Diabetes mellitus has become a common disease in modern society. It is prone to various co-morbidities and complications, which seriously affect the physical and mental health and quality of life of patients, and has attracted increasing attention. Over the years, we have applied the blood circulation method to treat the complications of diabetes mellitus and received good results [1]. The following examples are reported today.
1. Unstable angina pectoris.
Chen X, female, 68 years old, diabetic coronary artery disease for 6 years, applied Novocain treatment for 3 years. In the past 7 days, he had paroxysmal stabbing pain in the precordial region, with 3-5 episodes per day for several minutes each time, and was diagnosed as unstable angina in the Department of Cardiology. He had been treated with nitroglycerin, anti-cardiac pain, pansentin, aspirin, and cardiac blood. The symptoms did not abate, and he developed subcutaneous purpura and blood in urine, and came to TCM on December 6, 2006. His fasting blood glucose was 8.3 mmol/L, blood pressure was 150/90 mmhg, and his tongue was purple and red, and his veins were knotted… He was diagnosed with aching heart pain and stasis in the heart ligament. The proposed treatment is to invigorate blood circulation, remove blood stasis, and relieve pain. Herbs: 30g each of Salvia miltiorrhiza and Radix et Rhizoma root, 6g of Glycyrrhiza glabra, 15g each of Radix et Rhizoma Chuanxiong, Radix et Rhizoma rawhide, Radix et Rhizoma Puerariae, 10g each of Peach kernel, Safflower, Glycyrrhiza glabra, Sandalwood and Yujin. Decoction with water, 1 dose daily. After three days, angina did not occur and subcutaneous purpura had disappeared; continued with 5 doses, rechecked electrocardiogram and urinary routine were normal. He continued to take insulin and oral Tongxinluo pills for follow-up. The condition was stable at the recent follow-up.
According to: the application of insulin therapy for diabetes mellitus, the hypoglycemic effect is confirmed, but it does not prevent the occurrence of cardiovascular and cerebrovascular complications, which become the primary cause of disability and death. Therefore, modern medicine considers diabetes mellitus as a cardiovascular and cerebrovascular disease of equal risk [2]. Application of nitroglycerin, pansentin, aspirin, etc. can easily trigger bleeding conditions. According to the theory of Ye Tiantu’s long-standing disease into the ligament, the treatment starts from activating blood circulation and removing blood stasis, which can improve the blood supply to the heart muscle; pass the ligament to relieve pain, which can also eliminate angina; change the blood rheology, and subcutaneous purpura and blood in urine can be cured without treatment. Then he was cured with Tongxinluo Gum Pills, and no attack was seen for a long time. It shows the advantages of Chinese medicine complex theory in treating diabetic cardiovascular and cerebrovascular combined diseases and complications, which is worth summarizing and promoting.
2. Cerebral infarction with cerebral hemorrhage.
Li X, male, 73 years old, with diabetes mellitus and hypertension for 10 years, was treated with intermittent medication. He was admitted to a hospital due to headache and vomiting and right limb hemiparesis, diagnosed as cerebral infarction with cerebral hemorrhage for half a month, and was unable to operate. He was diagnosed with cerebral infarction with cerebral hemorrhage treatment for half a month, and could not be operated. He was given Novaline 30R morning and evening injection and Lodinexin 10mg once a day to lower blood pressure, and Chinese herbal medicine to activate blood circulation and remove blood stasis, and to promote blood circulation and relieve wind. Herbs: Salvia miltiorrhiza, Radix et Rhizoma, Silphium, Pueraria Mirifica, Radix et Rhizoma, Radix et Rhizoma, Rhizoma Dioscoreae, Rhizoma Peach, Rhizoma Rhei, Radix Scutellariae, Radix leech, Radix Bupleurum, 30g each, decoction in water, once a day, and combined with acupuncture therapy. After seven days, fasting blood sugar was 7.1mmol/L, blood pressure was 140/75mmhg, speech was fluent, muscle strength of right lower limb was grade 3, walking support was available, bowel movement was favorable, and symptoms were further improved after half a month. 1 month later, he could take care of himself, blood sugar and blood pressure were stable, and continued treatment with Novolin, Lodinxin and Tongxinluo pills. At present, the situation has further improved.
Press: Cerebrovascular accident is a common complication of diabetes mellitus, also most likely to cause disability and death. Modern medicine divides them into two categories: ischemic and hemorrhagic strokes, which are treated by thrombolysis or hemostasis respectively. This patient had a mixed stroke and thrombolysis needs to be performed within 6 hours to be effective [3]. Moreover, the combination of bleeding makes it inappropriate. Hemostasis is not in line with the treatment principles. Surgery and has some risks. Chinese medicine activates blood circulation, which is neither bleeding-causing nor aggravating embolism, and with acupuncture, hypoglycemia and hypotension, the comprehensive treatment is effective.
3, peripheral neuropathy.
Liu X, male, 63 years old, diabetes mellitus for 8 years, taking glipizide, bysynthesis and other treatments. In the past six months, he had numbness and pain in both lower limbs, and was sleepless at night. He used methylcobalamin, vitamin B12, diazepam and phenazopyridine, but his symptoms did not decrease. Diagnosis of paralysis of thirst and deficiency. Herbs: Salvia miltiorrhiza, Radix Paeoniae Alba, Rhizoma Chuanxiong, Radix Puerariae Ligustici, Radix Cinnamomi, Radix Angelicae Sinensis, Radix et Rhizoma Dioscoreae, Radix leeches, Radix Rehmanniae each 15g, Radix Achyranthes bidentatae, Radix lockorum each 10g, Centipede 1. After 7 days, the blood glucose was 6.6 mmol/L immediately and 8.3 mmol/L after meal, and the numbness and pain of both lower limbs were reduced.
