Thromboangiitis Obliterans, October 4, 1978

Thromboangiitis Obliterans, October 4, 1978

Key diagnostic points: ① males aged 20–45; ② weakened or absent arterial pulsation in the limbs; ③ accompanied by symptoms of limb ischemia, such as intermittent claudication; ④ rest pain, with muscle atrophy and ulcers at the extremities in the late stage; ⑤ some patients have a history of migratory phlebitis. Most patients have a history of exposure to cold and smoking. Below are specific classifications and treatments:

1. Deficiency-Cold Type

Equivalent to the ischemic phase, with cold limbs, intermittent claudication, rest pain, weakened local arterial pulsation, and low limb temperature. Warm the meridians and dispel cold with Yanghe Tang adjusted accordingly: 30 grams of Sheng Dihuang, 30 grams of Danggui, 30 grams of Gui Zhi, 3 grams of Lu Jiao Jiao, 3–5 grams of Fu Pian, 5–10 grams of Ni Xi, 5 grams of Rou Cong Rong, and 3–6 grams of Xi Xin.

2. Stagnation Type

Equivalent to the nutritional disorder phase, with purple-red or dark-red blood stasis at the extremities, rest pain, and muscle atrophy. Activate blood circulation, remove blood stasis, and unblock the collaterals. Use 12 grams of Danggui, 9 grams of Taoren, 9 grams of Honghua, 30 grams of Ni Xi, 9 grams of Di Long, 9 grams of Tu Bie Chong, 9 grams of Shuizhi, 15 grams of Chang Pu, and 15 grams of Chuanshan Jia.

3. Heat-Toxin Type

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Equivalent to the gangrenous stage, characterized by local redness and swelling, severe pain day and night, necrosis of the affected limb, dry and hard stools, short and reddish urine, and a yellow, dry or thick, greasy tongue coating. Clear heat and detoxify, activate blood circulation and relieve pain. Modified Si Miao Yong An Tang: Dang Gui 30g, Jinyinhua 30g, Xuan Shen 30g, Pu Gong Ying 30g, Chi Shao 30g, Niu Xi 30g, Yan Hu Suo 9g.

4. Qi and Blood Deficiency Type

Equivalent to the recovery stage, mainly manifested as emaciation, sallow complexion, palpitations and shortness of breath, aversion to cold with spontaneous sweating, muscle atrophy of the affected limb, dark-colored wound surface, and a deep, fine, and weak pulse. This type can be treated with Shiquan Dabu Tang or Renshen Yangrong Tang. (New Medicine, May 2, 1975)