Thrombo-occlusive vasculitis (thromboangitis obliterans) is a chronic, occlusive, inflammatory disease of the peripheral vasculature with secondary neuropathy that occurs mainly in the small and medium-sized arteries and veins of the extremities, especially in the lower extremities. The lesions often involve the entire vascular layer, resulting in luminal narrowing and occlusion, also known as Berg’s disease. The disease occurs mostly in young and middle-aged men between the ages of 25 and 45, with a slow course and a history of heavy tobacco addiction. The clinical features are ischemia of the affected limb, pain, intermittent claudication, weakening or disappearance of the affected artery, with wandering thrombotic superficial phlebitis, and in severe cases, ulceration or necrosis of the extremity, and arteriography showing segmental distribution of the lesion and stenosis or occlusion of the affected segment. Thrombo-occlusive vasculitis is a difficult disease, after years of clinical practice, Chinese medicine has accumulated rich clinical experience in the study of its etiology and pathogenesis, and the identification and treatment, and the combination of Chinese and Western medicine has become an important means of treating thrombo-occlusive vasculitis. A, Chinese medicine on thrombo-occlusive vasculitis etiology and mechanism of research thrombo-occlusive vasculitis in Chinese medicine belongs to the category of “gangrene”, also known as “carbuncle”, “ten fingers cold”. As early as in the Nei Jing, “Ling Shu – carbuncles and gangrene” chapter said: “The appearance of red and black gangrene in the feet and fingers, the name of the gangrene, death is not treated; not red and black, do not die. Does not decline, anxiously chopped, not is dead.” That is, the typical description of gangrene of the limbs, and has recognized the characteristics of the disease “gangrene” including thrombo-occlusive vasculitis. The Han Dynasty Hua Tuo “Secret Traditions of Divine Medicine” contains: “This disease occurs at the end of the fingers or toes, first itchy and then painful, the nail is now black, a long time is ulcerated, the nodes fall off, it is appropriate to use raw licorice, research into a fine powder, sesame oil dressing …… internal medicine with honeysuckle three taels, Yuan Shen three taels, angelica two taels, licorice one tael, water decoction ……”. This is the earliest summary of the “gangrene” internal drug therapy and external treatment method. After that, generations of doctors gradually improved, summarized the surgery, internal, external, acupuncture and other treatment methods, for the current combination of Chinese and Western medicine to treat thrombo-occlusive vasculitis still has great value. The cause of this disease is mostly related to external cold and dampness, poor diet, excessive emotions or excessive room and room, and the deficiency of long-term disease. Generally due to cold and freezing excess; or trauma caused by vascular and nerve damage; or diet, worry or excessive room labor, can make the heart, liver, spleen, kidney dysfunction, and lead to meridians, qi and blood dysfunction and disease. Summarizing the various schools of thought, the pathogenesis can be summarized into the following four types: 1, cold condensation and blood stasis: the spleen and kidney Yang is not full, Yin cold attack, cold condensation leads to blood stasis. The cold and dampness are found in the meridians, flesh and bones, and block the veins and channels, resulting in the inability of the blood and Qi to moisten the four extremities, resulting in pain and necrosis of the extremities, and even shedding. 2, dampness and stagnation: long-term guest wetlands or diet disorder, can accumulate dampness and brew phlegm. Dampness is heavy and sticky, most likely to damage Yang Qi, blocking the Qi, so that the blood transport loss of its smooth, so that the blood stagnation and impassable, then five toe necrosis. 3, heat poisoning: indiscipline in the room, the mood is not suitable, the kidney water deficit, the fire, liver wood loss of nourishment, blood does not glory tendons. Thick sorghum, wantonly addicted to spicy tobacco and alcohol, the damp heat is generated, turning into fire poison, fumigation of the internal organs, resulting in liver failure tendon death, spleen failure meat death, kidney failure bone death, and become the disease of gangrene. 4, deficiency of qi and blood: deficiency of qi and blood after a long illness, deficiency of qi is sluggish blood transport, blood deficiency is nothing to produce qi, blood stasis, the veins lose their moistening, and the four end of the qi and blood can not fill up, poisonous evil agglomeration, qi and blood stagnation, then vasculitis occurs. In addition, Luo believes that vasculitis patients although the affected limb local response is cold evidence, but in addition to the affected limb other parts such as the head, chest, abdomen, back of the four diagnostic examination is difficult to find the performance of cold evidence, but often show the heart and chest irritable heat, shortness of breath, diet is not afraid of hot and cold; tongue red dry more, light white less; urine yellow less more, clear long less; affected limb wear thick and more, the trunk wear thin and less, such as the evidence of yin deficiency and qi weakness. And qi weakness is mostly caused by yin deficiency. The “Danxi Xinfa” objectively proposed that “there is a change of blood heat inside, and then subjected to cold outside the fight and coagulation”. The “Medical Lin Correction” also said: “Blood subject to yin deficiency, a long time will produce deficiency heat. The deficiency of less thick and stagnant blood plus the decoction of fire and heat will become stasis. The deficiency of yin and blood, the lack of biochemical source of qi makes qi weak, and the weakness of qi makes blood run slowly and weakly, which aggravates blood stasis.” Accordingly, it is proposed that Yin deficiency and Qi weakness is an