Diabetes is not new to us, we often hear our friends talk about it in daily life, so-and-so’s blood sugar is high again, and there is a plus sign in the urine, which means that he has diabetes. In the early stage of diabetes mellitus, the clinical manifestation is often more drinking, more food, more urination, but the body is getting thinner and thinner, which is what we often call “three more and one less”.
The earliest understanding of diabetes in Chinese medicine was as early as the 5th-4th centuries B.C. in the “Huangdi Neijing” called “Suwen”, with the names “elimination of thirst”, “lung elimination”, “elimination of the middle” and so on. As for the treatment, different physicians have often had different views throughout the ages.
Today, we are going to talk about how to treat diabetes with sutra prescriptions.
First of all, let’s talk about what is Jing Fang: Jing Fang, as defined in the dictionary, is a term of Chinese medicine, a generic term for ancient prescription books. In later times, it was referred to as “Jing Fang” (經方), as opposed to the “Current Formula” (時方) of the Song and Yuan Dynasties, which was written in Zhang Zhong Jing’s “Treatise on Typhoid Fever” and “Jin Kui Yao” in the Han Dynasty. The characteristics of sutra prescriptions are “concise in taste, precise in quantity, flexible in addition and reduction, and outstanding in efficacy”.
What are the advantages of sutra prescriptions in treating diabetes?
1, prevention and treatment of complications; as we all know, diabetes itself is not terrible, if the blood sugar control is normal, it can still prolong life, but once the complications of diabetes, often bring endless worries to our life and work, the sutra formula plus or minus has unique advantages in the prevention and treatment of diabetes complications.
2.Improve physical fitness; improve quality of life.
I studied sutra prescriptions with my supervisor, Prof. Chen Ming, at Beijing University of Traditional Chinese Medicine during my master’s degree, then I studied for my PhD in diabetic nephrology at Shanghai University of Traditional Chinese Medicine, and now I am studying with Prof. Feng Shilun, a great sutra practitioner, and I have gradually developed a series of dialectical ideas in the clinical application of sutra prescriptions for the treatment of diabetes.
How do we use sutra to treat diabetes?
First of all, let’s look at the etiology of diabetes. In fact, the development of any disease is caused by two factors: internal and external factors. The internal cause of diabetes is the congenital deficiency of endowment, which is called genetic predisposition in modern medicine; the external cause is closely related to the patient’s diet, life, and living, and “how to eat” is the key factor, and the pathogenesis is often considered to be heat in the interior, depleting Qi and injuring fluid. From these two points, I clinically identify the patient’s physique, that is, to observe whether the patient is obese or thin; on the other hand, by identifying the patient’s stool, to see whether he has diarrhea or constipation, to speculate whether there is something wrong with his “eating”.
The following are a few commonly used clinical formulas: Ge Gen Scutellaria Tang, Bai Hu Plus Ginseng Tang, Fu Ling Drink, Huang Qi Gui Zhi Wu Wu Wu Wu Tang, Da Chai Hu Tang, Li Zhong Tang, etc.
The first formula: Ge Gen Scutellaria Tang, Article 34 of the Treatise on Typhoid Fever, is used in treating solar diseases, with the evidence of Gui Zhi. Indications for this formula: Diabetes mellitus with red tongue, diarrhea, rapid heart rhythm; with strong pain in the collar and back, headache, or lumbar and leg pain, and general weakness; alcoholic. Physical requirements: strong body, strong muscles, obese tendency, unformed stools or diarrhea, red tongue. Middle-aged men, especially those who are socially active and under pressure at work are more often seen with this formula. In March, a patient was admitted to the hospital and said, “Doctor, I have been diabetic for 5 years, my blood sugar is still under control, I have panic attacks, my electrocardiogram indicates frequent ventricular premature; he also said I have been treated in a tertiary care hospital for half a year, but my diarrhea is not improving, through dialectical evidence, this patient has a strong body, hot hands and feet, dry mouth and cold drinks, sweating at times, which is exactly in line with Ge Gen Scutellaria Tang. This fits the indications for Ge Gen Scutellaria Tang. I then prescribed this prescription, adding 15 grams of bitter ginseng, and after five doses, the premature beats stopped and the diarrhea stopped. If the evil is on the surface, headache and body pain will occur; if the heat is on the inside, diarrhea will occur if the heat presses the large intestine, and if the heat disturbs the heart, panic and palpitations may occur. This formula uses Radix et Rhizoma Puerariae to relieve the surface, and Radix Scutellariae to clear the heat on the inside.
