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Acupuncture Today
January, 2008, Vol. 09, Issue 01
 
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The Treatment of 58 Cases of Type 2 Diabetes Combining Chinese and Western Medicine

By Michael Johnston, LAc

In the April 2006 issue of Shi Yong Zhong Yi Nei Ke Za Zhi (Journal of Practical Traditional Chinese Internal Medicine), Xiang, et al., published an article titled "The treatment of 58 cases of type 2 diabetes combining Chinese and Western medicine." A summary of this article is presented below:

Cohort Description

According to the 1985 WHO diagnostic criteria for Type 2 diabetes, 58 cases with a definitive diagnosis of Type 2 diabetes were selected from our hospital ward.

Among them, 25 cases were male, 33 were female; six cases were 30-40 years old, 12 cases were 41-50 years old, 16 cases were 51-60 years old and 24 cases were over age 61. In 18 cases there was concomitant hypertension; in 17 cases there was coronary heart disease; in 8 cases there was hyperlipidemia; in six cases there was brain infarction; and in three cases there were cataracts. In some patients two or more complications were clear. The shortest course of disease was six months; the longest was 15 years.

Treatment Method

Zi Ni Yi Qi Yang Yin Hua Yu Tang (Boost One's Qi, Nourish Yin and Transform Blood Stasis Decoction)

  • huang qi (Radix astragali membranacei) 50g
  • shan yao (Radix dioscoreae oppositae) 30g
  • bai zhu (Rhizoma atractylodis macrocephalae) 15g
  • sheng di (Radix rehmanniae) 15g
  • shan yu rou (Fructus corni officinalis) 12g
  • mai dong (Tuber ophiopogonis japonici) 12g
  • dan shen (Radix salvia miltiorrhizae) 30g
  • dang gui (Radix angelicae sinensis) 10g
  • chi shao (Radix rubrus paeoniae lactiflorae) 12g
  • yi mu cao (Herba leonuri heterophylli) 12g

If there is large intake of fluids, add tian hua fen (Radix trichosanthis kirlowii) and ge gen (Radix puerariae). With a large intake of food, add huang lian (Rhizoma coptidis chinensis) and zhi mu (Rhizoma anemarrhenae aspheloidis). With polyuria, add fu pen zi (Fructus rubi chingii) and sha yuan zi (Semen astragali complanati). With edema or albuminuria, add ze xie (Rhizoma alismatis) and bai hua she she cao (Agkistrodon seu bungarus). With skin infection, add di ding cao (Radice violae yedoensitis) and lian qiao (Fructus forsythiae suspensae). With visual obstruction, add gou qi zi (Fructus lycii) and bai ju hua (Flos chrysanthemi morilolii). With hypertension, add xia ku cao (Spica prunellae vulgaris) and gou teng (Ramulus uncariae cum uncis). With coronary heart disease, add chuan xiong (Radix ligustici wallichii) and san qi (Radix pseudoginseng). With hyperlipidemia, add ji nei jin (Endothelium corneum gigeriae galli), sheng shan zha (Fructus crataegi) and ze xie (Rhizoma alismatis). With brain infarction, add shui zhi (Hirudo) and quan xie (Buthus martensis).

Decoct with water. Take one dose daily; divide the juice and take once in the morning and once in the evening. One month is equal to one course of treatment.

Western Medicine

According to the patient's condition, select hypoglycemic agents glipizide (Glucotrol) or metformin hydrochloride (Glucophage). Control diet and do suitable exercises.

Study Outcomes

A marked effect was defined as the main symptoms vanishing, blood sugar <7.2mmol/L on an empty stomach, blood sugar <8.3mmol/L two hours after eating, or if the blood sugar fell by more than 30 percent compared to pre-treatment levels. No effect was defined as: after the treatment, the symptoms did not improve; or blood sugar did not fall or did not reach the levels of effectiveness, based on the standard criteria. Among 58 cases, nine cases were cured, 43 cases improved and five cases showed no effect. The efficacy rate was 91.38 percent.

Discussion

Diabetes belongs to TCM's "wasting and thirsting" category. In the initial stages excessive thirst, hunger, urination and emaciation are its clinical features. TCM believes constitution; external contraction of toxic evil; overeating rich, greasy, fatty and sweet food; excessive work and desire; internal emotional injury, etc. have a bearing on its occurrence. Furthermore, vacuity is the crux of diabetes and ultimately diabetes results in blood stasis.

Yin-essence depletion, dryness-heat exuberance, yin-vacuity internal heat and internal heat lead to yin damage. In the course of time, there is wasting and thirsting. Yin and qi are both damaged and qi and blood vacuity lead to feeble blood movement. Furthermore, slow blood flow results in blood stasis; yin depletion can't transport blood, which dries up and easily develops blood stasis.

Consequently, yin vacuity, qi vacuity and blood stasis are diabetes' key disease mechanisms. In connection with diabetes, qi and yin, dual vacuity's pathomechanism relies on the characteristics of blood stasis' pathomechanism. The treatment principle is to boost qi, nourish yin and transform blood stasis.

In the prescription Zi Ni Yi Qi Yang Yin Hua Yu Tang (Boost One's Qi, Nourish Yin and Transform Blood Stasis Decoction), huang qi (Radix astragali membranacei), bai zhu (Rhizoma atractylodis macrocephalae) and shan yao (Radix dioscoreae oppositae) boost qi, nourish yin and fortify the spleen. Sheng di (Radix rehmanniae), shan yu rou (Fructus corni officinalis) and mai dong (Tuber ophiopogonis japonici) provide a reduction in insulin resistance, promote ß-cell aptitude for repair and strengthens an organism's insulin-activation function. Dan shen (Radix salviae miltiorrhizae), dang gui (Radix angelicae sinensis), chi shao (Radix rubrus paeoniae lactiflorae) and yi mu cao (Herba leonuri heterophylli) quicken blood, transform blood stasis and free the vessels.

Furthermore, studies on quickening blood and transforming blood stasis showed evidence that the method should improve circulation, increase blood flow and soften fibrous tissue. Later studies showed aspects of the extraordinary action of correcting blood flow. Various medicinals are fit for boosting qi and nourishing yin, quickening blood and transforming blood stasis. For the time being, combine Western medicine's treatment using hypoglycemic agents with Chinese medicine. Thus, treating both the root cause and the symptoms of the disease gives satisfying results.

 

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