To investigate the efficacy of surgical simmering pus and long flesh moistening method combined with internal administration of traditional Chinese medicine in the treatment of chronic lower limb ulcers. METHODS: Surgical simmering pus and long flesh moistening therapy was applied to 132 patients with chronic lower extremity ulcers, and local topical application of Fu Huang Sheng Shu Healing Oil Ointment was the main treatment, combined with internal administration of traditional Chinese medicine to help remove blood stasis, and the changes of wound healing rate, wound healing time and local symptom points such as wound exudate amount, color and pain were observed after 3 weeks of treatment. Results: In 132 patients, 30 cases were cured, 33 cases showed efficacy, 58 cases were effective and 11 cases were ineffective, with an overall effective rate of 91.67%; the wound healing time of cured patients ranged from 6 to 21 d, with an average of (13.63±4.80) d. The scar was small and close to flesh color after wound healing; the average wound healing rate was (62.57±30.02)%; the amount of exudate increased, the color of the treated wounds There was a significant difference in the quantitative score of symptoms before and after treatment (P<0.01). Conclusion: The combination of surgical simmering pus and long flesh moistening method with internal administration of traditional Chinese medicine can significantly promote the healing of chronic lower limb ulcers and improve the quality of wound healing, with significant clinical efficacy. Chronic skin ulcers are common and frequent diseases in clinical practice, and a few patients have ulcers that do not heal for many years, and even if they do heal, they are prone to scar formation, or they may heal and ulcerate at times, and in advanced stages, they may even develop cancer [1]. From June 2009 to December 2009, 132 cases of chronic lower extremity ulcers were treated with simmering pus and long flesh moistening therapy combined with Chinese herbal medicine in the Department of Chinese Medicine and Surgery of Longhua Hospital, Shanghai University of Traditional Chinese Medicine. The results were satisfactory. The clinical observation results are reported as follows. 1, Data and methods 1.1 Diagnostic criteria The skin ulcer wounds of lower extremities caused by various reasons, which have not healed for more than 1 month after conventional treatment [2]. 1.2 Inclusion and exclusion criteria (1) Inclusion criteria: those who meet the diagnostic criteria of the disease; at the late stage of wound healing (granulation tissue proliferation and tissue reconstruction stage), the pus and putrefied tissue of the wound has been exhausted and new muscle is difficult or not generated; the area of the wound is ≥ 2 Mm2. (2) Exclusion criteria: those who do not meet the diagnostic criteria or inclusion criteria; those who have combined serious primary diseases such as cardiovascular, cerebrovascular, liver, kidney and hematopoietic system. Psychiatric patients; those with combined neurotrophic disorders; those with combined diabetes mellitus and unstable glycemic control; those with combined serious infection and critical condition; pregnant or lactating women; those with allergy or allergy to treatment drugs; arterial disease ulcers; cancerous ulcers or tuberculosis ulcers, decubitus ulcers; those with ulcers and seen bone exposure; those who were not treated as prescribed and could not judge the efficacy or had incomplete information. 1.3 General data 132 patients were all patients with chronic lower limb ulcers who were hospitalized in the Department of Traditional Chinese Medicine Surgery of Longhua Hospital, Shanghai University of Traditional Chinese Medicine from June 2009 to December 2009. Among them, 91 were male and 41 were female; the youngest was 18 years old and the oldest was 92 years old, with a mean age of (65.75±17.33) years; the shortest duration of disease was 1.5 months and the longest was 482 months, with a mean of (29.35±83.25) months; the smallest initial trauma area was 2 cm2 and the largest was 380 cm2, with a mean of (22.78±50.26) cm2. There were 56 varicose venous ulcers, 31 diabetic ulcers, 15 soft tissue infected ulcers, 25 traumatic or trauma combined with infected ulcers, and 5 ulcers of other causes. 1.4 Treatment method 1.4.1 Simmering pus and long flesh moistening method Disinfect the skin around the wound with 75% alcohol cotton ball, then gently swab the wound secretion with 1:5000 furacilin cotton ball; use raw muscle san as adulterant medicine, evenly and thinly spread on the sore surface, then use compound yellow raw muscle healing ointment gauze layer on it, and finally use red oil ointment gauze cover and paste, wrap and fix. Change the medicine once a day for 3 weeks for a course of treatment, and judge the efficacy after 1 course of treatment. (Gu Xiaoyan's modified formula): 15g of Furfurylite, 9g of Lactite, 30g of Talc, 9g of Hematite, 3g of Cinnabar, 0.3g of ice chips, finely ground. Fuxiang Huang Sangmao Healing Ointment: composed of rhubarb, egg yolk oil, blood exhaust, pearl powder, comfrey, etc., prepared into ointment preparation according to traditional technology. Red oil ointment (empirical formula): 300g of Vaseline, 30g of Jiuyidan and 45g of Dongdan, blended into ointment. All the above drugs were provided with finished products by the preparation room of Longhua Hospital]. 