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Thrombotic phlebitis is an inflammatory reaction of the venous wall
caused by different factors. Sometimes, it is associated with venous thrombosis.
When the disease is present in the superficial group of veins, it is called
superficial phlebitis which commonly seen in the superficial veins of limbs and
the thoraco-epigastric walls. If the disease occurs in the deep veins, it is
known as deep phlebitis usually occurring in the veins of legs, pelvic cavity
and in the superior and inferior vena cava. This disease falls into the
categories of "e mai" (superficial phlebitis), (venous hyperemia) and
(rheumatism with the blood vessel involved) in TCM.
Superficial Phlebitis
Main Points of
Diagnosis
1. There is pain, swelling and obvious tenderness in the
superficial veins along the limbs or the thoracoepigastric walls.
Besides, some hard cord-like swollen masses may be felt.
2. It is accompanied by fever and discomfort all over.
3. after the acute stage, there are some cord-like masses which
will remain for a long time in the affected area with pigmentation in the local
skin.
Differentiation and
Treatment of Common Syndromes
1. Internal Treatment
1) Acute Stage
Main Symptoms and signs: In the affected areas, there is redness,
swelling, pain, tenderness and cord-like masses, Other symptoms and signs such
as yellow and greasy fur on the tongue, soft and rapid or taut and rapid pulse
may appear.
Therapeutic Principle: In the cases of superficial phlebitis of
limbs, its therapeutic principles are clearing away pathogenic heat and dampness
and promoting blood circulation to remove blood stasis. For cases of superficial
phlebitis of the chest and abdominal wall, the therapy aims at clearing away
pathogenic heat and toxin and promoting qi and blood circulation.
Recipe No.1: Decoction of Four Wonderful herbs for Quick
Restoration of Health with additional ingredients
honeysuckle flower
figwort root
Chinese angelica root
red peony root
achyranthes root
phellodendron bark
scutellaria root
capejasmine fruit
forsythia fruit
atractylodes rhizome
fangji root
arnebia root
licorice root
safflower
All the above herbs are to be decocted in water for oral
administration for those who have superficial thrombotic phlebitis of limbs.
Recipe No.2: Decoction of Oriental Wormwood and Red Bean
oriental wormwood
red bean
spatholobus stem
honeysuckle flower
honeysuckle stem
raw Job's tears seed
atractylodes rhizome
flavescent sophora root
fangji root
oriental water plantain rhizome
phellodendron bark
achyranthes root
red peony root
All the above herbs are to be decocted in water for oral
administration for cases of superficial thrombotic phlebitis of limbs.
Recipe No.3: Bupleurum Decoction for Removing Heat Bupleurum Root
honeysuckle flower
red sage root
red peony root
scutellaria root
capejasmine fruit
forsythia fruit
Chinese angelica root
ligusticum rhizome
safflower
curcuma root
nutgrass flatsedge rhizome
All the above herbs are to be decocted in water for oral
administration for the treatment of superficial phlebitis of thoraco-abdominal
wall.
2) Chronic Stage
Main Symptoms and Signs: The local skin of the affected area is
dark purple in color. There are some hard cord-like subcutaneous swollen masses
which are not painful when they are pressed. Other features are some ecchymoses
on the tongue, and soft and slow pulse.
Therapeutic Principle: Promoting blood circulation, removing the
stasis and clearing out the obstruction in the channels to resolve masses.
Recipe: Red Decoction for Promoting Blood Circulation
red sage root
red peony root
Chinese angelica root
spatholobus stem
loranthus mulberry mistletoe
achyranthes root
ligusticum rhizome
milkvetch root
curcuma root
All the above herbs are to be decocted in water for oral
administration.
2. External Treatment
1) At the early stage, of the illness, Paste of Isatis Leaf or
Golden Paste may be applied onto the affected parts.
2) At the chronic stage, Powder for Promoting Blood Circulation and
Reducing Pain may be decocted. Its hot decoction is used for fumigating and
washing the affected parts, twice a day.