The diabetic disease was complicated by peripheral neuropathy, and the effect of nerve-nourishing agents and analgesics is not good in Western medicine [4]. The Chinese medicine identified the disease as a long-standing disease into the ligaments, Qi and blood blockage, and the evidence belongs to the paralysis of deficiency cold. The main treatment was with Danshen, Chuanxiong, Astragalus, Angelica, and Danggui, to activate blood circulation and resolve blood stasis; moreover, Gui Zhi and Lock Yang were used to warm Yang and tonify the kidney, and Centipede, Ling Xian, and Niubizi were used to promote the circulation.
4, retinopathy with hemorrhage and glaucoma.
Chen X, female, 68, diabetes mellitus for 6 years, intermittently treated with abstinence pills and metformin. In the past half month, she had a headache like splitting, nausea and vomiting, red eyes and blurred vision due to grief of losing her son, and was diagnosed with acute angle-closure glaucoma and retinopathy with a small amount of hemorrhage. On November 7, 2008, he came to TCM for treatment. He has a red tongue with yellow coating and a stringent pulse, and a fasting blood glucose of 13.6 mmol/L. He is suffering from Yin deficiency and Yang hyperactivity. Wood and fire interfered with the eyes. Oral hypoglycemic drugs were changed to glimepiride 2mgbid metformin 0.5tid, Chinese herbal medicine with white peony, asparagus, raw earth, elemental ginseng, oyster, tortoise shell, dragon bones, wood sorrel, Xia Ku Cao, dandruff, Gu Jing Zhu nourished yin and lowered fire, pacified liver and submerged yang, taking 3 days, symptoms remained. The treatment was changed to invigorate blood circulation and eliminate blood stasis, and pacify the sunset and open the ligaments. The medicine used Danshen, Radix et Rhizoma, Pueraria Mirifica, 15g each, Peach kernel, Safflower, Niubizi, Leech, Tribulus terrestris, Yujin, 10g each, Mother of Pearl, 60g. Three doses of headache stopped, eyes clear, fasting blood glucose decreased to 6.3mmol/L, ophthalmologic examination of intraocular pressure is normal, continue Glimepiride, Metformin and Tongxinluo pills treatment. Recently, he was followed up and his visual acuity improved.
Note: Ophthalmopathy is a common complication of diabetes mellitus and a major cause of diabetic blindness [5]. This patient had both glaucoma due to fundus vascular sclerosis and exudative hemorrhage. Western medicine was ineffective. Chinese medicine was first used to tonify Yin and lower fire, and to calm the liver and subdue Yang. The results were not satisfactory. The patient’s headache was stopped, the eyes were clear, and the vision was preserved, indicating that the treatment of diabetic ophthalmic complications by activating blood circulation and promoting blood circulation is promising.
5. Gout.
Huang X, male, 54 years old, with diabetes mellitus for 3 years, was treated with Damacell and metformin. In the past 1 month, he has been suffering from recurrent red, swollen and painful joints of both toes, and his blood uric acid is 510-1020 mmol/L. He has taken allopurinol, colchicine and fenpropathrin, but his symptoms are mild and severe. He came to TCM on June 18, 2003 due to leukopenia and severe gastrointestinal reactions. The tongue was purple and red, the coating was yellow and greasy, and the pulse was stringent and slippery. Proposed diagnosis: thirst and damp-heat paralysis. Treatment started with clearing heat and dampness, invigorating blood circulation. We used Danshen, Huangpai, Gentiana, Lingxian, Plantago ovata, 15 grams each of Oxalis, 30 grams each of Pueraria lobata, Shengdi, Silphium, 10 grams of Xu Changqing, 60 grams of gypsum, decoction in water, 1 dose daily. After 5 days, the redness, swelling, heat and pain in the joints disappeared, and the patient continued to take oral hypoglycemic drugs and intermittent activation of blood circulation and elimination of blood stasis soup. Recently, he was still taking oral glucose-lowering drugs and no further gout attack.
Note: Gout is also a common complication (co-morbidity) of diabetes mellitus. It is due to disorder of purine metabolism. The deposition of uric acid in the blood leads to swollen and painful joints, and even kidney stones and kidney failure. The side effects of Western medicines such as allopurinol, colchicine and antipyretic painkillers are more reactive and difficult for patients to tolerate. In Chinese medicine, dampness and heat are internalized, blocking blood vessels and meridians, so the treatment is to clear heat and dampness, activate blood and open the meridians, and achieve better results.
Discussion: Diabetes mellitus has various metabolic disorders, resulting in hyperglycemia, hyperlipidemia, hypertension, and hyperuricemia. It is easy to produce serious complications, which greatly affect the health and quality of life of patients. Studies have shown that the complications of diabetes mellitus are characterized by vasculopathy, and the development of lesions is consistent with the pathological processes of qi stagnation, blood stasis, fluid and phlegm condensation, loss of nourishment in the ligaments and veins, and stasis and toxin obstruction [6]. I have been engaged in clinical work for forty years, using blood activation, blood stasis and ligament nourishment throughout the treatment of various complications of diabetes mellitus, and received good results, indicating the scientific nature of the theoretical system of Chinese medicine ligament disease, and the practicality of clinical application, which is worth further summarizing and promoting the use.
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［5］ Liu Xinmin, Practical Endocrinology, Beijing, People’s Health Publishing House, 1997, 2nd edition, 325-3329.
［6］ Lou Jinli, Wang Qian, Zhang Yunling, et al. Study on the mechanism of cardiac and cerebral damage in type 2 diabetes mellitus, Journal of Beijing University of Traditional Chinese Medicine; 2009; 34-39.