Traditional Chinese medicine classifies diabetes mellitus in the category of “thirst disorders” in Chinese medicine, which is divided into upper, middle and lower extremes. The upper extremes are caused by heat and fluid injury in the lungs, and the treatment is reduced by the Thirst Dissipation Formula; the middle extremes are caused by heat in the stomach, and the treatment is reduced by Bai Hu Tang or Yu Nui Decoction; the lower extremes are divided into deficiency of kidney yin and deficiency of kidney yin and yang. If there is deficiency of kidney yin, Liu Wei Di Huang Wan is used, and if there is deficiency of both kidney yin and yang, Jin Qi Wan is used. However, using the above theories to treat diabetes in modern medicine is often difficult to achieve good results. The reason for this is that due to the advancement of modern treatment methods, the detection of diabetes has been greatly advanced, coupled with the emergence of hypoglycemic western drugs, especially the application of insulin, the symptoms of “three more” caused by elevated blood glucose are quickly controlled and the natural course of diabetes has changed greatly. As a result, the traditional theory of three eliminations cannot effectively guide the clinical treatment of diabetes.
In recent years, Prof. Tong Xiaolin of the Diabetes Branch of the Chinese Academy of Traditional Chinese Medicine (CACM) and others have re-understood modern diabetes and summarized the theory of Chinese medicine diagnosis and treatment of diabetes in accordance with modern disease characteristics. We have applied this theory to guide clinical practice and achieved good results. The theory is roughly as follows.
One: Diabetes mellitus is roughly divided into two categories according to fatness, i.e., obese type and wasting type.
There is a great difference between the two in terms of etiology, progression and treatment.
1. Obese diabetes mellitus (spleen disease)
Obese diabetes mellitus is characterized by obesity, and elevated blood sugar is often accompanied by dyslipidemia, elevated blood pressure, elevated blood uric acid and other metabolic disorders. The book “Su Wen – Theory of Strange Diseases” says: “This fatty disease is also caused by the fat, this person must eat a lot of sweet and fat. The fat makes the internal heat, and the sweet makes the middle full, so its gas overflows and turns into thirst.” The cause of the disease is long term over-eating of fatty and sweet food, alcoholic wine and roasted stems, and the disease is caused by (16) instantaneous suffering of the disease. The basic pathological mechanism is internal heat in the middle fullness, and the pathological center is in the stomach and intestines.
2, wasting diabetes mellitus (wasting disease)
In ancient times, it was called “wasting disease”. The “Spiritual Pivot – Five Changes” said: “If a person is good at wasting disease, how can we wait for it? Shao Yu replied: the five organs are soft and weak, good sickness and disease ……”, the onset is mostly related to genetic, physical, emotional and other factors. Weak endowment, spleen and kidney deficiency, liver yin deficiency, if long-term emotional stimulation, depression and anger into fire, then the development of the disease. The basic pathogenesis is spleen deficiency and stomach heat, and the pathology centers on the spleen and kidney.
2: The natural evolution of diabetes is divided into four stages: depression, heat, deficiency, and loss.
1. The stage of depression: representing the early stage of diabetes mellitus, most patients with obese diabetes mellitus (spleen disease) form six depressions of qi, blood, dampness, fire, phlegm and food, characterized by food depression, due to over-eating and less movement. If the patient eats too much, the grain and qi will be stagnant in the middle jiao, the stomach will take in too much, the spleen will not be able to transport enough, the earth will be congested, the wood will be depressed, the liver qi will be stagnant and not work, coupled with little movement, the whole body qi will be astringent and stagnant, the liver will not be drained, and the spleen will be offended by the stomach. The wasting type diabetes mellitus (elimination) patients because of the internal organs are soft and weak, the body’s regulatory ability is poor, manifesting wasting, depression, easy to external sensation.
2, heat evidence stage: obesity type diabetes disease mechanism for in full internal heat, that is, in full on the basis of the counter-generation of internal heat, the performance of a school of fire and heat, such as phlegm heat, damp heat, stomach heat, intestinal heat, liver heat, etc., of which the liver and stomach heat is most common, the typical performance of bitter mouth, irritability, good hunger, constipation, great thirst and lead to drink, etc..
3. Deficiency stage: The disease develops further, the fire and heat is not removed, the function of the internal organs continues to be hyperactive, the vital energy of the internal organs is dissipated, the functional activities of the internal organs, meridians and other tissues and organs are weak, the production and metabolism of qi, blood and fluid are impaired, in addition, the fire and heat burns the fluid, the dry heat hurts the yin, resulting in both qi and yin, and then yin and yang are lost, and yin and yang are deficient, while phlegm and blood stasis and other pathological products accumulate internally.
4, loss of evidence stage: the late stage of diabetes, all deficiencies gradually heavy, or because of the extreme deficiency and visceral damage, or because of long-term disease into the complex, the complex stasis vein loss, mainly in the complex loss and vein loss, based on the damage to the visceral organs.
Three: diabetes treatment method
1, bitter-acid system of sweet: bitter opposites for sweet, sweet for the taste of sugar, sweet in and for acid, bitter can be seasoned, bitter can drain heat, bitter can be firm yin, acid can astringent, acid to produce fluid, etc.. In short, bitter and acid together, with clearing Qi and astringent Yin, clear fire and firm Yin effect, used in all stages of diabetes.
2.Opening and clearing the heat: the core pathogenesis of obese diabetes mellitus is internal heat, so the treatment focuses on bitter cold to clear the internal heat, accompanied by pungent open to eliminate the central fullness, clinical treatment for liver and stomach heat and gastrointestinal heat, treatment to open and clear the stomach method and pass the internal organs to drain heat method.
3, regulate the stomach and intestines: long-term overeating, the spleen and stomach to transport weakened, resulting in fat, sweet and thick taste congestion gathered in the middle jiao, does not transform the essence, but the production of cream and turbidity, does not return to the right transformation, but the collection of dampness and phlegm, cream, phlegm and dampness congestion in the veins, blood flow is not conducive to stasis; cream, phlegm and dampness stasis further affect the operation of the qi. The atmosphere in the middle jiao does not turn, the whole body is disturbed, and the spleen and stomach rebel against each other, which can be seen clinically as vomiting, erratic, constipation, etc. The treatment regulates the stomach and intestines, including pungent opening and bitter lowering, eliminating the paste and lowering the turbidity, opening the internal organs and activating the blood.
4.Tonic deficiency and diarrhea: Applicable to diabetes mellitus for a long time, fire and heat consume qi, phlegm and heat injure yin and other deficiencies caused by the real, focus on the treatment of deficiency. It includes clearing heat and tonifying the spleen, clearing heat and benefiting qi, and dipping fire and nourishing yin.
5.Adjustment of deficiency: diabetes mellitus for a long time, heat and exhaustion, the first is the loss of qi and fluid, yin injury and fluid deficiency, long is the loss of yin and yang, and even the vital fire is insufficient, so must adjust the deficiency, including nourishing yin and moistening dryness, benefit qi and nourishing yin, yin and yang double tonic, warm tonic less fire, etc.
6, invigorate blood circulation: obesity type diabetes early that there is food depression as the precursor of blood depression, blood flow is not smooth, ligament stagnation, long ligament stasis, the late development of ligament stasis and ligament damage, while involving the veins and ligaments. Including pungent aroma to dredge the ligaments, remove blood stasis and pass the ligaments, break the blood and pass the ligaments, cool the blood and pass the ligaments, stop the blood and nourish the ligaments, and tonify the deficient ligaments.
7.Early pass the ligaments and pass the whole ligaments.