External Treatment Methods of Traditional Chinese Medicine for Burn Wounds

1 Chinese Herbal Bath (Soaking) Therapy

Soaking therapy is widely used in burn wound treatment, but using it alone to treat residual burn wounds has certain limitations. Related studies show that during the soaking process, this therapy can soften scabs and eschar, promoting their separation and facilitating drainage of pus beneath the scab. At the same time, under the combined effect of the warm water and the medicinal properties, it can soften scars, improve local blood circulation, and increase joint mobility, reducing joint flexion/extension impairment caused by scar contracture — laying a good foundation for later functional recovery.

1.1 Plant-Based Medicines

From the perspective of traditional Chinese medicine, when heat-toxin attacks the body externally, the first priority is to clear the heat-toxin from the superficial layer (the skin). Therefore, herbs that clear heat and resolve toxicity, and that gently disperse external pathogens, are the main category used. In the soaking process, the various herbs in the formula mainly act as antibacterial, wound-healing-accelerating, anti-inflammatory, and analgesic agents. Studies show that after using herbal soaking therapy, the bacterial clearance rate in the observation group was significantly higher than in the control group (P<0.05).

In the formula, herbs such as Coptis (Huang Lian), Scutellaria (Huang Qin), and Phellodendron (Huang Bai) work together to clear heat, dry dampness, and purge fire and toxicity. Borneol (Bing Pian) is added to effectively relieve the swelling and pain of sores and ulcers, and to promote the contraction and healing of ulcerated wounds. Gardenia (Zhi Zi) plays an important role in cooling the blood and resolving toxicity, while also reducing swelling and relieving pain.

Modern pharmacological research shows that borneol has antibacterial, anti-inflammatory, and analgesic effects; a gardenia decoction inhibits various bacterial toxins and also has antifungal effects on skin fungi. Coptis, Scutellaria, and Phellodendron act on bacterial toxins from various bacteria including Staphylococcus aureus and Pseudomonas aeruginosa, while raw Sanguisorba (Di Yu), which contains tannins, has astringent and hemostatic effects.

Clinical research also shows that these "three yellows" (Coptis, Scutellaria, Phellodendron) all have wound-healing and broad-spectrum antibacterial properties, inhibiting various bacteria and fungi. Raw Sanguisorba is considered a key herb for treating burns and scalds, as it can reduce exudation and accelerate wound healing. Other studies show that a compound formula combining Coptis and Scutellaria with Honeysuckle (Jin Yin Hua) and Forsythia (Lian Qiao) produces good antibacterial effects, thereby speeding up average wound healing time and joint recovery.

In terms of pain relief, modern pharmacological research indicates that raw Sanguisorba, Polygonum cuspidatum (Hu Zhang), and borneol in the formula not only provide antibacterial, anti-infective, and anti-inflammatory effects, but also relieve and control pain. Herbal soaking therapy acts on the affected area and the skin surface of the whole body through the fumigation effect of the soaking solution; after absorption through the skin, it reaches the interior and exterior relationship of the organ-meridian system, allowing the medicinal effect to spread externally through the meridians and reach the internal organs.

2 Topical Chinese Herbal Ointments

Chinese herbal ointments have broad applicability and are simple to use. The ointment forms a sealed oily film on the wound surface, maintaining a moist environment and reducing water evaporation. Research shows that a moist environment promotes cell migration and proliferation, thereby accelerating re-epithelialization. Depending on the combination of herbs used, different effects can be achieved to promote the repair of residual wounds.

2.1 Plant-Based Medicines

Studies on self-prepared ointments applied externally to residual post-burn wounds show significant effects, notably shortening wound healing time and improving the wound healing rate, with statistically significant differences (P<0.05). In the formula, Phellodendron clears heat, dries dampness, purges fire, resolves toxicity, and reduces swelling and necrotic tissue; Dragon's Blood (Xue Jie) invigorates blood circulation, resolves stasis, stops bleeding, and promotes tissue regeneration; Centella asiatica (Ji Xue Cao) clears heat, drains dampness, invigorates blood, stops bleeding, and resolves toxicity and swelling. Both Angelica sinensis (Dang Gui) and Ligusticum (Chuan Xiong) invigorate blood circulation, but Chuan Xiong also moves qi, while Dang Gui additionally tonifies blood.

Modern medical research shows that decoctions and extracts of Phellodendron have a strong inhibitory effect on pyogenic bacteria; during wound repair, Dragon's Blood effectively promotes capillary regeneration. Dang Gui and Chuan Xiong regulate wound microcirculation, dilating blood vessels and improving blood supply to the wound, thereby advancing the healing process. Asiaticoside, the active compound in Centella asiatica, promotes epithelial cell migration, accelerates fibroblast proliferation, and promotes new capillary formation, thereby facilitating wound healing.

Research shows that a "detoxifying and tissue-regenerating ointment" (jiedu shengji gao), which has the functions of resolving toxicity, removing necrotic tissue, and promoting scar-free healing, was used to treat residual wounds left after burns. After one week of treatment, the IL-6 (interleukin-6) level in the experimental group was significantly lower than in the control group, a statistically significant difference (P<0.05). According to TCM theory, herbs with necrotic-tissue-removing effects can markedly reduce wound inflammation during the healing process while also providing antibacterial and disinfecting effects. For example, the active components of myrrh (Mo Yao) can inhibit the NF-κB (nuclear factor-κB) signaling pathway in lipopolysaccharide-induced mouse macrophages, reducing the release of inflammatory factors.

2.2 Animal-Derived Medicines

From a TCM perspective, pearl (Zhen Zhu) resolves toxicity, promotes tissue regeneration, and moisturizes and lightens the skin. Research shows that pearl powder promotes the proliferation and differentiation of wound cells, supports granulation tissue growth, and speeds up wound healing. It also accelerates blood circulation at the wound site and enhances the body's local anti-infective ability.

Related pharmacological and animal studies show that during treatment, the detoxifying and tissue-regenerating ointment demonstrates good anti-inflammatory effects. For example, centipede venom can stimulate macrophages to release IL-6, thereby exerting an anti-inflammatory effect. In addition, clinical research shows that this ointment can reduce wound exudation and promote the growth of fresh granulation tissue and re-epithelialization, consistent with results observed in related studies on treating chronic wounds in rats.

Chinese herbal ointments can be applied directly to the wound, allowing the medicinal effect to reach the affected area directly. Deep second-degree wounds often retain necrotic tissue or eschar; the oily base of the ointment can penetrate beneath the scab, softening the dry scab through an emulsifying action and promoting the liquefaction and separation of necrotic tissue. This "scab-dissolving" effect avoids the secondary damage caused by mechanical debridement.