Objective To study the efficacy of physique differentiation combined with syndrome differentiation for venous insufficiency. Methods Totally 438 cases of venous insufficiency were divided into the Chinese medicine group（ 123 cases） and western medicine group（ 315 cases） according to the intention of patients. Physical identification was conducted in the Chinese medicine group. The patients with obvious biased physique were given basic formula according to physique differentiation. The patients without obvious biased physique or with placid constitution were treated on the basis of syndrome differentiation. According to the Clinical-Etiology-Anatomy-Pathophysiology（ CEAP） classification

C0- C3 patients in the western medicine group were orally taken Melilotus Extract Tablets or Diosmin Tablets

C4- C5 patients were orally taken Maixuekang Capsules or Ginkgo biloba Dripping Pills

and C6 patients were orally taken or intravenously infused antibiotics. The CEAP classification of patients with different physique and syndrome was observed in the Chinese medicine group. The Venous Clinical Severity Score（ VCSS） was compared before and after treatment in both groups. Results The patients in the Chinese medicine group were mainly with blood deficiency physique. The C2- C6 patients were mainly with blood deficiency physique

qi deficiency physique

blood deficiency physique

blood deficiency physique or yin deficiency physique and intense heat physique in turn. Totally 77 patients were classified by TCM syndromes. The common TCM syndromes were dampness-heat flowing downward and blood-deficiency wind-dryness. The common TCM syndromes in C2- C6 patients were dampness-heat flowing downward

liver（ qi） stagnation transforming into fire

blood-deficiency wind-dryness

blood-deficiency wind-dryness and dampness-heat flowing downward in turn. There were significant differences between before and after treatment in VCSS in both groups（ P < 0. 01）. Comparing with the same level in western medicine group

the VCSS of C4- C6 patients were significantly decreased in the Chinese medicine group（ P < 0. 05 or P < 0. 01）. Conclusion The treatment of physique differentiation combined with syndrome differentiation can effectively relieve the symptoms in venous insufficiency patients

especially in C4- C6 patients.