Sores and ulcers are commonly seen in localized areas due to various diseases such as furuncles, carbuncles, abscesses, ulcers, and pressure sores, presenting symptoms of redness, swelling, heat, and pain, and may even become purulent and ulcerated. Patients may suffer from external pathogenic factors, special epidemic toxins, or irregular diet. Below, we will discuss the common causes of sores and ulcers, TCM diagnostic patterns and treatments, as well as examples of commonly used Chinese patent medicines.
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Common Causes and Diagnostic Treatments
Furuncles: These are acute suppurative diseases that commonly occur in superficial skin areas, usually small (less than 3cm), with only one pus plug. Generally, there are no systemic symptoms or only mild ones. They are prone to suppuration, ulceration, and healing, presenting as red, burning, and painful, possibly accompanied by fever, dry mouth, constipation, yellow tongue coating, and rapid pulse. Common syndromes include heat toxin accumulation, damp toxin stagnation, and yin deficiency with internal heat. Treatment focuses on clearing heat and detoxifying, while also supporting the body’s righteousness.
Carbuncles: These often occur on the face and extremities, with a small swelling range of about 3-6cm, having a hard root resembling a nail, and causing severe swelling and pain. The condition develops rapidly, and the toxic pathogen can easily spread, with severe cases presenting with chills and fever. Carbuncles on the extremities include snake-eye carbuncles, snake-head carbuncles, snake-belly carbuncles, and sole carbuncles.
Abscesses: These are acute suppurative diseases that commonly occur between skin and flesh, often on the back and neck. They present as firm, dark red swellings, ranging from 6 to 9cm, with a rapid onset, easy swelling, suppuration, and ulceration, often accompanied by severe pain or tenderness. Generally, they take 1-2 weeks to suppurate, and most patients experience chills and fever as systemic symptoms. They typically do not damage tendons or bones or cause sinking syndrome. Common syndromes include fire toxin coagulation, heat overwhelming flesh corruption, and qi and blood deficiency. Treatment focuses on clearing heat and detoxifying, promoting drainage, and ensuring thorough pus expulsion, with integrated TCM and Western medicine treatment for those with pus and blood symptoms.
Head abscesses: These have a millet-like pus head, larger than abscesses, with diameters exceeding 10cm and can reach up to 30cm, easily spreading to deeper tissues and surrounding areas, with multiple pus plugs. Upon ulceration, they resemble a honeycomb, with local skin presenting as red, swollen, hot, and painful, prone to inward sinking, commonly seen in middle-aged and diabetic patients. Common syndromes include qi stagnation with heat obstruction, excessive heat toxin, yin deficiency with fiery heat, and damp-heat obstruction. Treatment focuses on clearing heat, draining fire, transforming dampness, nourishing yin, and harmonizing the blood to expel toxins.
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7 Commonly Used Chinese Patent Medicines for Sores and Ulcers:
Lianqiao Baidu Wan – 【Function】Clears heat and detoxifies, reduces swelling and alleviates pain; 【Indications】Furuncles and ulcers, erysipelas, purulent discharge, burning fever, scabies, and itching. 【Formula】Lianqiao (Forsythia), Jinyinhua (Honeysuckle), Huanglian (Coptis), Huangbai (Phellodendron), Tianhuafen (Trichosanthes), Huangqin (Scutellaria), Fangfeng (Siler), Baizhi (Angelica dahurica), Qianghuo (Notopterygium), Kudi (Bitter herb), Dahuang (Rhubarb), Chaihu (Bupleurum), Danggui (Angelica sinensis), Chishaoyao (Red peony), Kushen (Sophora), Jingjiesui (Schizonepeta), Mahuang (Ephedra), Bohe (Mint), and Gancao (Licorice).
Niuhuang Xingxiao Wan – 【Function】Clears heat and detoxifies, reduces swelling and alleviates pain; 【Indications】Unidentified swelling and toxins, scrofula, abscesses, and mastitis. 【Formula】Ruxiang (Frankincense, processed), Moyi (Myrrh, processed), artificial Niuhuang (Bovine bile), Shexiang (Musk), and Xionghuang (Realgar).