important etiology of thrombo-occlusive vasculitis. In conclusion, the main lesion of this disease is in the blood vessels and is most closely related to the heart, liver, spleen, and kidney, because the heart governs the veins, liver the tendons, spleen the flesh, and kidney the bones. The origin of the disease is the deficiency of Yang Qi and the weakness of Qi and blood, and the symptoms of the disease are blood stasis, dampness, heat poisoning, stagnation of tendons and meridians, and corruption of blood and flesh. If the disease is prolonged, the limb necrosis, trauma does not heal, pus and blood constantly, which can lead to a great injury to the qi and blood, and a series of changes in the evidence. Second, the identification of thrombo-occlusive vasculitis typing of the clinical identification of the disease typing, there is no uniform standard. According to local reports can be summarized as the following five types: 1, deficiency cold type: the initial lower limbs cool, cold, numbness, pain, accompanied by a sense of fatigue, local swelling and tight pressure or plantar pad feeling, intermittent limp, walking because of the calf sinking, suffocating, walking distance is getting shorter, the tongue is light, the moss is thin and white, the pulse is sunken and late. Treatment is recommended to warm the meridians and disperse cold, benefit Qi and invigorate Blood, resolve blood stasis and open the channels. 2. Damp-heat type: manifests as coldness and pain in the affected limbs, often wandering. The lower limbs are sore, suffocating, heavy and weak when walking. Lower limbs often have lumps or nodules with redness, swelling, heat and pain. The affected limbs are sometimes swollen. The tongue is red, with yellow or white greasy coating, and the pulse is mostly smooth or stringy. Treatment is recommended to clear heat and cool the blood, followed by resolving blood stasis, dispersing nodules and relieving dampness. 3. Stasis type: manifesting as coldness of the affected limb, cold to touch, persistent pain, purplish red, dark red or greenish purple skin, and petechiae on the skin of the foot end. The tongue is red-red or purple-dark with petechiae, the tongue coating is thin and white, and the pulse is sunken and thin. Treatment should be to warm the meridians and channels, activate blood circulation and remove blood stasis. 4.Toxic type: Ulcer or gangrene occurs in the affected limb, followed by severe infection, red, purple, painful and diffuse swelling, with a lot of pus and foul odor. Systemic symptoms may include high fever and chills, irritability, dry stools and yellow urine. The tongue is red and vivid, with yellowish, yellow-dry or black-brown coating, and the pulse is slippery and large or thin. Treatment should be to clear heat and detoxify the toxin, resolve blood stasis and open the ligaments. 5.Qi and blood deficiency type: the patient is weak and feeble after a long illness, the affected limb muscle wasting, toe end ulcers, traumatic pus clear and thin, does not heal for a long time. The tongue is light, the coating is thin and white, and the pulse is sunken and weak. The treatment is to tonify the qi and nourish the blood and harmonize the Ying and Wei. For the treatment of thrombo-occlusive vasculitis, many effective special prescriptions and medicines have been summarized on the basis of identification and treatment, selection of prescriptions and medicines by generations of doctors. For example, the prescriptions of Si Miao Yong An Tang, Yang He Tang, Gu Bu Tang, and Tong Yue Wu Xing Blood Tang have all achieved good results in the treatment of thrombo-occlusive vasculitis. To summarize its treatment, there are mainly treatments such as activating blood circulation and removing blood stasis, clearing heat and detoxification, and warming the meridians and dispersing cold, especially activating blood circulation and removing blood stasis has become a recognized promising treatment principle. Although the etiology of the disease varies, the main pathogenesis is still stagnation of blood vessels and channels, so the treatment is still based on activating blood circulation and removing blood stasis and unblocking the veins and channels throughout the disease. Tang et al. showed through the study of microcirculation and blood rheology testing of nail wrinkles that the disease is not just an arterial disease, but there is thrombosis in the lumen of parallel arteries and veins, such as slowed or unclear blood flow in microvessels, abnormal flow pattern, aggregation of red blood cells, and granular blood flow. The microcirculatory disorders lead to the aggravation of local lesions and cause a vicious circle. Therefore, correction of microcirculatory disorders not only relieves clinical symptoms but also has a positive effect on the prevention of limb necrosis. This study also argues the importance of activating blood circulation and removing blood stasis in the treatment of thrombo-occlusive vasculitis. In addition, in recent years, worm medicines have shown better prospects in the treatment of thrombo-occlusive vasculitis. For example, leeches, gadfly, V worms, wuzhishan snake, dirong, centipede, etc. have the function of promoting blood circulation, activating blood circulation and relieving pain, which have good curative effect on thrombo-occlusive vasculitis. In addition to internal Chinese medicine treatment, with the application of acupuncture, fumigation and topical powder therapy, all have a positive effect on improving the efficiency of the treatment of this disease. At present, the etiology of thrombo-occlusive vasculitis is not yet fully understood, the treatment still lacks reliable treatment means, must take a comprehensive treatment method according to the different stages of the disease, is never a drug, a method can solve the problem. Therefore, the only best way is to use the method of combining Chinese and Western medicine, staging and typing, and applying the treatment of internal and external combination.