| Wu S et al/201011) | External Preparation | Traditional Chinese Medicine Bathing Method[E]Group A(Grade1):蒼朮、黄柏、白鲜皮各等份Herbal soak treatment with Formula 1 was used. Based on the affected frostbite area, three types of herbs from Formula 1 (10–30g) were wrapped in clean white cloth and boiled in 1000–5000㎖ of water for 20 minutes (brought to a boil over high heat, then simmered on low heat for 20 minutes). The herbal water was poured into a clean basin, and once it cooled to a comfortable temperature, the affected areas (hands, feet) were soaked, or a towel was used to dab the solution on affected areas (ears, face). When the water cooled, warm water could be added. Each soak lasted 30 minutes, twice daily (morning and evening), with a course duration of 5 days.Group B(Grade2):蒼朮、黄柏、白鲜皮、薏苡仁、白芨、蛇床子、地肤子各等份Formula 2 was used for the soak treatment, following the same method as Formula 1.[C]No treatment(Natural recovery) | 30days(f/u until 50days) | No mention |
| Liu W et al/199812) | External Preparation | [E]: External preparation (Traditional Chinese Medicine solution: 黄柏 50g, 地榆 50g、大黄 50g, 冰片10g, 75% Ethanol 1000㎖)Clean the frostbite area with normal saline. If blisters form use sterile scissors to make a small hole at the base of the blister to drain the fluid. Disinfect with alcohol, then spray the affected area with Da Huang frostbite solution. Spray the medication twice daily and continue until the wound is completely healed. The affected area should remain uncovered and exposed, without bandages.[C]: Ointment for frosbite | [E]: 3-7d(Mean: 5.42d)[C]5-15d(Mean:10.86d) | Antibiotic Administration Intravenous injection of penicillin, ampicillin, orgentamicinisused top revent infection |
| Feng Z et al/199513) | External Preparation | External preparation (Herb; 黄芩, 白芍, 丹参, 补骨脂 etc. + Vaseline Mix)Prescription:黄芩, 白芍, 丹参, 补骨脂 etc.Preparation Method: No mention/ Application Method: No mention | No mention | No mention |
| Cheng Z et al/201815) | External Preparation | Traditional Chinese Herbal powder; 桂枝, 制附子, 荆芥, 路路通, 當歸, 川芎, 制吴萸- Fumigation & Washing methodIngredients: 桂枝 500g, 制附子 150g, 荆芥 150g, 路路通 150g, 當歸 150g, 川芎 100g, 制吴萸 100gPreparation: The herbs were crushed separately and passed through a 30-mesh sieve. The powdered herbs were mixed uniformly in proportion. 40g of the compound herbal powder was packaged in small plastic bags for later use.Fumigation Method:When needed, 40g of the herbal powder was placed in a prepared gauze bag, sealed tightly, and placed in a larger enamel basin. Boiling water (500-1000㎖) was added to steep the herbs, and when the water temperature reached an appropriate level (around 42°C), both hands were soaked while gently massaging and moving the hands for approximately 20 minutes per session. The herbal liquid could be retained and reheated for two sessions per day, using one dose daily. | 7days | No mention |
| Lin L/200618) | External Preparation | External application(云南白药)A basin of warm water was prepared at a tolerable temperature for the patients, and an appropriate amount of salt was added. The affected hands were soaked for about 30 minutes. After drying, a disinfected cotton swab dipped in hydrogen peroxide was used to clean the exudate and necrotic tissue at the ulcerated area, followed by sprinkling a small amount of 云南白药 powder on the wound. For larger ulcerated areas, more powder was applied, and the area was bandaged with sterile gauze, changing the dressing once or twice daily. Local warmth was also maintained. | 1-7days | No mention |