The second formula: Bai Hu plus Ginseng Tang, Article 26 of the Treatise on Typhoid Fever: After taking Gui Zhi Tang and sweating profusely, those who are greatly troubled and thirsty without relief, and whose pulse is large and flooded, Bai Hu plus Ginseng Tang is the mainstay. Indications for this formula: diabetes mellitus is seen with irritable thirst and excessive drinking, dry mouth and tongue, emaciation of the body, dry stools and easy sweating. Physical requirements: emaciation, less lustrous skin, thirst, dry tongue and dry stools. As early as 1958, ginseng was found to have a good hypoglycemic effect, and the effect of containing tablets is good; ginseng beard and ginseng root have the same effect; ginseng is the main medicine in the formula; for those with depressed spirit, sweating and asthma, and weak pulse, Jilin ginseng is the main medicine; for those with dry mouth and dry tongue, Western ginseng is suitable; for those with loss of appetite and emaciation, Party ginseng is suitable; for those with dry cough and dry stool, Sha Shen and Xuan Shen are available. This formula is commonly seen in patients with long duration of diabetes mellitus, who have been detained by heat for a long time, depleting their qi and injuring their fluids, gradually losing weight and having increasingly dry stools. Feng Lao likes to use gypsum in this formula, which is considered a good medicine for clearing heat and removing irritation. 45g is used every time for patients with dry mouth and tongue, and it can have a good effect of laxative.
Not all of the thin form, dry stools can be applied without thinking about this formula, but also see that there must be heat in the inside, depletion of qi and injury to the manifestation of fluid: thirsty and drink, dry mouth and tongue. There are some diabetic patients who do not have heat in the lining, but have cold deficiency in the lining, and for this pathology, I like to use this formula in clinical practice: Fu Ling Drink.
The third formula: Fu Ling Drink, “Jin Kui Essentials of Phlegm and Cough Disease”: Wai Tai Fu Ling Drink, treating the heart and chest between the stop phlegm and persistent water, since the vomiting of water, the heart and chest between the deficiency, full of gas can not eat, eliminate phlegm and water, so that you can eat. Indications for this formula: Diabetes mellitus is emaciated, cold hands and feet, coldness and heat, abdominal distention and fullness, poor appetite, dry stools. The pathogenesis is often the presence of drinking evil, Qi stagnation, Fu Ling, Atractylodes Macrocephalae to facilitate water, Chen Pi, Citrus Aurantium to eliminate distension, de-stuff the Qi, reuse raw Atractylodes Macrocephalae 30g to slow down the passage of stool, ginseng to benefit Qi, generate fluid and moisten dryness. Patient Li, female, with a history of diabetes mellitus for 15 years, had recurrent urinary tract infections, cold extremities, and wasting in the past year, and was treated with Chinese medicine for more than 1 year, and observed her previous medical prescriptions: most of the drugs for clearing heat and detoxification, diuresis and dampness; at the moment the symptoms were: dry stools, once every 2-3 days, coldness, weakness, poor appetite, four rebellious, frequent urinary urgency, sometimes cough, palpitations. Identification: Taiyin deficiency cold. After one month, the symptoms of urinary tract irritation were significantly relieved, and the stool was passed once a day, and is still being followed up.
The first recipe mentioned Ge Gen Scutellaria Tang for treating patients with a strong body and diarrhea, what recipe is used for a strong body and dry stool?
The fourth formula: Da Chai Hu Tang; the second formula, Bai Hu plus Ginseng Tang, treats patients with emaciation and dry stools.
The fifth formula: Li Zhong Tang.
The sixth formula: Huangqi Gui Zhi Wu Wu Wu Tang, “The Second Article of the Sixth Book of the Golden Horoscope”, blood paralysis Yin and Yang are both microscopic, the inch mouth shut on microscopic, small and medium tightness in the ulna, external evidence of the body is not benevolent, like wind paralysis, Huangqi Gui Zhi Wu Wu Wu Wu Tang is the mainstay. This formula is mainly applied to diabetic peripheral neuropathy, skin numbness and sensory disorders; may have local skin darkening, ulcers, etc.; often combined with complications of the heart, brain and kidneys. Physical requirements: the person is more fat, muscle relaxation, lack of elasticity of the skin, abdominal flaccidity; easy fatigue, dizziness, shortness of breath, especially when exercising, more weak; lower extremities are swollen, usually lack of exercise, although good appetite, the face is yellow and dark, also see dark red; the tongue is more light red or light fat, or purple and dark. This formula is composed of Gui Zhi Tang with Astragalus multiplying ginger. Ginger is the main herb, warming the middle and dispersing cold, stopping vomiting, warming the whole body after taking it, dispersing wind and cold, and promoting blood paralysis. Prof. Huang Huang, a professor of Sutra at Nanjing University of Traditional Chinese Medicine, called this formula “a vascular neuromuscular nutrient for diabetic patients”. In clinical practice, we often apply this formula in combination with Paeonia lactiflora and Glycyrrhiza glabra to treat patients with diabetic vascular nerve muscle damage, often with unexpected results.
Peripheral neuropathy with Huang Qi Gui Zhi Wu Wu Tang, the main treatment of muscle relaxation, lack of elasticity of the skin, abdominal pressed flabby, often weakness and shortness of breath in people with deficiency; diabetes has another most troublesome complication, and also the specialty I have been studying for many years, diabetes combined with nephropathy, and there are many scripture prescriptions for the treatment of diabetic nephropathy, today I only recommend one prescription, Eight Flavors Kidney Qi Pill, and Huang Qi Gui Zhi Wu Wu Wu Wu Tang together called the treatment of Diabetic nephropathy edema is a good prescription.