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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