Experiences of famous Chinese medical practitioners in the treatment of diabetes mellitus by activating blood circulation and resolving blood stasis.
Zhu Chen Yu.
1. emphasizes the combination of disease identification and evidence identification, and believes that diabetes belongs to the category of thirst in TCM, but is not equivalent.
2. He pioneered the treatment of diabetes mellitus by activating blood circulation and resolving blood stasis, believing that blood stasis in diabetes mellitus is mainly caused by deficiency of both qi and yin. Self-designed formula for lowering sugar and invigorating blood.
Astragalus membranaceus, Atractylodes macrocephala, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix et Rhizoma Ligustici, Radix et Rhizoma Ligustici
Yin Huihe: The main method is to reduce heat and fire, benefit Qi and nourish Yin, and invigorate blood stasis.
Zhao Qing: Emphasis on the treatment of blood stasis in diabetes mellitus.
Many diabetic patients often have elevated blood lipids and cholesterol along with elevated blood glucose, resulting in hypercoagulation of blood, slow blood flow, or even stasis of blood, which is considered “blood stasis” in Chinese medicine.
Lv Jingzhong.
1. Spleen deficiency is the key to the pathogenesis of diabetes mellitus, and treatment of the spleen should be the main focus.
2. The long duration of diabetes and the rise of many complications are mainly related to the prevalence of blood stasis in diabetes, which is caused by the deficiency of both Qi and Yin.
3. If insulin resistance is present and insulin dosage is high, the use of high-dose blood-stasis activators can enhance insulin sensitivity and reduce insulin dosage.
Ren Jixue: thirst disease for a long time, it is inevitable that the original element is greatly injured, the signs of deficiency overlap, deficiency of Qi is weak in transporting blood, deficiency of Yin is hard and astringent blood flow. The more deficient the blood is, the more stagnant it is, and the more stagnant it is, the more deficient it is, which is the cause and effect of each other. Therefore, if the stagnant blood does not work, the new blood will not be born, and in order to achieve new life, we must first push the old. He is good at using saffron, herb saffron, hen’s-eye gold, wine rhubarb, yujin, danshen, blood dried, peony bark and other flavors, often using two or three flavors flexibly added to the identification and treatment of thirst, and repeatedly obtained good results, and the method of invigorating blood stasis and generating new blood as a common method of treating thirst.
Chen Jinzhuo: Although Yin deficiency and dry heat is the basic pathogenesis of diabetes mellitus, geriatric diabetes mellitus has the dual special characteristics of the elderly and diabetes mellitus, so its main pathological link lies in the deficiency of both spleen and kidney and the blockage of phlegm and stagnation. Therefore, treatment attaches importance to tonifying the kidneys and strengthening the spleen, activating blood stasis, resolving phlegm and clearing heat, and is not confined to the method of nourishing Yin and clearing heat.
Liu Qiting: Blood stasis is present throughout the course of diabetes. In clinical treatment, we should not forget to invigorate the blood at all times, and often choose among the blood-stasis invigorating drugs such as wine rhubarb, yujin, danpi, safflower, xuan ginseng, henna, leech, motherwort and danshen. According to the characteristics of the pathogenesis of diabetes at different times and the patient’s constitution, the treatment is based on evidence, either to benefit Qi and invigorate Blood, or to nourish Yin and invigorate Blood, or to warm Yang and invigorate Blood, or to dispel phlegm and invigorate Blood, which has been tried and tested repeatedly, and has significantly reduced the development of diabetic complications.
Wang Zili.
1. focusing on tonifying the kidneys is the basic principle in the treatment of diabetes mellitus.
2. attaching importance to strengthening the spleen is the main link in the treatment of diabetes mellitus.
3. There are not only tangible stasis in diabetes, but also invisible stasis. Therefore, generally, on the basis of evidence-based treatment, 1~3 drugs are used for each type to invigorate blood circulation and resolve blood stasis, such as: Salvia miltiorrhiza, Radix Paeoniae, Chuanxiong, Dilong, Safflower, Dampi, etc. Especially for those who have complications, the dosage of blood activating and stasis removing drugs can be increased to receive satisfactory results.
Xiong Manqi: Stasis and heat intermingling in the lining is one of the characteristics of the pathogenesis of type II diabetes.
When hyperglycemia is not controlled, type II diabetic patients often have symptoms of excessive drinking, polyphagia, polyuria, dry stool and constipation, and the “three more” and constipation often appear at the same time, and the degree of constipation is related to the severity of the disease, and most of them are caused by stomach heat and intestinal dryness.
2. Blood stasis is a common pathological product of diabetes, and is an important mechanism affecting the development of diabetes. Type II diabetes mellitus is a chronic lifelong disease, and prolonged illness is bound to stasis; when patients do not have obvious complications, their tongue, sublingual veins, blood rheology and microcirculation already show signs of stasis; and patients with multiple chronic comorbidities mostly have obvious signs of stasis.
3.Specific treatment.
Early stage: to exorcise heat and expel blood stasis – Peach Kernel Cheng Qi Tang with flavour
(after the next) rhubarb 10~15 peach kernel 12 raw earth 24 licorice 3 (punch) mannitol 10 gui Zhi 6 xuan Shen
Middle to late stage: Benefiting Qi, nourishing Yin, invigorating Blood, supplemented with diarrhea and heat to clear the lower part of the body – Peach Nucleus Cheng Qi Tang with added flavor
Radix Astragali 30, Rhubarb 6~10, Peach kernel 12, Radix Rehmanniae 24, Glycyrrhiza glabra 3, Maldonate 12, (punch) Mannitol 3~6, Gui Zhi 9, Radix et Rhizoma Ginseng
Diabetes mellitus is a systemic chronic metabolic disease that is genetically determined and is associated with infections, obesity and other factors that promote its clinical signs of hyperglycemia, hyperlipidemia and hyperviscosity.
Modern pathological and anatomical studies: about 1/3 of diabetic patients have no pathological and anatomical changes in the pancreas. In the cases of changes, fibrous hyperplasia or hyaline degeneration of islet tissue or stasis of pancreatic tissue caused by atherosclerosis are seen. About 70% of patients die from cardiovascular and cerebrovascular complications. The physiopathological basis of diabetic blood stasis evidence is illustrated from the perspective of modern medicine.
Summary.
The significance of activating blood stasis in diabetes mellitus: to prevent or treat various complications; a common pathological mechanism in the middle and late stages of the disease, so it becomes the basic treatment for this period; early application can improve the efficacy and promote the production of new blood; as one of the basic treatments throughout the whole course of diabetes mellitus.
Commonly used drugs for activating blood circulation and eliminating blood stasis: Salvia miltiorrhiza, rhubarb, red peony, peach kernel, panax notoginseng, cow’s knee, Chuanxiong, motherwort, tannin, Zeilan, chicken blood vine, etc.