1.History of Chinese medicine external therapy For thousands of years, Chinese medicine external therapy has been loved by patients for its simplicity, convenience, cheapness and effectiveness. From the famous doctor Hua Tuo of the Three Kingdoms who used Ma Bo San to remove dead bones and perform abdominal surgery, to the insightful argument of Wu Shi Ji, a master of external treatment in the Qing Dynasty that “the theory of external treatment is the theory of internal treatment, and the medicine of external treatment is also the medicine of internal treatment, the only difference is the method”, external treatment of Chinese medicine has gradually accumulated a perfect theoretical foundation and rich clinical experience. Acupuncture point dressing: It is the application of Chinese medicine to the Yu points on the body surface, due to drug and heat stimulation, so that the local blood vessels dilate, blood circulation accelerates, thus promoting the penetration, absorption, and dissemination of drugs, increasing the effect of the whole body. The clinical scope of application is quite wide, and it can be applied to all kinds of diseases such as internal, external, gynecological and pediatric diseases. For example, in cases of liver pain (chronic hepatitis B), we often choose the acupuncture points of Zhimen, Zhangmen, and Gallbladder acupuncture. Ear acupuncture point pressure bean method: According to the “Nei Jing” and “Difficult Jing” books, the ear and the five organs have a physiological connection, and stimulation of the relevant acupuncture points on the auricle can play a role in preventing and curing diseases when people are sick. The front of the auricle is supplied by the upper, middle and lower branches of the superficial temporal artery, while the back of the auricle is supplied by the upper, middle and lower branches of the postauricular artery, and sometimes the occipital artery also supplies the lower 1/3 of the back of the auricle. The superficial temporal, posterior auricular, and occipital arteries are connected by large anastomosing branches that interpenetrate from front to back, forming a blood supply network in the ear. The auricle is richly innervated by the auricular nerve, the lesser occipital nerve, the greater occipital nerve, as well as the trigeminal and facial nerves. There are also fibers of the sympathetic nerve participating. The various nerve branches overlap and anastomose with each other and interweave a mesh-like plexus, so that the auricle has a close connection with the somatic and central nerves. Ear acupuncture is a method of using needles or other methods to stimulate the acupuncture points on the auricle to prevent and treat diseases, while ear acupuncture pressure bean method is a health care method developed on the basis of ear acupuncture therapy. Moxibustion, also known as moxibustion, is a treatment method that uses moxa cones and moxa rolls made of moxa (or other drugs) to burn and warm the acupuncture points on the body surface, using the heat of the moxibustion fire and the effect of drugs to conduct through the meridians and acupuncture points to warm the qi and blood, support the righteousness and dispel the evil, and achieve the prevention and treatment of diseases. It has been widely used clinically for thousands of years for both health care and treatment of diseases, for fitness, disease prevention and cure. As early as the Spring and Autumn and Warring States period, people have begun to use moxibustion method widely, such as “Zhuangzi” has “Yueren smoked with moxa”, “Mencius” also has “seven years of illness for three years of moxa” record. Moxibustion can stimulate and improve the body’s immune function and enhance the body’s ability to resist disease. Guan Yuan, Qi Hai, and Foot San Li are the main points of the human body to strengthen health care, moxibustion once a day can adjust and improve the body’s immune function and enhance the body’s ability to resist diseases. In the Song Dynasty, the Book of the Heart of the Magpie says: “When a person is not sick, he can live a hundred years by moxibustion of Guan Yuan, Qi Hai, Life Gate and Zhong Gui.” Moxibustion at the foot San Li point can relieve gastrointestinal spasms, and for chronic liver disease, moxibustion can achieve the effect of adjusting the function of the stomach and intestines and relieving the pain in the ribs and abdomen. Chinese herbal enemas: Chinese herbal enemas can laxate toxins, remove blood stasis, and regulate qi, etc. They are suitable for liver with, kidney terminal, intestinal paralysis, and anal lesions. According to historical records, the earliest use of enema therapy was the ancient Egyptians, and the Chinese medicine enema is a method of treating diseases by clearing heat and detoxifying, activating blood circulation and removing stasis, dispelling wind and dampness, permeating dampness and water, and adjusting yin and yang according to the Chinese medicine theory of “opening the door of ghosts, cleansing the internal organs, and removing Ivana Chen sitting”. For example, the use of Chinese herbal enemas to treat chronic liver disease can achieve the purpose of clearing toxins, invigorating blood and enhancing the immune function of the intestines. Cupping therapy refers to the treatment of cupping with fire, water and medicine jars. The ancient name of “jiao method” is recorded in the “Fifty-two Disease Formula”, a silk book from the Han tomb excavated at Mawangdui. The most common clinical use is the use of special glass jars or pottery jars, bamboo jars, with the help of heat, to remove the air inside the jar, so that the formation of negative pressure inside the jar, adsorbed on the skin or acupuncture points, causing skin congestion or stasis of blood treatment method. It has the effect of warming the meridians and dispersing cold, moving qi and blood, relieving pain and swelling, extracting toxins and draining pus. We use cupping therapy to treat liver disease, often using back walking cupping therapy to extract toxins and clear heat and activate blood circulation to remove blood stasis. Acupoint injection Acupoint injection, also known as “water injection”, is a method to treat diseases by injecting drugs into the relevant acupuncture points. This treatment uses less drugs, is highly effective, and has a very wide range of application, most of the indications for acupuncture can be treated with this method. It is also effective in treating dysmenorrhea, abdominal pain, and menstrual disorders, which are common in people with chronic liver disease. Clinically we often use acupuncture point injections include: w Angelica injection Vitamin B12 injection Chuanxiong Danshen injection w Huangqi injection Red Arrow Tianma injection Ginseng injection, etc. Commonly used injection points include: nei guan, sesan li, hanging bell, etc. Hot ironing therapy: Hot amanbag hot ironing for the treatment of dystocia and abdominal