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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 invasion of the six excesses, 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 of about 3-6cm, having a hard root resembling a nail, and causing severe swelling and pain. The condition progresses rapidly, and the toxic evil 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 foot-bottom carbuncles.
Abscesses: These are acute suppurative diseases that commonly occur between the 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 have accompanying systemic symptoms such as chills and fever, but 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, with an emphasis on unblocking and reducing, and for those that have suppurated, thorough drainage is necessary. For those with purulent blood syndrome, timely integrated treatment with Western medicine is required.
Head abscesses: These have a millet-like pus head, larger than abscesses, with a diameter exceeding 10cm and can reach up to 30cm, easily spreading to deeper tissues and surrounding areas, with multiple pus plugs. After ulceration, they resemble a honeycomb, with local skin presenting as red, swollen, hot, and painful, and are prone to inward sinking. They are more common in middle-aged and elderly individuals and diabetic patients. Common syndromes include qi stagnation with heat obstruction, excessive heat toxin, yin deficiency with fiery excess, and damp-heat obstruction. Treatment focuses on clearing heat, draining fire, transforming dampness, nourishing yin, generating fluids, and harmonizing the blood to expel toxins.
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Seven 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 flow, 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), Kudiqing (Gentiana), Dahuang (Rhubarb), Chaihu (Bupleurum), Danggui (Angelica sinensis), Chishaoyao (Red Peony), Kushen (Sophora flavescens), 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, lymphatic flow, abscesses, and breast abscesses. 【Formula】Ruxiang (Frankincense, processed), Moyi (Myrrh, processed), artificial Niuhuang (Bovine bile), Shexiang (Musk), and Xionghuang (Realgar).
Ruyi Jinhuang 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), Shengtianshan (Fresh Arisaema), 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 of meridians, warm heat rashes, athlete’s foot, skin itching, freckles, facial redness, wind rash, fever, dizziness, and constipation. 【Formula】Qincao (Rubia), Taoren (Peach kernel), Chishaoyao (Red Peony), Danggui (Angelica sinensis), Dihuang (Rehmannia), Lianqiao (Forsythia), Jinyinhua (Honeysuckle), Kudiqing (Gentiana), Tufuling (Smilax), Huangbai (Phellodendron), Yimucao (Motherwort), Fangfeng (Siler), Chishaoyao (Red Peony), Shudihuang (Rehmannia, cooked), Zicao (Lithospermum), Chuanxiong (Ligusticum, wine-fried), Gancao (Licorice), Baizhi (Angelica dahurica), Zijingpi (Cercis), Jixueteng (Spatholobus), and Honghua (Carthamus).
Dasima Bao Wan, 【Function】Clears heat and detoxifies, reduces inflammation and pestilence; 【Indications】Meningitis, influenza, sores and ulcers, pneumonia, pharyngitis, and various epidemic diseases. 【Formula】Tieban (Iron hammer), Zicao (Lithospermum), Hezi (Terminalia), Muxiang (Aucklandia), Tuercao (Rabbit ear grass), Tanggu Te Wutou (Aconitum), Zhixia Muzi (Stop diarrhea wood), Zangqincao (Zang Rubia), Jidou (Jujube), and Anxixiang (Benzoin).
Zicao Gao, 【Function】Transforms necrosis and promotes tissue regeneration; 【Indications】Sores and ulcers, and abscesses that have already suppurated. 【Formula】Zicao (Lithospermum), Danggui (Angelica sinensis), Dihuang (Rehmannia), Ruxiang (Frankincense), Baizhi (Angelica dahurica), and Fangfeng (Siler).
Baduxingji San, 【Function】Expels toxins and promotes tissue regeneration; 【Indications】Sores and ulcers with yang syndrome that have suppurated, with pus and necrosis not yet cleared, and chronic non-healing wounds. 【Formula】Bingpian (Borneol), Luganshi (Calamine, calcined), Longgu (Dragon bone, calcined), Hongfen (Red powder), Huangdan (Yellow lead), Qingfen (Light powder), Chongbaili (Insect white wax), and Shigao (Gypsum, calcined).
【Clinical Experience with Medications】:
1. Tang Tian conducted clinical research on the use of Baduxingji San for treating non-lactating breast abscesses with pus and necrosis, concluding that the external application of Baduxingji San can effectively reduce lumps, promote pus discharge, and relieve pain; its application over 4 weeks is within the safe medication range and has clinical promotion value.
2. Fu Liyuan and others observed the clinical efficacy of Baduxingji San for postoperative dressing changes in anal and rectal diseases, concluding that Baduxingji 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 Baduxingji San for treating diabetic foot ulcers, concluding that the application of Baduxingji San 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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