1.4.2 Chinese herbal medicine was used internally to support the positive and resolve the stasis, "tonify" and "pass", and supplemented by harmonizing the camp and promoting the toxicity of the muscle. Commonly used drugs such as Astragalus membranaceus, Radix et Rhizoma Atractylodes Macrocephala, Poria, Radix Angelicae Sinensis, Radix Paeoniae Alba, Rhizoma Chuanxiong, Salviae Miltiorrhizae, Peach kernel, Safflower, Radix et Rhizoma Cantonis, Radix Puerariae Sinensis, Red Date, Radix Bupleurum, etc. If the sore surface is pale or light red, increase the dosage of Atractylodes; if the sore surface is purple or blue, add leeches; if the skin is hard and knotted, add trigonella, curcuma, white mustard; if the swelling is obvious, add motherwort, zelenium, lutong; if the deficiency of qi is obvious, use astragalus 60-120g; if the deficiency of blood is obvious, add henbane, rehmannia, white peony; if the deficiency of yin is obvious, add raw groundnut, xuan shen, maitong; if the deficiency of yang is obvious For obvious yin deficiency, add Radix et Rhizoma, Radix et Rhizoma Ginseng and Radix et Rhizoma Polygonati. Decoction with water, 1 dose daily, divided into 2 doses with warm water. 1.4.3 Etiological treatment In addition to the above treatment, corresponding therapeutic measures are taken for the primary causes of chronic lower limb ulcers, such as active control of blood glucose for diabetic ulcers and treatment with elastic bandages for varicose ulcers. 1.5 Observation indexes 1.5.1 Evaluation indexes of wound healing Evaluation indexes of wound healing include wound healing rate and wound healing time. Trauma healing rate = (original trauma area - unhealed trauma area)/original trauma area × 100%. Trauma healing time is the time required for complete epithelialization of the trauma from the time the trauma is medicated. 1.5.2 Quantification of local symptoms The most common local symptoms of chronic lower limb ulcers were selected and recorded as 0, 1, 2, 3 and 4 points according to the absence, mild, moderate, severe and very severe symptoms, respectively. 1.5.2.1 The amount of exudate on the traumatic surface was classified as none, light (<4 layers), moderate (>4 layers and <8 layers), heavy (≥8 layers and <16 layers), and very heavy (≥16 layers) according to the degree of not soaking half (4 layers) of gauze, soaking half (4 layers) of gauze, soaking one (8 layers) of gauze, and soaking two (16 layers) of gauze or more. 1.5.2.2 The color of the traumatic surface is divided into none, light, medium, heavy, and very heavy according to the degree of healing, redness, dark redness, light/pale color, and purple/gray color of the traumatic surface. 1.5.2.3 Traumatic pain: no pain, mild discomfort, intermittent pain, continuous pain/interference with rest, continuous severe pain/remission after medication, classified as none, mild, moderate, severe, very severe. 1.6 Efficacy evaluation criteria Referring to the "Chinese medicine industry standard of the People's Republic of China? Diagnostic Efficacy Criteria for TCM Evidence [3], and Shanghai Diagnostic and Treatment Routines for TCM Evidence (2nd edition) [4] for efficacy evaluation. (1) Cured: complete healing of the wound. (2) Significant effect: The wound surface is significantly reduced by 75% or more. (3) Effective: more than 25% reduction of trauma. (4) Ineffective: less than 25% reduction or even enlargement of the wound. Please add the evaluation criteria of healing, efficacy, effectiveness and ineffectiveness. 1.7 Statistical methods SPSS 13.0 statistical software was applied for statistical analysis of data. χ2 test was performed for count data, Ridit analysis was performed for rank data; ANOVA was used for measurement data. 2. Results 2.1 Trauma healing 132 patients, 30 were cured, 33 were effective, 58 were effective, and 11 were ineffective, with a healing rate of 22.73% and an overall effective rate of 91.67%. The wound healing time of the healed patients ranged from 6 to 21 d, with an average of (13.63±4.80) d; the scar was small and close to the flesh color after healing. The trauma healing rate of patients ranged from 10% to 100%, with a mean of (62.57±30.02)%. 2.2 Quantitative score of local symptoms Except for 30 healed patients, the remaining 102 patients showed an increase in the amount of local exudate, a change in color to red and active, and a significant reduction in pain after treatment, and their quantitative scores of symptoms before and after treatment were significantly different (P<0.01).