pain that are easily seen in chronic liver disease is one of our common clinical external treatments. It is a method of treating liver disease with some herbs and heat transfer objects, heated and placed on the abdomen. (1) Ironing method, like fumigation teng method, is an exposure therapy. The combined effect of heat and medicine is the main treatment principle of ironing method, which has the effect of warming the meridians, moving qi and blood, dispelling dampness and dispersing cold. In the stimulation of local tissues by drugs and warmth, the drugs pass through subcutaneous tissues and produce relative advantages in local drug concentration, some aromatic drugs, can improve the transdermal diffusion ability of cortisol. The local blood vessels are dilated and the blood flow is accelerated after the hot aman pack treatment, which improves the nutrition of the surrounding tissues and makes the body produce certain antibodies, thus improving the immunity of the body and achieving the role of promoting the balance of yin and yang and preventing diseases and health care. (2) hot aman bag hot ironing therapy commonly used Chinese herbs: patchouli, Chuanxiong, raw rhubarb, Zeilan, etc. Chinese medicine foot bath: Chinese medicine believes that the five internal organs of the human body have a corresponding projection on the feet, the foot is the starting point of the three yin meridians, and the termination point of the three yang meridians, there are more than sixty points below the ankle joint. Feet on the human health care role, very early to attract the attention of the ancients and research. One of the “foot bath” more with its simple and effective characteristics, prevailing for thousands of years and not decline. Ancient cloud: “the foot is the bottom of the person, a night wash”. Such as the “Son of Heaven” Emperor Qianlong, also believed in “300 steps in the morning, a pot of soup in the evening,” the way to maintain health. If you often use the foot bath, can stimulate the foot acupuncture points, enhance the operation of blood vessels, regulate the internal organs, Shu Tong meridians, enhance metabolism, so as to achieve the purpose of strengthening the body to get rid of disease and evil. Our folk song: “spring feet, Yang solid off; summer feet, summer humidity can be dispelled; autumn feet, lung moisten intestines moisten; winter feet, Dantian warm burning”. Ancestral medicine believes that the big toe is the liver, spleen, two channels, more activities of the big toe, can soothe the liver and spleen, enhance appetite, the liver and spleen enlargement also have auxiliary therapeutic effect. The fourth toe is the bile meridian, massage can prevent constipation, dysfunctional pain. Foot bath after the massage of the soles of the feet, toes has an important health care medical role. Especially for liver and kidney deficiency appears to be lumbar weakness, irritability and insomnia, dysmenorrhea and kidney dysfunction have a certain curative effect or auxiliary treatment effect. The Yongquan point on the heart of the foot has the function of nourishing the liver and kidneys, nourishing the five internal organs, which is conducive to a long and healthy life. Insist on soaking the feet with Chinese herbs for 15-20 minutes before bedtime, to promote the operation of qi and blood, warming the internal organs, the elderly often massage the heart of the feet, can prevent numbness in the legs and feet, help calm the mind and dispel annoyance, hypnotic sleep, so that sleep is more sweet. Add a small amount of vinegar essence to the decoction of Chinese herbs such as patchouli, peppermint, white lichen bark, sumac and soapberry, etc. The acid can enter the liver meridian to ease the anxiety and soothe the liver. 2. Clinical teaching model of sequential therapy for liver disease: We encourage internists, advanced practitioners, postgraduates and other types of medical students to “move their mouths as well as their hands” in clinical practice, and enhance their hands-on ability through hands-on teaching. The students said, “Through the internship, we deeply appreciate the clinical effectiveness and practicality of Chinese medicine!” 3.Experience The 4 years of classroom teaching are only half of the medical students’ education. Clinical internship is the process of linking theory with practice, which is an important stage of transition from medical students to practicing physicians, and is also directly related to the expansion of thinking on disease diagnosis and differential diagnosis in clinical work after graduation. Strict and correct clinical teaching is an effective way to train qualified medical workers, which is the duty of clinical teaching teachers and an important part of medical education that cannot be ignored. The transformation of medical market, education mode and employment form has brought new issues to the current internship teaching of graduates. As a national TCM clinical pharmacology research (liver disease direction) base, we undertake international, provincial and hospital level research projects and a large number of new drug development and clinical pharmacology research of TCM protected species. The department encourages everyone to summarize their experience to write papers and declare scientific research topics, and gives certain time to recharge and complete scientific research topics, which greatly improves the scientific research ability and awareness of teachers. The formation of scientific research as the driving force to promote the continuous deepening of teaching reform, so that the quality of teaching is constantly improved. In turn, teaching and learning further improve our scientific research. Through the scientific research results, we have been able to pass them on to the interns, further strengthening their enthusiasm and enthusiasm for this course and achieving better teaching results. With the progress of science and technology, multimedia tools are becoming more and more auxiliary tools for clinical teaching, and the effect of teaching interns to memorize the treatment of common digestive system diseases through graphics is far better than traditional teaching methods. From the start of this study in October 2007 to December 2009, 109 interns, 12 trainees, 16 postgraduates, and over 100 trainees have benefited from this study. In 2007, 89 patients with liver disease were admitted to our department, 168 patients were admitted in 2008, and 134 patients were admitted in 2009. All patients with liver disease were treated with TCM sequential external treatment method, and achieved a better efficacy of 94% total efficiency. In the end, we choose the famous words of young Marx: “If we choose the profession that best serves the welfare of mankind, then the burden cannot overwhelm us, for it is a sacrifice for all. What we feel then will not be a poor, limited, selfish pleasure, but our happiness will belong to millions of people!”