Arteriosclerosis obliterans of limbs

Arteriosclerosis obliterans of limbs is a chronic obstructive disease caused by atheroscleorsis of limbs. The disease mostly happens to male patients in their 50-70s. It often involves the large or medium arteries of the lower limbs, such as iliac, femoral and posterior tibial arteries, etc. Those who suffer form diabetes are prone to be affected by this kind of disease, in which case the patient's condition may be serious and often complicated with ulcer and gangrene. This disease also falls into the category of "tuo ju" (gangrene of finger or toe) in TCM.

Main Points of Diagnosis
1. The patients with this kind of disease are mostly over 45 years old and often suffer form hypertension.
2. The affected limb has coldness, numbness, formication twinge and intermittent claudication.
3. The arteriopalmus of the femoral artery, poplitealartery, posterior tibial artery, and dorsal artery of foot disappears.
4.Gangrene in the affected limb develops very quickly and it often spreads over to the shank and the thigh , In serious cases, it is associated with high and other general symptoms.
5. The cholesterol, triglyceride and ß-lipoprotein in blood often increase. Those who suffer from diabetes are found to have an increase in blood sugar and positive glucose in urine.
6. X-ray examination reveals some irregular calcified spots in the sclerosed artery. An ultrasonography of blood vessel shows that the arteriopalmus of the affected limb is weakened or has disappeared. Arteriography shows that there is an obstruction or stricture in the arterial lumen.
Differentiation and Treatment of Common Syndromes
1. Internal Treatment
1) Blood Stasis Type
Main Symptoms and signs: It is characterized by pale skin, coldness, numbness, pain and intermittent claudication of the affected limb, ecchymoses on the tongue with white greasy, taut and uneven pulse.
Therapeutic Principle: Promoting blood circulation to remove the stasis.
Recipe : Red Sage Decoction for Promoting Blood Circulation
red sage root
red peony root
Chinese angelica root
spatholobus stem
loranthus mulberry mistletoe
achyranthes root
chuanxiong rhizome
milkvetch root
curcuma root
All the above herbs are to be decocted in water for oral administration.
2)Heat-Toxin Type
Main Symptoms and signs: There is a severe pain in the affected limb and the limb has an infection or gangrene, with a great amount of pus on ulceration, which may be accompanied by pyrexia, red or crimson tongue with yellow greasy or yellow dry fur, taut, thready and rapid pulse.
Therapeutic Principle: Clearing away pathogenic heat and toxin, promoting blood circulation to remove blood stasis.
Recipe: Decoction of Four Wonderful Ingredients for Promoting Blood Circulation
honeysuckle flower
dandelion herb
Chinese violet
figwort root
Chinese angelica root
milkvetch root
dried rehmannia root
red sage root
achyranthes root
forsythia fruit
globethistle
fangji root
scutellaria root
goldthread root
basket fern
safflower
frankincense
myrrha
All the above herbs are to be decocted in water for oral administration.
For those who feel cold and numb in the limbs, add 30 grams of milkvetch root 15 grams of pilose asiabell root 9 grams of prepared aconite root and 9 grams of cinnamon twig. For those who have cinnamon twig. For those who have hypertension, add 30 grams of loranthus mulberry mistletoe and 9 grams of prunella spike, 12 grams each of hooked uncaria and eucommia bark. For those who have diabetes, add 30 grams of milkvetch root, 15 grams of Chinese yam rhizome 15 grams of China smilax root and snakegourd root each. For those with severe pain, add 9 grams each of frankincense, myrrha and corydalis tuber.
2. External Treatment
Fumigation and Washing Therapy: For those whose sickness is at the early stage with no ulcerate on the affected limb, use the warm decoction of Powder for Promoting Blood Circulation and Reducing Pain (for this prescription, please see the part of Thrombotic Phlebitis) for fumigating and washing the affected limb, 1-2 times a day.
By
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China