Objective To explore new therapeutic methods for the treatment of chronic lymphedema. Methods 50 patients with chronic limb lymphedema received comprehensive decongestive treatment with Manual Lymph Drainage (MLD). Among them, 29 cases of primary lymphedema, 21 cases of secondary, 42 cases of lower extremity disease, and 8 cases of upper extremity disease. Multi-frequency bioresistance body composition analyzer was used to detect tissue edema and measure limb circumference to check the treatment effect. Results After 1-2 courses of treatment, the edema of all 50 cases of diseased limbs was reduced to different degrees, which was manifested by a significant reduction in the degree of tissue edema of the affected limbs (P<0.05) and a significant reduction in the circumference of the affected limbs (P<0.05). The correlation test between limb circumference and changes in tissue edema showed a very significant correlation between the two (rs=0.774, P<0.0001, Figure 3). Conclusion Manual lymphatic drainage is an effective treatment for chronic lymphedema as it promotes the return of lymphoedema from stagnant tissues, reduces limb swelling, and improves the appearance of the affected limb. Limb lymphedema is considered to be a medical problem and there is a lack of effective treatment. The causes of lymphedema include primary lymphedema, whose pathogenesis is unclear, and secondary lymphedema caused by infection and radical tumor surgery. The pathological process of lymphedema is the retention of lymphatic fluid in the tissues due to impaired lymphatic return, followed by "irreversible" pathological changes such as tissue fibrosis and fat deposition, and infectious complications such as salpingitis. If not treated early, elephantiasis can develop in the affected limb and lead to disability. Manual Lymph Drainage (MLD) is the most widely used and effective treatment for lymphedema in the last two decades. Manual Lymph Drainage MLD is also known as Complex Decongestion Therapy CDT (CDT) when combined with elastic bandage, skin care and functional exercises. Since 2008, our center has been carrying out Complex Decongestion Therapy CDT with manual lymphatic drainage to treat limb lymphedema, and has achieved satisfactory results. This article reports the clinical results of fifty cases of limb lymphedema. I. METHODS AND PATIENTS PATIENTS: There were 17 males and 33 females among the fifty treated patients. The maximum age was 73 years old and the minimum age was 7 years old. There were 8 cases of upper limb lymphedema and 42 cases of lower limb disease, including 29 cases of primary lymphedema and 21 cases of secondary. The longest duration of the disease was 28 years, the shortest was half a year, and the average duration was 6.7 years. Treatment: The operation method of manipulative lymphatic drainage was based on the method introduced by Prof. Foeldi, in which the lymphatic system of the body surface (including trunk and limbs) was gently pressed and massaged along the direction and pathway of lymphatic reflux. The order of treatment is (1) trunk first, then limbs, (2) healthy side first, then affected side, (3) press regional lymph nodes (supraclavicular, axillary, inguinal) first, and then massage according to the direction of lymphatic vessels in the drainage area. The above treatment promotes the return of peripheral lymphatic fluid to the central lymphatic system, and achieves the effect of reducing and eliminating the edema of the diseased limb tissues. At the end of manual drainage, the affected limb is bandaged with a low elasticity bandage (Hartmann Trade Co., Ltd. Germany). The procedure takes about one and a half hours and is performed once a day for a period of twenty treatments. The treatment was accompanied by skin cleansing care, and the patients were asked to do functional exercises such as gymnastics and walking. Observation items: (1) limb circumference: five points were set up to measure the circumference of the healthy and affected limbs (cm), the measurement points of the lower limbs: the root and middle of the thigh, the middle of the calf and above the ankle joint as well as the dorsum of the foot; the measurement points of the upper limbs: the upper end of the upper arm and the middle of the arm, the middle of the forearm and the upper part of the wrist joint as well as the dorsum of the hand. (2) Tissue edema: a multi-frequency bioelectrical impedance analyzer was used to analyze the tissue edema, and the patient was asked to walk and do functional exercises. frequency bioelectrical impedance analysis, Inbody 3.0, Biospace Korea) was used to detect the degree of tissue edema, i.e., extracellular fluid content (liters), in the healthy and affected limbs, respectively. Statistical methods Changes in limb circumference: The results of measurements at five points of the limb were obtained by subtracting the value of the affected limb from the value of the healthy limb at the corresponding position, and the resulting differences were summed up to obtain the mean, and the changes in circumference before and after treatment were compared by the nonparametric signed-rank test (The nonparametric Wilcoxon signed-rank test). Changes in edema: Similarly, the nonparametric Wilcoxon signed-rank test (The nonparametric Wilcoxon signed-rank test ) was used to compare the changes in edema in the tissues of the affected limbs before and after treatment. Spearman correlation coefficient (Spearman correlation coefficient) was used to detect the correlation between the changes in tissue edema and limb circumference before and after treatment. p<0.05 was considered statistically significant. After 1-2 courses of treatment, the edema of 50 cases of diseased limbs was reduced to different degrees, which was manifested by the significant reduction of the degree of tissue edema of the affected limbs (P<0.05, Table 1) and the significant reduction of the circumference of the affected limbs (P<0.05, Table 2). Table 1 Comparison of the difference in hydration before and after manipulative lymphatic drainage Before and after treatment Difference S-value P-value Mean±SD(n) 1.81±1.47 (50) 0.76±0.82 (50) 1.05±0.92 (50) 227.5 0.0220 Median(Min～Max) 1.38(0.05～6.55) 0.56(-0.09 0.56(-0.09) ～4.04) 0.77(0.03～4.28)