| Fan J/200519) | External Preparation | External preparation(川芎 60g, 蘇木 45g, 蜂蜡 50g + Glycerol Monostearate 125g + Dehydrated Sorbitan Oleate 7.5g + White Vaseline 50g + Emulsifier OP 5g + Liquid Paraffin 260g + Glycerin 125g + Paraffin 25g + Hydroxybenzoate 1g + Distilled Water: Adequate amount to make 1000gPreparation MethodSoak 川芎 60g and 苏木 45g in 200㎖ of 80% ethanol for 72 hours.Boil the mixture over medium heat for about 10 minutes (using reflux condensation), then allow it to cool. Filter the mixture to obtain the filtrate, recover the ethanol, and concentrate it into a thick paste for later use.In a separate container, combine Glycerol Monostearate, White Vaseline, Liquid Paraffin, Paraffin, Beeswax, Dehydrated Sorbitan Oleate, and Emulsifier OP (oil phase).In another container, combine the thick paste, Glycerin, Hydroxybenzoate, and an adequate amount of distilled water (water phase).Heat both phases in a water bath until completely melted. Slowly add the oil phase to the water phase while stirring continuously in the same direction until it solidifies. | 14days | None |
| Chen Y et al/200220) | External Preparation | External application(云南白药)For patients with intact skin, soak the affected area in warm water (around 40 °C) for 5-10min. For those with ulcers, first rinse the affected area repeatedly with physiological saline (also around 40 °C) before applying 云南白药 to cover the entire frostbite area. The area should then be bandaged with gauze. Change the dressing once every two days according to the condition until healing is achieved. | 2-10days | No mention |
| Feng J et al/200121) | External Preparation | External application: Self-developed Traditional Chinese Medicine soaking treatmentPresription:山查20g, 附子 20g, 乾薑 25g, 细辛 20g, 生薑 50g, 荆芥 30g, 桂枝 30g, 红花 20g, 蘇葉 30g, 葱白 3 rootsThese were wrapped in 3-5 pieces of medical gauze and sewn up, then soaked in a sand pot with cold water for 30-40 minutes to allow the medication to permeate. After that, the herbs were boiled over high heat for 50 minutes to 1 hour. The prepared liquid was then poured into a basin for steaming the affected area. When the liquid temperature reached approximately 45°C, it was used to wash the frostbitten area, reheating as necessary. The treatment was performed twice daily for 40 minutes each session over a total of 7 days. | 7days | None |
| Yi C et al/199822) | External Preparation | External application(云南白药+与盐酸山莨菪碱)First, soak the affected area in warm water for 5-6min. For cases with ulceration, rinse the affected area repeatedly with warm sterile saline. Then, mix 4g of 云南白药 with 10mg of 与盐酸山莨菪碱(Anisodamini; an alkaloid compound derived from the plant Anisodus 山莨菪) and 10ml of 75% alcohol to form a paste. Apply an appropriate amount of the prepared paste evenly to the frostbite area and cover it with sterile gauze. Change the dressing once a day until healed. During the treatment, keep warm. | 1-8days | No mention |
| Song C et al/199523) | External Preparation | External preparation (Traditional Chinese Medicine solution: 乳香 15g, 没药 15g, 龍骨 50g, 儿茶 50g, 血竭 20g, 冰片 20g)Preparation: Grind the above ingredients into a fine powder and sift.Mix the powder with an appropriate amount of petroleum jelly to create the ointment.Application: Disinfect the frostbitten area as usual. Apply the ointment and wrap the area with sterile gauze, ensuring the gauze covers a larger area than the wound. Change the dressing every 16 hours. | 4-10days(Mean: 7d) | No mention |
