A case of diabetic vegetative neuropathy with gastric gangrene treated with the treatment method of harmonizing the spleen and stomach and regulating qi and activating blood Feng, Moumou, female, 58 years old, Dongguan, Tongzhou District, Beijing. Initially diagnosed on September 15, 1998. The patient has a history of diabetes mellitus and has been taking western hypoglycemic drugs for a long time with unsatisfactory glycemic control. In the past six months, she developed headache, and was suffering from gastric distension and fullness, fullness after eating, irregular bowel movement, dark tongue, greasy tongue coating, thin and stringent pulse, urine glucose +1, postprandial blood glucose 10.5 mmol/L. The diagnosis is that the spleen and stomach are not in harmony, Qi stagnation and blood stasis, the treatment is to harmonize the spleen and stomach, regulate Qi and activate blood, and the formula is Xiang Su San with added flavor. Prescription: Aromatic Herb 10 g, Su Stem 6 g, Chen Pi 6 g, Citrus Aurantium 10 g, Citron 6 g, Fructus 6 g, Roasted Licorice 6 g, Atractylodes Macrocephala 25 g, Poria 15 g, Chuanxiong 15 g, Weimei 15 g, Lychee Kernel 15 g, Pueraria Mirifica 25 g, Salviae 15 g. 7 doses. Second diagnosis: October 13, 1998. After taking the medicine, the distention and fullness of the stomach disappeared, headache significantly improved, stool once a day. Stopped using Chinese medicine. Third consultation: November 17, 1998. Recently, he developed gastric and epigastric distention and fullness, easy to wake up after sleep, stool is sometimes dry and sometimes thin, tongue is dark red, tongue coating is yellow and slippery, pulse is thin and slippery, urine glucose is negative, 5.1 mmol/L after meal, consider phlegm obstruction and heat depression, spleen and stomach disharmony, treatment is proposed to resolve phlegm and heat, regulate the middle and stomach, prescription: Chen Pi 9 g, Qing Han Xia 15 g, Huang Lian 6 g, Yun Ling 15 g, raw fried jujube seeds 12 g, roasted licorice 6 g, wine army 6 g, Dendrobium 12 g g, Tongcao 5 g, Jujube 6, Danshen 15 g, Wuweizi 6 g, Gangsong 6 g, Aromatic Herb 10 g, Su Stem 6 g, Chen Pi 6 g, Citrus Aurantium 10 g, Citron 6 g, Buddha’s Hand 6 g. 7 doses. Fourth consultation: November 24, 1998. After taking the medicine, the distention and fullness of the stomach and epigastrium were significantly reduced, and the patient could sleep again after waking up. The effect is not more prescription. He was advised to continue to take the medicine. His condition was stable and his blood sugar was well controlled. [Comment] Diabetic gastrointestinal vegetative neuropathy can be manifested as diabetic gastroparesis, diabetic constipation and diarrhea, etc. Chinese medicine often identifies the symptoms as Qi blockage, or the disease is located in the spleen and stomach, or in the intestines. Treatment focuses on regulating the qi mechanism. In this case, the patient is suffering from Qi stagnation in the spleen and stomach, so the symptoms include distention and fullness in the stomach and epigastrium, fullness after eating, and irregular bowel movements; Qi stagnation over time becomes blood stasis, so the patient has headache and a dark tongue. Therefore, the treatment is based on the formula of “Bureau of Recipe”, Xiang Su San, with heavy use of Atractylodes macrocephala intended to sweeten and moisten the bowels and Chuan Xiong intended to invigorate blood to treat headache. Weimao, Lychee kernel, Pueraria lobata and Salviae can invigorate Blood and regulate Qi, generate fluid and quench thirst. Later, due to repeated discontinuation of the medicine, the symptoms include distension and fullness in the stomach and epigastrium, easy to wake up from sleep, dry stools at times, dark red tongue, yellowish slippery tongue coating, and fine slippery pulse, which is caused by phlegm and heat obstruction and stagnation in the spleen and stomach. The use of raw fried jujube seeds and schisandra is to nourish the heart, astringent and tranquilize the mind, which is a special medicine for treating insomnia. The original formula is Moutong, and its intention is to nourish yin on the basis of the urine and stool, and guide the evil heat downward. Clinical application is really effective. Nowadays, the nephrotoxicity of Guanmutong is replaced by Tongcao, and it has been observed that it also has certain curative effect.