臁疮的中西医治疗进展

Advances in Integrated Traditional Chinese and Western Medicine of Venous Leg Ulcers

摘要: 下肢静脉性溃疡(Venous Leg Ulcers, VLU)是一种常见的慢性溃疡性疾病，中医病名为“臁疮”，以其病程长、治疗困难和高复发率而著称，严重影响患者的生活质量。临床治疗中，中医基于“风、湿、热、毒、虚、瘀”病机理论，以内服外治相结合的治疗方式，通过祛腐生肌、改善气血运行以促进向愈，西医则以压力治疗、清创术、静脉介入手术及生物材料应用为主，注重局部感染控制与修复静脉结构，中西医结合治疗通过整合中医辨证论治与西医靶向治疗，兼顾局部创面修复与全身微循环改善，为患者提供了更全面的治疗方案。本文综述中医、西医及中西医结合治疗VLU的研究进展，分析了其协同优势与局限性，展望未来研究方向，旨在为临床实践和研究提供参考依据。

Abstract: Venous leg ulcers (VLU), known as “leg ulcers” in traditional Chinese medicine (TCM), are a common chronic ulcerative disease characterized by prolonged duration, therapeutic challenges, and high recurrence rates, severely impacting patients’ quality of life. In clinical practice, TCM employs a holistic approach based on the pathological mechanisms of “wind, dampness, heat, toxin, deficiency, and stasis,” combining oral administration and external therapies to remove necrotic tissues, promote regeneration, and enhance qi and blood circulation to facilitate healing. Western medicine primarily focuses on compression therapy, debridement, venous interventional surgery, and biomaterial applications to control local infections and restore venous structural integrity. Integrated traditional Chinese and Western medicine synergizes TCM’s syndrome differentiation and treatment with Western medicine’s targeted interventions, addressing both local wound repair and systemic microcirculation improvement, thereby offering a comprehensive therapeutic strategy. This article reviews advancements in TCM, Western medicine, and integrated approaches for VLU, analyzes their synergistic benefits and limitations, and proposes future research directions to guide clinical practice and scientific inquiry.