infection is combined, a combined chemotherapy regimen should be developed for treatment.

(5) Correct, sufficient, regular, and comprehensive treatment: The drug most sensitive to N. gonorrhoeae should be selected for treatment, and as far as possible, a drug sensitivity test, an allergy test or a beta-lactamase assay. The dose should be sufficient, the treatment course should be regular, and the medication method should be correct. Various effective methods should be selected for comprehensive treatment.

(6) Strict assessment of efficacy and follow-up observation: The cure standard should be strictly controlled, and the efficacy assessment should be adhered to. Only when the cure standard is reached can it be judged to be cured to prevent recurrence. Healers should insist on regular review and observe for a sufficient period of time. (7) Simultaneous examination and treatment of their sexual partners: The patient's husband and wife or both partners should be examined and treated at the same time.

2. General Therapy

(1) Sexual segregation: sexual life is prohibited.

(2) Rest: STD patients with high fever and severe comorbidities should rest appropriately, and should rest in bed if necessary.

(3) To maintain the balance of water, electrolytes, and sugar-water compounds, supplement a high-sugar, high-protein diet.

(4) Wash or irrigate the genitals with Jieyin lotion to disinfect and inhibit bacteria.

3. Systemic therapy

There are many drugs for the treatment of gonorrhea, but they should be selected based on the principles of high efficiency, safety and reasonable price.

Penicillins: It can kill bacteria by destroying the synthesis of bacteria wall. This class of drugs is suitable for the treatment of gonorrhea caused by non-penicillin-resistant gonococci (PPNG) and is the "standard treatment" for this disease. However, it is not appropriate to use a drug sensitivity test as a conventional therapy before treatment. When the prevalence of PPNG strains is greater than 5%, penicillin treatment should not be used, and other preparations should be used. The purpose of adding probenecid is to slow the excretion of penicillin from the kidney, reduce its binding to plasma proteins, increase blood levels, and extend the half-life to fully exert its antibacterial effect.

-lactamase inhibitors: The reason why PPNG strains are resistant to penicillin and some cephalosporins is mainly caused by the production of -lactamase. Clavulanic acid and penicillane sulfone are compounds with very weak antibacterial activity. When combined with -lactam ring-containing antibiotics, they can protect the antibiotics from damage by inhibiting -lactamase, which can inhibit the growth of PPNG strains. Non-PPNG strains do not play a significant role. The pharmacokinetic characteristics of clavulanic acid and penicillin are similar to those of amoxicillin (ampicillin) and ampicillin (ampicillin), respectively, and they are suitable for combined use with the latter.

Aminoglycosides and aminocyclic sugar alcohols: the main role is to inhibit the synthesis of bacterial protein. Used to treat patients who are resistant or allergic to penicillin. Gentamicin (gentamycin), kanamycin (kanamycin), amikacin (amikacin) and netilmicin (ethylxisomycin) are commonly used in the former category; the latter The class of drugs is mainly spectinomycin (Linzhizhi), which has a cure rate of more than 98% for simple gonorrhea caused by PPNG strains and non-PPNG strains, and also has excellent curative effect on comorbid gonorrhea; It does not produce cross-resistance with penicillin and cephalosporins, is safe to use, and is one of the best drugs for treating gonorrhea. At present, spectinomycin-resistant Neisseria gonorrhoeae strains have appeared. Its replacement product, trospectomycin, has a broader antibacterial spectrum, including Gram-positive bacteria, negative bacteria, anaerobic bacteria, and chlamydia, and it has a higher concentration in the tissue and a longer half-life. Chlamydia urethritis has a better effect.

Cephalosporins: It has the effect of destroying the bacteria wall and inhibiting the protein synthesis of the bacteria. Although they also belong to -lactam ring antibiotics, they are relatively stable or very stable to -lactamase. Therefore, they can often effectively replace penicillin against gonorrhea caused by PPNG strains and chromosome-resistant drug-resistant strains. class. The emergence of spectinomycin-resistant strains has made them viable substitutes. Commonly used cephalosporins are cefazolin, cefoxitin, cefoxitin, cefotaxime, cefoperazone (pioneer must), ceftizoxime (benefit) Shiling), Ceftazidime (Fudaxin) and Ceftriaxone (Ceftriazine). Among them, ceftriaxone (ceftizine) and ceftazidime are more effective. Lavocef (oxaconazole) has a high concentration in the cerebrospinal fluid and is very suitable for the treatment of gonococcal meningitis.

