Objective To explore the possible mechanism of Huiyang Shengji Ointment（ 回阳生肌膏） in promoting wound healing in patients of chronic skin ulcer with spleen and kidney yang deficiency syndrome. Methods A total of 20 patients with chronic skin ulcers with spleen and kidney yang deficiency syndrome were randomly divided into a treatment group of 34 cases and a control group of 36 cases. The treatment group was given Huiyang Shengji Ointment and the control group was treated with Mupirocin Ointment to cover the wound. The course of treatment was both 14 days. The central granulation and the secretion of the wound were extracted before treatment

on the 3 rd

7 th and 14 th day of the treatment. Immunohistochemistry was used to detect the number of macrophages in the wound tissue（ CD68 positive cells）

M1 macrophages [CD86

inducible nitric oxide synthase（ i-NOS） positive cells]

M2 macrophages [CD206

arginine（ Argi） positive cells]. The relative content of tumor necrosis factor-α（ TNF-α） and interleukin 10（ IL-10） secreted by macrophages in the wound was measured by ELISA. Results In the treatment group

the number of M1 macrophages（ CD86

i-NOS positive cells） and the relative content of TNF-α on the 7 th day of treatment was significantly increased compared with those before treatment（ P < 0. 05）. On the 14 th day of treatment

the number of M1 macrophages and the relative content of TNF-α were significantly reduced compared with those on the 7 th day of treatment

and the number of M2 macrophages（ CD206

Argi-positive cells） and the relative content of IL-10 were significantly increased compared with those before treatment（ P < 0. 05）. In the control group

the number of CD68

CD86

i-NOS positive cells and relative content of TNF-α on the 7 th day of treatment were significantly lower than those before treatment（ P < 0. 05）. On the 14 th day

the relative content of IL-10 was significantly lower than that before treatment（ P < 0. 05）. The number of CD68 positive cells and the relative content of TNF-a on the 3 rd

7 th and 14 th day of treatment

the number of CD86 and i-NOS positive cells on the 3 rd and 7 th day of treatment

the number of CD206 and Argi positive cells and the relative content of IL-10 on the 14 th day after treatment in the treatment group were significantly higher than those in the control group（ P < 0. 05）. Conclusion Huiyang Shengji Ointment promote wound healing in patients with chronic skin ulcer with spleen and kidney yang deficiency syndrome probably through promoting the secretion of macrophages and the transformed phenotype

and its effects are better than Mupirocin Ointment.