| Liu X/199524) | External Preparation | External preparation (Traditional Chinese Medicine solution: 生川乌 50g, 生草乌 50g，桂枝 50g，芒硝 40g，细辛 30g，红花 20g，樟脑 15g，60% ethanol 1000㎖)Preparation: Coarsely grind the 生川乌 50g, 生草乌 50g，桂枝 50g，细辛 30g，红花 20g. Mix the powders with 芒硝 40g and 樟脑 15g, then immerse them in ethanol. Seal the mixture and let it steep for 7days, then filter the solution for use.Application: Use a cotton swab to apply the solution to the affected area. For cases with ulcers or secondary infections, follow surgical infection management protocols.Massage the area gently while applying the solution, three times a day—morning, noon, and evening. Continue treatment for 1 week or until symptoms subside. | 3-7days(Mean: 5d) | No mention |
| Chai J et al/201110) | AcupunctureHeatsensitiveMoxibustion | [E]Combination of Acupuncture and Cupping on Back-Shu Points with Heat sensitive moxibustion1. Acupucture & Fire Cupping:① Acupuncture Point Selection: 背俞穴 of 五脏俞and 膈俞(BL17) were selected for all cases.② Procedure: Patients were placed in a prone position with their whole body relaxed, and the acupuncture points were located. A disposable sterile acupuncture needle (0.25㎜ × 40㎜) was selected, and the needle was held in place by supporting the skin with the ring and little fingers. The needle was then inserted using a twisting technique to a depth of 0.8–1.5㎝, at which point patients experienced a significant sensation of "得气" (arrival of qi). Needle insertion was stopped at this point, and a fire cup was applied to the needle, leaving the needle and cup in place for 20 minutes.③ Treatment Period: This treatment was performed once daily. After one week, it was applied every other day, with continuous treatment for four weeks.2. Heat sensitive moxibustion:① Heat sensitive points Selection: Heat sensitive points were located on the arms (from the dorsal wrist crease to the lateral elbow crease), on the legs (between the lateral malleolus and the fibular head), and behind the ears.② Procedure: 回旋灸 was performed, followed by 雀啄灸 to increase the intensity and activate qi along the meridians. 溫和灸 was applied to each heat-sensitive point until sensations of penetrating and spreading heat were observed.③ Treatment Period: This treatment was administered every other day. After one week, a two-day break was given, and treatment resumed. During weeks 2–4, moxibustion was applied twice per week.*回旋灸: A type of hanging moxibustion (懸起灸), where moxibustion is applied by holding the moxa stick by hand.*雀啄灸: This method involves rolling moxa into a thick, cigar-like shape, lighting one end, and then bringing it close to and away from the acupoint repeatedly to apply heat to the area.*溫和灸: This moxibustion technique involves holding a lit moxa stick about 1 inch above the skin surface of the treatment area, providing just enough warmth for a heating sensation without causing discomfort.[C]Ointment for frosbite(manufactured by Hubei Ketian Pharmaceutical Co., Ltd., with national drug approval number H42020886): external application, applied four times daily. | 3years | None |
| Norheim A et al/201826) | Acupuncture | Acupuncture八邪(EX-UE9), 太衝(LR3), 合谷(LI4), (百會(GV20), 印堂(EX-HN3)) → 復溜(KI7), 足三里(ST36)Acupuncture Points for Circulation: 八邪(EX-UE9), 太衝(LR3), 合谷(LI4)Additional Points for Cold Sensation: 復溜(KI7), 足三里(ST36)Frequency: Weekly for 12 weeks (12 sessions).Initial Points (TCM Consultation): 百會(GV20), 印堂(EX-HN3)Adjustment:百會(GV20), 印堂(EX-HN3) replaced with 復溜(KI7), 足三里(ST36) due to post-treatment feeling of "being low." | 84days | None |