Fluoroquinolones: inhibit DNA and protein synthesis of bacteria by inhibiting DNA gyrase. The commonly used preparations for the treatment of gonorrhea include norfloxacin (haloperic acid), enoxacin (floxacin), ofloxacin (floxacin) and ciprofloxacin (ciprofloxacin). In in vitro tests, they have good antibacterial effects on both PPNG strains and non-PPNG strains. It has been reported that the cure rate for simple gonorrhea is 97% for norfloxacin (haloperic acid), enoxacin (floxacin), ofloxacin (floxacin) and ciprofloxacin (ciprofloxacin). Haloperic acid) has a good effect in treating gonorrhea, and has a certain effect on chlamydia infection. In recent years, the use of Jieyin lotion to clean or irrigate the genitals, disinfection, bacteriostasis combined with oral medication has been effective.

Tetracyclines: play a role by inhibiting the biosynthesis of bacterial proteins. It also has a good effect on gonorrhea, but not as a first-line medication. Commonly used are tetracycline, doxycycline (doxycycline), and minocycline (milomycin).

Macrolides: Inhibit the biosynthesis of bacterial proteins. Not as a first-line medication, mainly used as a substitute for tetracyclines. Recently, a single dose of 1.0 g of azithromycin has a cure rate of 96.4% for gonorrhea without comorbidity and a cure rate of 100% for concurrent chlamydia infection.

Chloramphenicols: inhibit the biosynthesis of bacterial proteins. A single dose of 2.5 g of methamphenicol (Will) is used, and the cure rate for comorbid gonorrhea is 93%.

Lincomycin: high tissue concentration in the body, low toxicity, safe, good effect on anaerobic bacteria. Clindamycin (clagecin) is commonly used to treat pelvic inflammatory disease.

Rifamycin: It has a strong effect on both Gram-negative and positive bacteria, and it is effective against leprosy, virus, and chlamydia infection. Commonly used drugs are rifampin and rifamdin.

Sulfa: It has a strong inhibitory effect on Gram negative and positive bacteria. Commonly used drugs are sulfamethoxazole (sinomethoxin), sulfamethoxazole / trimethoprim (compound sinomethoxin) and probenecid.

4. Topical Therapy

Topical therapy is only used as an adjunct to antibacterial therapy, and plays a role in cleaning and removing secretions.

(1) Urogenital gonorrhea:

You can use Jieyin lotion to clean the part, and disinfect and inhibit bacteria.

30g of Sophora flavescens, 30g of wild chrysanthemum, 20g of silver flower, 20g of cork, 20g of snake bed, 15g of alum, 15g of Platycladus orientalis, wash the affected area with decoction.

(2) Gonorrhea ophthalmia:

The patient's eyes should be flushed with isotonic saline or ophthalmic buffer to remove secretions every 2 hours. After rinsing, use 0.5% erythromycin eye drops or 1% silver nitrate eye drops.

(3) Gonorrhea pharyngitis: Ecu mouthwash or lysozyme tablets can be used.

5. Surgery

(1) Gonococcal pelvic inflammatory disease: Fallopian tube ovarian abscess occurs in patients with gonococcal pelvic inflammatory disease. After 48 to 72 hours of ineffective or ruptured active treatment, the diseased tissue should be surgically removed, the abdominal cavity should be cleaned, drainage should be placed, and fertility should be preserved as far as possible.

(2) Chronic gonorrhea: Those with chronic gonorrhea who have developed urethral strictures can use urethral dilatation or urethral resection.

6. Cure standard and observation after treatment

(1) Cure criteria: In the absence of sexual contact within 3 weeks after the end of treatment, a cure can be judged if the following criteria are met.

All clinical symptoms and signs disappeared.