The ingredients of the powder are as follows.
speranskia herb
corydalis tuber
Chinese angelica root-tip
turmeria rhizome
pepertree pricklyash peel
erythrina bark
clematis root
frankincense
myrrha
notopterygium root
dahurian angelica root
sppan wood
acanthopanax bark
safflower
smilax glabra rhizome
Deep Phlebitis
Main Points of
Diagnosis
1.There is a pain in the affected limbs and it is made more severe
by movements and walking and often accompanied with fever.
2. A swelling may occur in the affected limbs and a tenderness will
appear in the affected parts. When the dorsum pedis of the affected leg bends,
is will cause an ache in the muscles of the shank (i.e. positive Hoffmann's
sign). The temperature of the sick limbs may change, a little higher than normal
or the limbs may even be cold locally for a short time.
3. Thrombotic Phlebitis of the Shank: There is a pain and a
tenderness in the gastrocnemius muscle of the shank. A swelling may occur in the
dorsum pedis and the ankle. Hoffmanns' sign is positive.
4. Femoral Thrombophlebitis: There is pyrexia and tenderness at the
medial part of the thigh, popliteal fossa and shank. The shank and ankle may be
slightly hydropic.
5. Thrombotic Phlebitis of the Iliofemoral Vein: Its onset is
sudden and acute with fever (not exceeding 39¡æ.). There is a pain and an
obvious swelling in the affected leg. The skin of the affected parts appears
pale. In serious cases it is livid i color. There is an obvious tenderness in
the medial aspect of the thigh. The superficial veins in the proximal part of
the thigh and the lower abdominal wall often dilate.
Differentiation and
Treatment of Common Syndromes
1. Internal Treatment
1) Downward Flow of Damp-Heat
Main symptoms and Signs: At the early stage of the illness there is
pyrexia, pain, swelling and an obvious tenderness with thin yellow or yellow
greasy fur, taut rapid or slippery rapid pulse.
Therapeutic Principle: Clearing away pathogenic heat and dampness
and promoting blood circulation to remove blood stasis.
Recipe: Modified Diction of Four Wonderful Herbs for Quick
Restoration of Health or Decoction of Oriental Worm-wood and Red Bean (All the
above two recipes may be seen in the part of Superficial Phlebitis).
2) Severe Dampness and Blood Stasis
Main Symptoms and Signs: In the affected limbs there are such
symptoms as continuous swelling, distending pain, obvious tenderness, dark red
skin or ecchymoses, pigmentation, superficial venous engorgement, telangiectasis,
red tongue or with ecchymoses and white and greasy fur, soft-thready or
deep-moderate pulse.
Therapeutic Principle: Promoting blood circulation to remove
stasis, removing dampness and dredging channels.
Recipe: Red Sage Decoction for Promoting Blood Circulation
red sage root
red peony root
Chinese angelica root
honeysuckle flower
achyranthes root
globethistle root
oriental water plantain rhizome
Chinese flowering quince
chuanxiong rhizome
safflower
earthworm
fangji root
All the above herbs are decocted in water for oral use.
Main Symptoms and Signs: At the late stage of the illness, the
patient feels tired and fatigued. there is swelling, heavy sensation and
distending pain at the affected parts. The pain will be mild in the morning and
serious in the evening, Other features are ache at the waist, aversion to cold,
pale tongue with thin and white fur ,deep and slow pulse.
Therapeutic Principle: Warming the Kidneys and Strengthening the
Spleen
milkvetch root
pilose asiabell root
bighead atraclylodes rhizome
Chinese angelica root
Chinese yam rhizome
achyranthes root
spatholobus stem
red sage root
prepared aconite root
dried ginger rhizome
tangerine peel
Chinese flowering quince
Job's tears seed
tuckahoe
All the above herbs are decocted in water for oral use.
2. External Treatment
The herbs of Powder for Promoting blood Circulation and Reducing
Pain see the part of Superficial Phlebitis) are to be decocted in water for
fumigating and washing the affected parts of the limbs, 30-60 minutes each time,
1-2 times a day.
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