| Ha SJ et al/20242) | AcupuctureBloodlettingMoxibustionHerbal MedicineExternalPreparation | AcupunctureLocal acupoints : around the injured area at intervals of 0.3㎝ and distally related acupoints on the lower and upper extremities.Major distal acupuncture points : 合谷(LI4), 後谿(SI3), 陽谿(LI5), 陽池(TE4), 腕骨(SI5), 大陵(PC7), 內關(PC6), 外關(TE5), 曲池(LI11), 手三里(LI10), 三陰交(SP6), 崑崙(BL60), 太谿(KI3), 太衝(LR3), 血海(SP10), 丘墟(GB40), 足三里(ST36).The duration and pecifications of the acupuncture needle changed as the tissues recovered and sensation was restored.Bloodletting: using a lancet or needle at three points along the border of the injury until spontaneous bleeding stopped, with up to 10㏄ of blood collected at each point.Direct moxibustion : three sheets of moxa placed at intervals of 0.5㎝ around the border.Herbal medicine: Danggwisayeokgaohsuyusaenggang-tang(當歸四逆加吳茱萸生薑湯), which consists of Angelicae Gigantis Radix, Cinnamomi Ramulus, Paeoniae Radix, Akebiae Caulis, Asiasari Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Evodiae Fructus, Zizyphi Fructus, Zingiberis Rhizoma. Two doses of 120t㏄External Preparation: Jaungo (紫雲膏), made from Lithospermi Radix and Angelicae Gigantis Radix, was used for dressing. | 53days,78days,91days | 1 case: None/ 2 case: Analgesic, antibiotics |
| Xia H/201814) | Heat sensitive Moxibustion | Moxibustion: Heat sensitive moxibustion at auricular pointsHeat sensitive moxibustion at auricular points after kindling common moxaThe patient is positioned in either a supine or seated position. Two or four moxa sticks are used, with two sticks grouped together. After igniting, they are applied to the lower segment of the antihelix and/or the notch between the earlobe and tragus. During the moxibustion process, the technique and position should be adjusted as needed.*When applied to the lower segment of the antihelix, the sensation of warmth may radiate to the same-side face, neck, shoulder, and upper arm, and along the entire spine down to the sacral region.*When applied to the notch near the earlobe, the warm sensation may spread along the outer side of the same or opposite upper limb down to the first and second fingers or throughout all five fingers of the hand. The sensation felt during moxibustion is characterized by the conduction of heat.The duration and dosage of moxibustion are based on completing the four-phase process of sensation conduction, typically taking about one hour. | 7days | None |
| Wang Z/200916) | TDP therapyBloodletting | TDP therapy: Irradiate the affected area with a TDP therapy lamp for 15-20 minutes until it becomes congested and reddened.锋钩针 Bloodletting: Soak the tip of 锋钩针 in 75% alcohol for 15-20 minutes. After standard disinfection of the frostbite area, the physician quickly puncture the frostbite center and surrounding areas with 1 to 4 insertions, depending on the size of the affected area.After needle withdrawal, the affected area is gently compressed to induce bleeding from the puncture site. The process continues until the blood changes from a dark red to a bright red color.Treatment is performed every other day, with one treatment course consisting of seven sessions. The results are observed after completing one course | 14days | No mention |
| Tang Y/200617) | BloodlettingHerbal Medicine | Grade 1: 三棱针 BloodlettingAt the frostbite area using a three-edged needle(三棱针), with a bloodletting volume of approximately 0.2–0.3㎖once per day.Grade 2: 三棱针 Bloodletting +Herbal medicineHerbal medicine: 毛冬青 30g, 當歸 20g, 乳香 15g, 没药 15g, 路路通 10g, 细辛 3g, 甘草 5g*Dosages should be adjusted for minors accordingly. For upper body conditions: Add 川芎 10g, 桂枝 10g. For lower body conditions: Add 牛膝 12g. For symptoms of heat toxins: Add 黄柏 10g, 金银花 20g | 3-9days | No mention |
| Wang D/201925) | Bee Venom Therapy | Bee Venom TherapyThe small toe was treated by scattering bee needles at the acupoint, administered once every two days. After the patient adjusted, a direct bee needle insertion method was adopted, using 解溪, 通谷, 公孙, 商丘, 三阴交. After three treatments with bee needle stings, he reported a warm sensation in the affected area and achieved full recovery. | 6days | No mention |