Ruyi Jinhua San – 【Function】Clears heat and detoxifies, reduces swelling and alleviates pain; 【Indications】Symptoms of skin redness, swelling, heat, and pain due to heat toxin stagnation causing furuncles and swelling, also applicable for trauma. 【Formula】Jianghuang (Turmeric), Dahuang (Rhubarb), Huangbai (Phellodendron), Cangzhu (Atractylodes), Houpo (Magnolia bark), Chenpi (Dried tangerine peel), Gancao (Licorice), Shengtian Nansheng (Fresh Pinellia), Baizhi (Angelica dahurica), and Tianhuafen (Trichosanthes).
Pifubing Xuedu Wan – 【Function】Clears blood and detoxifies, reduces swelling and alleviates itching; 【Indications】Sores and swelling caused by disharmony in the meridians, warm heat rashes, skin itching, freckles, acne, facial redness, wind rash, and dizziness with dry stools. 【Formula】Qincao (Rubia), Taoren (Peach kernel), Chishaoyao (Red peony), Danggui (Angelica sinensis), Dihuang (Rehmannia), Lianqiao (Forsythia), Jinyinhua (Honeysuckle), Kudi (Bitter herb), Tufuling (Smilax), Huangbai (Phellodendron), Yimucao (Motherwort), Fangfeng (Siler), Chishaoyao (Red peony), Shudihuang (Cooked rehmannia), Zicao (Lithospermum), Chuanxiong (Ligusticum, wine-fried), Gancao (Licorice), Baizhi (Angelica dahurica), Zijingpi (Cercis), Jixueteng (Spatholobus), and Honghua (Carthamus).
Dasi Ma Bao Wan – 【Function】Clears heat and detoxifies, reduces inflammation and kills pathogens; 【Indications】Meningitis, influenza, sores and ulcers, pneumonia, pharyngitis, and various epidemic diseases. 【Formula】Tieban (Iron hammer), Zicao (Lithospermum), Hezi (Myrobalan), Muxiang (Aucklandia), Tuercao (Rabbit ear grass), Tanggu Te Wutou (Aconitum), Zhixia Muzi (Stop diarrhea wood), Zangqincao (Tibetan Rubia), Jidou (Jujube), and Anxixiang (Benzoin).
Zicao Gao – 【Function】Transforms necrosis and promotes tissue regeneration; 【Indications】Sores and ulcers, and abscesses that have already ulcerated. 【Formula】Zicao (Lithospermum), Danggui (Angelica sinensis), Dihuang (Rehmannia), Ruxiang (Frankincense), Baizhi (Angelica dahurica), Fangfeng (Siler), and Moyi (Myrrh).
Baodu Shengji San – 【Function】Draws out toxins and promotes tissue regeneration; 【Indications】Sores and ulcers with yang syndrome that have ulcerated, with pus and necrosis not cleared, and delayed tissue regeneration. 【Formula】Bingpian (Borneol), Lugan (Calamine, calcined), Longgu (Dragon bone, calcined), Hongfen (Red powder), Huangdan (Yellow lead), Qingfen (Light powder), Chongbaili (White wax), and Shigao (Gypsum, calcined).
【Clinical Experience with Medications】:
1. Tang Tian conducted clinical research on Baodu Shengji San for treating non-lactating breast abscesses, concluding that the external treatment with Baodu Shengji San can effectively reduce lumps, promote pus discharge, and alleviate pain; its application over 4 weeks falls within the safe medication range and has clinical promotion value.
2. Fu Liyuan and others observed the clinical efficacy of Baodu Shengji San for postoperative dressing changes in anal and rectal diseases, concluding that Baodu Shengji San is effective and safe for dressing changes in difficult-to-heal and infected wounds after anal and rectal surgeries, warranting further research.
3. Guo Xingrui and others observed the clinical efficacy of Baodu Shengji San for treating diabetic foot ulcers, concluding that the application of Baodu Shengji San in diabetic foot ulcers can alleviate patient suffering, shorten treatment cycles, act quickly, show significant efficacy, have few adverse reactions, and be convenient for direct observation and timely monitoring; it has clear advantages in treating diabetic foot ulcers.
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