Diabetic peripheral neuropathy belongs to the category of “paralysis” (skin paralysis, muscle paralysis, tendon paralysis) in Chinese medicine. The pathogenesis of the disease is based on deficiency: deficiency of the spleen, kidney, yin and yang, and deficiency of liver and blood; the symptoms of the disease are based on blood stasis, phlegm, and dampness and heat. Diabetic peripheral neuropathy is clinically characterized by four main symptoms: coldness, numbness, pain, and impotence. The main pathogenesis is Qi deficiency, Yin deficiency and Yang deficiency, and Blood stasis and phlegm blocking the ligaments as the symptoms. The deficiency should be identified as the location of Qi deficiency, Yin deficiency and Yang deficiency; the reality should be identified as the difference between stasis and phlegm, but the deficiency with reality is always the most common. Treatment should be based on the premise of identifying and treating the deficiency and selecting the medicine, and selecting and adding the products to resolve the stasis and open the ligaments as appropriate, taking the meaning of “to open as a tonic” and “to open as a help”.
1.Qi deficiency and blood stasis type
Symptoms: numbness of hands and feet, such as ants, pain at the end of the limbs, mostly stabbing pain, mainly in the lower limbs, pain at night, less breath and lazy speech, fatigue, soreness and weakness of the waist and legs, or a white face, sweating and fearing the wind, easy to catch a cold, light purple tongue, or purple spots, thin white moss, sunken and astringent pulse.
Treatment: Tonifying Qi and invigorating Blood, resolving blood stasis and clearing paralysis.
Formula: Tonic Yang Returning Five Soup (“Medical Forest Reform”) plus and minus: Sang Astragalus 30g Radix Angelicae Sinensis 10g Rhizoma Chuanxiong 10g Radix Paeoniae Alba 10g Rhizoma Safflower 10g Di Long 12g.
2. Kidney Yin deficiency and Blood stasis type
Symptoms: numbness of the limbs, or burning pain at night, not close to the clothes, night sweats, spontaneous sweating, five hearts, soreness and weakness of the waist and knees, dry mouth, dry stools, dark red tongue with little or no moss, thin and astringent pulse.
Treatment: Tonifying the kidney, nourishing Yin and invigorating Blood.
Formula: Zhi Bai Di Huang Wan plus Tao Hong Si Wu Tang: Zhi Mu 10g Huang Bai 10g Sheng Di 30g Dan Pi 10g Fu Ling 15g Ze Di 10g Yam 10g Cornu 10g Tao Ren 10g Safflower 10g Angelica Sinensis 15g Chuan Xiong 10g Red Peony 15g
3. Kidney Yang deficiency and blood stasis type
Symptoms: numbness in the limbs, cold pain, coldness in the limbs, soreness and weakness of the waist and knees, or severe pain at night, light mouth, no thirst, poor bowel movements or loose stools, impotence and premature ejaculation, pale tongue, fat, thick or greasy moss, sunken or sluggish pulse.
Treatment: Tonifying the kidney, warming the Yang and activating the Blood.
Formula: Jin Kui Kidney Qi Pill plus Tao Hong Si Wu Tang: Radix et Rhizoma Polygonati 15g Gui Zhi 10g Sheng Di 30g Dan Pi 10g Fu Ling 15g Ze Di 10g Shan Yao 10g Shan Yu 10g Tao Ren 10g Safflower 10g Angelica Sinensis 15g Chuan Xiong 10g Red Peony 15g
4.Phlegm and stasis blocking the ligament type
Symptoms: numbness, often with a fixed place, feet like stepping on cotton, drowsy limbs, heavy head like a wrap, faintness, obesity, mucous and tasteless mouth, chest tightness and dullness, abdominal distension and discomfort, sticky stool, purple and dark tongue, fat tongue with teeth marks, white thick and greasy moss, sunken smooth or sunken astringent pulse.
Treatment: Expel phlegm, resolve blood stasis, promote paralysis and promote circulation.
Formulas: Finger Mist Poring Pill (Zizhi Zhuanzhi) combined with Huang Qi Gui Zhi Wu Wu Wu Wu Tang (Jin Kui Yao)
Treatment with proprietary Chinese medicine: Oral preparation: Jin Kui Kidney Qi Pills (water drops): 20 capsules per dose, 3 times daily. Suitable for neuropathy with cold and painful extremities and numbness due to deficiency of kidney yang; Blood-vitalizing and blood-ventilating capsule or blood-vitalizing and blood-ventilating tablet: 4 tablets per dose, 3 times daily, suitable for those with blood stasis obstruction, different tendons and veins, and numbness of extremities. Intravenous preparations: raw vein injection, ginseng and wheat injection, astragalus injection, hemosiderin injection, thromboxone injection, geranium injection, lantern flower injection, etc. Benefit qi, nourish yin and help correctness, invigorate blood stagnation, pass blood circulation and relieve pain. Or with physical therapy acupuncture and other treatment.
Drug external treatment.
Sugar pain external cleansing formula: 30g of transverse bone herb, 15g of cinnamon stick, 30g of mugwort leaf, 12g of papaya, 10g of sumac, 10g of safflower, 10g of dahurica, 10g of Chuanwu, 10g of grass wu. together into an enamel pot, add 5000ml of water and soak for 100-200 minutes, boil on a gentle fire, then boil for 30 minutes, after removing from the fire, first smoked hands and feet, when the temperature of the medicinal solution drops to 38℃~42℃, then put the hands and feet into the liquid and soak for 30 minutes.