Infected diabetic foot ulcers are the main cause of diabetic foot amputation, and their clinical manifestations have not only local symptoms, but also overall (systemic) symptoms: local symptoms: local redness, swelling, pain, unclear boundaries with the surrounding foot ulcers, burning sensation, obvious feeling of increased skin temperature when touched by hand, more secretions, thick texture, accompanied by odor. If there is pus formation and no breakage, there will be a throbbing pain and a fluctuating feeling when pressed. These symptoms are often referred to as “redness, swelling, heat and pain”. Overall symptoms.
If the local infection is mild, there may be no systemic manifestations; however, if the infection is severe, symptoms such as fever, thirst, dry throat, irritability, dry stools, yellow urine, etc. may appear; in more severe cases, toxemia, bacteraemia, such as high fever and chills, and even heart and kidney failure may appear. Generally speaking, the overall symptoms are usually consistent with the local symptoms, but due to the long duration of diabetes or the different physical conditions of patients, the overall symptoms are often inconsistent with the local symptoms, which means that the local symptoms may be obvious redness, swelling, heat, pain, more pus and thicker, but the overall symptoms may not be feverish, but may be cold, weakness, shortness of breath, dizziness, edema, thin stools, etc. The symptoms of “deficiency and cold” may even be combined with other systemic diseases such as lung infections, urinary tract infections and cardiac insufficiency, which makes the treatment difficult: should we clear the heat and detoxify the toxin according to the local performance or should we supplement the vital energy according to the overall performance? It is easy to lose sight of both when using medicine. Chinese medicine can solve the above problem to a certain extent by combining local treatment with overall treatment. Local treatment: Local treatment can be applied alone or as an effective supplement to the overall treatment, especially when the overall diagnosis and local diagnosis do not match, local medication can be used to make up for the lack of overall medication. Local medication methods include: soaking method, hoop surrounding method, compress method, etc.; dosage forms include creams, tinctures, powders, etc. Both medication methods and dosage forms need to be specifically determined according to local performance. Holistic treatment: that is, oral treatment with Chinese medicine. The basis of medication is the overall diagnosis and treatment, which requires the four diagnoses of “look, smell, ask, and cut”. When the overall and local symptoms are compatible, the same principles as local medication can be applied; when the overall and local performance are not coordinated, it depends on which one of the overall and local symptoms has more influence on the patient, and which one is the main one in the identification, while taking into account the symptoms of the other side; if both cannot be taken into account, the overall medication is based on the overall identification, and the local medication is based on the local identification. Therefore, according to the specific situation of the whole and the local, there are: clearing heat and detoxifying alone, clearing heat and detoxifying together with supporting Zheng Qi, or supporting Zheng Qi together with clearing heat and detoxifying, or supporting Zheng Qi alone, respectively. Local treatment and overall treatment can complement each other, especially when local performance and overall performance are inconsistent. Local treatment acts directly on the local area of foot ulcer, supplementing the effect that cannot be achieved by oral Chinese medicine; overall treatment can enhance the body’s positive energy and promote the action of local medicine.