The urine is clear and transparent.

Men should take a prostate massage 2 weeks after the clinical symptoms disappear, and take a full urine and segmented urine sediment. Women should take materials from the cervical or urethral opening 1 week after the clinical symptoms disappear, and use them as prostate massage fluid and urine sediment. Or smear and culture of secretions, once every 5 to 7 days, two consecutive N. gonorrhoeae cultures were negative.

It is worth noting that PCR is to determine the presence of N. gonorrhoeae by detecting the presence of the CppB gene on the concealed plasmid of N. gonorrhoeae. In some patients, the urethra still has a killed CppB gene that is harmless, The non-fertile bacteria and its fragments, although no N. gonorrhoeae were detected in the smear and culture, PCR can amplify the CppB gene and still obtain positive results. Therefore, PCR test results cannot be used as an indicator of gonorrhea cure.

(2) Observation after treatment:

For cases treated with penicillin, if gonorrhoea persists 3 to 7 days after the end of treatment, the possibility of infection with PPNG strains should be considered. Drugs that target resistant strains should be selected for treatment.

After the above treatment, those who still have gonorrhea may be resistant to spectinomycin or ceftriaxone (ceftizine). Drug sensitivity tests should be performed, and sensitive drugs should be used instead.

After treatment, gonorrhea relapses, it is re-infection or repeated infection, not necessarily treatment failure. Patients should be educated and their sexual partners checked, diagnosed, and treated if necessary. Use of drugs such as

Treatment of sexual partners: Those who have had sexual contact with gonorrhea patients within 1 month should be given preventive treatment. If there is evidence of gonorrhea, they should be treated according to the treatment plan for gonorrhea.

Gonorrhea TCM Treatment

Chinese medicine and traditional Chinese medicine can be used as auxiliary measures for the treatment of gonorrhea, and must not be taken as the main treatment method. It can be used in combination with Jieyin lotion to clean or lavage the genitals to disinfect and inhibit bacteria. Ignoring antibacterial treatment, otherwise the disease will only be delayed and the disease will be unresolved.

Internal law

(1) Damp heat poisoning (acute gonorrhea) urethral redness, swelling, urgency, frequent urination, dysuria, leaching, turbid urine such as fat, urethral discharge, severe urethral mucosal edema, nearby lymph nodes swelling and pain, female cervix Congestion, tenderness, and purulent discharge, may have vestibular glandular swelling and hot pain, etc .; may have systemic symptoms such as fever; red tongue, yellow greasy fur, slippery pulses. Dialectical analysis: Exogenous heat and poison, hot and dirty turbid evil, invades the horse's mouth, is swollen on the skin, so see urethral mouth swelling; damp and hot toxin is placed on the bladder, bladder gasification is not good, so urgency, frequent urination, dysuria, leaching Leak more than, or see urine turbidity like fat; wet poisonous, edema of the urethra, edema and swelling of nearby lymph nodes, vestibular glands; hot meat rot, pus urethral discharge, cervical purulent discharge; wet poison If the blood is clogged, the cervix is congested and tender. The red tongue, yellow greasy fur, and slippery pulses are the signs of damp heat. Governing Law: clearing away heat and dampness, detoxifying and turbidity. Recipe: Longdan Xiegan Decoction, add Poria cocos, Hongteng, Cao Mo and so on. Those who are hot and poisonous, Heqingying Tongtang.

(2) Yin deficiency and poisonous love (chronic gonorrhea) Poor urination, shortness and astringency, endless leaching; backaches are soft, five are upset and hot, prone to drinking or fatigue, less appetite and poor appetite, women carry more; red tongue , Less moss, pulse count. Dialectical analysis: prolonged illness, or excessive room labor, so that Zhengxu can't fall in love, bet on the bladder, so I see urinary dysfunction, shortness, and endless leaching; female damp and hot evil poisons and cell palace, so see leucorrhea Increased kidney yin deficiency and deficient heat endogenous, but with backaches and soft legs, five upsets and fever; Alcoholic dampness and heat endogenous, fatigue more hurts righteousness, so the disease relapses; spleen deficiency, so see less appetite; red tongue, There are few moss and the pulse counts are like yin deficiency and poisonous love. Governing law: nourishing yin and lowering fire, dampening turbidity. Recipe: Zhibai Dihuang Pills, including Poria cocos, Poria, and so on.

