Professor Zhang’s Design Of External Treatment Of Venous Ulcer Of Lower Limbs And Summary Of Academic Experience

Objective:1.Through the study of ancient literature and modern literature,summarize the treatment concepts and methods of ancient and modern Chinese medicine for venous ulcers of lower limbs,explore the diagnosis and treatment rules and limitations of the two,and provide theoretical support for Professor Zhang Zhang’s concept of treating venous ulcers of lower limbs based on the view of external treatment design.2.Through a retrospective study on the case data of patients with venous ulcers of lower extremities diagnosed and treated by Professor Zhang,the academic views and clinical experience of Professor Zhang’s external treatment design concept were sorted out and summarized.Methods: 1.Ancient Literature Research: Set key words,using the fifth edition of the Chinese Medical Code as the retrieval platform,carry out keyword search for the names of traditional Chinese medicine diseases related to venous ulcer of lower extremities,screen the ancient books related to pathogenesis and treatment of venous ulcer of lower extremities and their provisions according to the narb standard,input the included provisions into Excel software and establish a database.The understanding and experience of ancient doctors on the pathogenesis and treatment of venous ulcer disease of lower extremity were summarized.2.Modern literature Research: Keywords were set.The three Chinese databases(CNKI,WANFANG and VIP)were used as search platforms.The literatures on clinical observation of TCM treatment of venous ulcers of lower limbs in the past 22 years were retrieved through professional search in the three databases,and the literatures were screened according to the Nadb criteria.Basic information,number of cases,treatment methods and other information of the included literature were extracted,and the included information was input into Excel software to establish a database and summarize the clinical status of modern Chinese medicine treatment of venous ulcers of lower limbs.3.Retrospective analysis of cases: To collect case data of patients with wound repair and peripheral vascular surgery outpatient clinic or hospital in the First Affiliated Hospital of Guangxi University of Chinese Medicine from September 1,2020 to December 31,2022,diagnosed as venous ulcers of lower limbs by Western medicine and ecthyma by traditional Chinese medicine and diagnosed by Professor Zhang,and to select cases according to the study criteria.The basic information,treatment methods,wound prognosis and other information of the included cases were extracted and summarized for statistical analysis of the data.On this basis,the academic views and clinical experience of Professor Zhang Li were sorted out and summarized to verify the rationality of the views of external treatment design.Results: 1.In ancient literature,statistical analysis of the frequency of literature shows that both ancient and modern treatments for venous ulcers of lower limbs are mainly external treatment,and the etiology and pathogenesis are mainly dampness,heat,poison,blood stasis and deficiency.In ancient books and articles,there is no mention that the occurrence of venous ulcers of lower extremities is closely related to venous hypertension of lower extremities.In ancient Chinese medicine,no relevant ancient books and articles mention surgery or pressure treatment to relieve venous hypertension of affected limbs.The treatment of venous ulcers of lower extremities is mainly based on external drug treatment,and most of the external drugs are mineral drugs to remove saprophylaxis and strengthen muscle.The application of external treatment forms and external treatment methods of traditional Chinese medicine is relatively chaotic,lack of standardization,and there are certain limitations in understanding.2.In modern literature studies,modern Chinese medicine has a further understanding of venous ulcer disease of lower extremity.A large number of studies have shown that venous hypertension of lower extremity is the key to the formation of ulcers.The importance of relieving venous hypertension as a key therapy is not well understood by modern doctors.In modern literature,the treatment of local ulcers is basically consistent with the ancient methods,but in terms of external drug application,safflower,peach kernel,astragalus membranaceus,salvia miltiorrhiza and other drugs for promoting blood circulation and removing blood stasis are used to promote ulcer healing,and the types of external treatment dosage forms and methods are more abundant than in ancient times.3.A total of 60 cases were included in this retrospective study,reflecting Professor Zhang’s idea of treating venous ulcers of lower limbs with external treatment design.In the clinical case review study,Professor Zhang took ancient and modern literature as the theoretical support,applied the perspective of external treatment design,and according to the patient’s wound condition,physical condition,own needs and hospital conditions,to grasp the treatment outcome and prognosis of the disease as a whole.He adopted "elastic bandage pressure dressing as the main method,surgical operation as the auxiliary method" and "combination of medicine and knife" to treat the wound jointly with traditional Chinese and Western medicine."With the least damage,in exchange for the most satisfactory curative effect",achieved good curative effect.Conclusion(s): 1.The understanding of venous ulcers of lower extremity in ancient Chinese medicine is very limited,mostly confined to local ulcers.Due to the backward development of science and technology,venous insufficiency of lower extremity is not really recognized as the cause of ulcers;The treatment is mainly external treatment,simple "remove saprophytic muscle".2.In modern times,the etiology of venous ulcers of lower extremities has been further understood,the etiology has been recognized through modern medical technology,and the removal of venous hypertension is the key to treatment.However,in clinical treatment,the proportion of removing venous hypertension with surgical operation or elastic bandage is still low,and no systematic and standardized treatment plan has been formed.3.Based on the diagnosis and treatment rules and limitations of ancient Chinese medicine and modern Chinese medicine,combined with many years of clinical teaching and diagnosis and treatment experience of traditional Chinese medicine surgery,based on the concept of disease design,based on the holistic view of traditional Chinese medicine and evidence-based medicine,Professor Zhang pointed out that the lesions are local,but they are local manifestations of the dysfunction of zang-fu organs,and the two are connected by the relevant meridians between the zang-fu organs.In addition,evidence-based medicine emphasizes the combination of traditional Chinese medicine and modern medical theories,integrates traditional Chinese medicine thinking with modern medical theories,emphasizes the design of disease diagnosis and treatment according to the etiology,pathophysiology,treatment,prognosis and nursing of surgical diseases,and puts forward the idea of designing external treatment to treat venous ulcers of lower limbs.On this basis,Professor Zhang’s views on the design of external treatment for venous ulcers of lower extremities are reflected in the relief of venous hypertension of lower extremities and the treatment of local ulcers,and the rational selection of treatment plans according to the patient’s wound condition,physical condition,patient’s appeal and hospital conditions.And in the diagnosis and treatment of venous ulcers of lower limbs achieved good effect,worthy of clinical promotion.