| Objective:To summarize and bring forword the perifocal area theory of surgery of TCM,and to explore the clinical efficacy and the machnism of the external therapy of TCM on venous ulceration according to the theory. Methods:Based on the data-base of TCM,the literature of surgery of TCM was analized, the Perifocal Area Theory and its developing history was summarized.According to the Perifocal Area Theory, a prospective,randomized study was performed on 60 patients with venous ulceration, treated by external therapy of TCM,and compared with the control group. Taking rats as the experimental ulceration model,the onintment of Chinese medicine herb was used on the perifocal area or/and wound, and its effect on granulation growth, epidermis growth, DNA copy of repair cell and expression of bFGF were detected. Results: The conception of perifocal area seen in the classics of TCM has not been summarized systematically and the perifocal area theory was only applied on the infectious diseases of peripherala. Clinical study shows that the total effective rate of the group of the perifocal area therapy(97.5 per cent) is better than the control group(P<0.05). Experimental study indicate that the perifocal area therapy can effectively improve the microcirculation of wound,increase the microvascular perfusion and the velocity of red blood cell significantly compared with the control group(P<0.01). Meanwhile, it also increase the amount of bFGF and DNA in wound,promote the proliferation of fibroblasts, angiogenesis and the synthesization of collagen matrix,promote the constraction of wound and accelerate the velocity of epithelial metaplasia obviously copmpared with the control group(P<0.05). Conclusion: The Perifocal Area Theory is a important theory of TCM, it can be applied to guide the treatment of venous ulceration. The perifocal area therapy canimprove the treatment result of ulcer and promote the wound healing.
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