Foreign law

Wash or irrigate the genitals with Jieyin lotion, disinfect and bacteriostatic.

Or you can choose 30g each of Poria cocos, ground skin seeds, Sophora flavescens, and Glauber's salt, and wash them with decoction. 3 times a day.

Government researchers in Atlanta report that gonorrhea is becoming increasingly difficult to treat and that it is resistant to two antibiotics. The Centers for Disease Control reports that in Hawaii, resistance to fluoroquinolone, a conventional treatment for STI strains, has increased from 1.4% in 1997 to 9.5% last year. In Mo, Kansas, gonorrhea was found to be resistant to a new antibiotic, azithromycin, in 12 patients. The government has suggested three other antibiotics for gonorrhea, all of which are expensive. A CDC epidemiologist, Susan Wang, said that the introduction of drug-resistant strains of gonorrhea from Asia would inevitably lead to similar resistance in the United States. In the 1980s, gonorrhea developed similar resistance to penicillin and tetracycline, rendering these antibiotics useless.

Gonorrhea folk remedies

The use of Chinese herbal medicine to treat gonorrhea should be treated according to the different stages and symptoms of the patient. The patient was infected with unclean sexual intercourse, infected with hot and hot evil poison, and contained in the lower coke, leading to the acute phase symptoms of large leucorrhea and redness and swelling of the vulva. But the poisoning is not gone, it is true and evil; it may also be because the patient is excessive indulgence and hurt the kidney essence. Oral treatment of gonorrhea with traditional Chinese medicine not only has good antibacterial and anti-inflammatory use, but also can help righteousness and enhance the body's immunity. In addition, external treatment of traditional Chinese medicine is also an important part of traditional Chinese medicine treatment of gonorrhea, clearing heat and detoxifying, removing dampness and itching, and alleviating local symptoms.

Waizhifang:

Prescription ("Unique Secret Recipes for Dermatological and Venereological Diseases"): raw army powder, 10 grams of Houttuynia cordata, 60 grams of cork, 12 grams of alum, 5 grams of ume, and 3 decoctions, washed twice daily for 30 minutes. For the treatment of acute gonorrhea.

Prescription ("Practical Manual for Men and Women's Disease and Sexually Transmitted Diseases"): 1000 grams of mischievous herb has the effect of clearing away heat and detoxification. Add 2000 ml of water to the medicine, fry for 30 minutes, remove the residue and let it cool. 1 dose daily. Prescription ("Clinical Manual of Practical Men and Women's Disease and Sexually Transmitted Diseases"): 20 grams of silver flower and 20 grams of dandelion. Wash the genitals with decoction several times a day.

Gonorrhea diet method

After suffering from gonorrhea, the diet should be light, drink plenty of water, avoid spicy products, and not drink alcohol. Some patients often get sick or relapse because of drinking. Here are some dietary prescriptions for reference.

1. Talc porridge Source: "New Book for Seniors and Senior Citizens" Raw materials: 30g of talc, 10g of qumai, 30-60g of japonica rice. Production: First wrap talc with cloth, then cook in water with Qumai, take juice, remove residue, add rice to cook gruel. Usage: Take on an empty stomach. Indications: Indications for gonorrhea are damp heat syndrome.

2. Mallow soup Source: "Medicinal theory" Ingredients: 200g mallow leaves. Usage: Cooking soup. Indications: Gonorrhea is a damp-heat syndrome.

3 Source of Shiwei Decoction: "Guizhou Herbal Medicine" Ingredients: 15g of Shiwei, 15g of Liaoning grass, 15g of bristle grass. Usage: Decoction for juice, frequent drinking on behalf of tea. Indication: all types of gonorrhea.

4 Sunflower root drink: "Sheng Huifang" Ingredients: 30g mallow root, 15g psyllium. Usage: Decoction for juice, substitute tea. Indication: all types of gonorrhea.