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6 Diabetes
Diabetes corresponds to "xiao ke" in TCM. Pathologically, yin deficiency is the primary cause, and dryness and heat are the secondary ones. If the disease involves five zang organs, various complications may occur such as cataract, night blindness, deafness, boil, hypertension and myocardiac infarction.
Syndrome differentiation and treatment
Dryness and heat due to yin deficiency
It manifests dry mouth or thirst with inclination to drink, potyphagia, bulimia, cloudy and sweet urine, soreness and flaccidity of the waist and knees, dizziness, tinnitus, dry skin, red tongue with a little fur, thready and rapid pulse. It is advisable to nourish yin and tonify blood, clear away heat and moisten dryness. The prescription used is the modified Dihuang Decoction (Rehmannia Decoction) in combination with Liuwei Dihuang Bolus (Bolus of Six Drugs Including Rehmannia).
Deficiency of both yin and yang
It manifests frequent urination, very turbid urine, even urination immediately after drinking in severe cases, feverish palms and soles, dry throat and tongue, wan and sallow complexion, or blackish complexion, soreness and flaccidity of the waist and knees, cold limbs, aversion to cold, even impotency in severe cases, pale tongue with whitish fur, deep and thready pulse without force. It is advisable to warm yang, nourish yin and tonify the kidney. The prescription used is the modified Jinkui Shenqi Pill.
Deficiency of splenogastric qi
It manifests thirst with the inclination to drink, coexistence of polyphagia and loose stool, or reduced appetite, listlessness, lassitude of limbs, pale tongue with whitish fur, thready and weak pulse without force. It is suitable to strengthen the spleen, supplement qi, promote the production of body fluids to quench thirst. The prescription used is the modified Qiwei Baizhu Powder (Seven-Ingredient Powder with Rhizoma Atractylodis Macrocephalae).
If the above syndromes have the complications of cataract, night blindness and deafness, it is suitable to nourish and tonify the liver and kidney, strengthen essence and nourish blood. The selected prescriptions include Mingrnu Dihuang Bolus (Sight-Improving Bolus with Radix Rehmanniae), Shihu Yeguang Pill (Nyctalopia-Curing Pill with Herba Dendrobii), and Qiju Dihuang Bolus (Bolus of Six Drugs, Rehmannia with Wolfberry and Chrysanthemum), etc. In the case of the complication of boil, it is advisable to clear away heat and remove toxic substances. The prescription used is the modified Wuwei Xiaodu Decoction (Antiphlogistic Decoction of Five Drugs).
Rehabilitation Methods
The basic rehabilitation principle of the disease mainly lies in supplementing qi, nourishing yin, clearing away heat and promoting body fluids production. In the case of complications, the treatment should be based on the syndromes accordingly.
Regulating emotions and recreation therapy
Please refer to the relevant part of the section of "Coronary heart disease".
Physical training
Physical training can improve the regulatory function of central nervous system, enhance the metabolic function of body, reduce the factors which easily cause diabetes (such as obesity, hyperlipemia and arteriosclerosis), consequently reducing blood-sugar. The patients may select events like walking, jogging, swimming, boating, cycling, Taijiquan and eight-section brocade, of which walking is the most common method. Take a walk once or twice a day, with a daily amount of exercise less than 5km.
The patients with the administration of insulin should avoid excessive training during the maximal action period. Otherwise, the training may aggravate the hypoglycemic reaction. When having physical training at ordinary times, the patients should take some sweet with them for later use so as to prevent hypoglycemic reaction.
Acumox and massage
Acumox: In the case of dryness and heat due to yin deficiency, select Shuigou (GV 26), Chengjiang (CV 24), Jinjin (EX-HN 12), Yuye (EX-I-IN 13), Lianquan (CV 23), Quchi (LI 11), Laogong (PC 8), Taichong (LR 3), Xingjian (LR 2), Shangqiu (KI 7), Rangu (KI 2), Yinbai (SP 1), Sanyinjiao (SP 6), Shenshu (BL 23), Sanjiaoshu (BL 22), etc. Select three to five acupoints each time and adopt the reinforcing method and reducing method simultaneously. In the case of deficiency of both yin and yang, select Mingmen (GV 4) and Guanyuan (CV 4) in addition; in the case of splenogastric qi deficiency, select Pishu (BL 20), Weishu (BL 21), Qihai (CV 6) and Zusanli (ST 36).
In the case of concurrent night blindness, select Chengqi (ST 1), Sibai (ST 2), Juliao (ST 3), Sanyinjiao (SP 6), Zusanli (ST 36) and Neiting (ST 44). Retain the needle for ten minutes. Apply the method once every other day. In the case of concurrent boil, select Quchi (LI 11), Chize (LU 5), Sanyinjiao (SP 6) and Zusanli (ST 36). Retain the needle for 15 minutes or so. Apply the method once every other day.
Ear acupuncture: Select the main acupoints of Yi (MA- SC 6) and Neifenmi (MA- IC 3) and the adjuvant acupoints of Shen, Sanjiao (MA- IC 4), Ermigen, Ershenmen (MA- TF 1 ), Xin and Gan (MA- SC 5). Apply the therapy with the filiform needle once every other day, or adopt the pill-pressing method. The return visit should be followed once every three to seven days. Select three or four acupoints each time.
In the case of concurrent cataract, select Yanqu and retain the needle for fifteen to thirty minutes. Apply the therapy once every other day. Twenty times make up one course of treatment. Or select the sensitive spots from Yan (MA - SC 5), Gan (MA - SC 6), Shen, Shenshangxian, Xin and Jiaogan (MA-AH 7). Then, apply Wangbuliuxingzi (Semen Vaccariae) on the spots. Select two or three such spots each time. Replace these spots with new ones once every three to five days. Apply the method on the two ears alternately.
Massage: Push the two sides of the spine, rub and scrub the back from the upper part to the lower part, knead the acupoint of the back, pinch and twirl the toes. In the case of concurrent ocular diseases, press, push and rub Shangdantian, digitally press the inner canthi and gently knead the upper and lower eyelids.
Self massage Ask the patients to massage Chengjiang (CV 24), Zhongwan (CV 12), Guanyuan (C V4), Qimen (LR 14) and Shenshu (BL 23) regularly. Massage each acupoint for eighteen to thirty-six times with the coordination of abdominal breathing.
Dietary therapy
Control the intake of sugar. Suddenly or gradually limit the intake of sugar in the staple food. At the beginning of the control over the diet, the patients may feel hungry. Then, they may eat some proper vegetables (except the melons with a high content of carbohydrate). If the conditions permit, it is advisable to eat for more times with less amount of food at a time. This can lessen the burden of islet cells. If the control over the diet alone fails to check the development of the state of illness, adopt other therapeutic methods. The patient should not depend on merely reducing food intake unlimitedly. Otherwise, it may give rise to ketoacidosis.
Eat more coix seeds, bran, pumpkins, red beans, celery, cabbage, chives, packchoi, spinach, wax gourds, tomatoes, soybeans, eggs, lean meat, etc. Onions, rice-field eels, soft-shelled turtles, etc. can help the organism make better use of glucose and have the action of reducing blood sugar. Therefore, eat them regularly.
The prescriptions of the dietary therapy include Thick Soup of Zhuji (Medulla Suis ), Seamed Crucian Carp with Tea, etc. In the case of marked dryness and heat, select Five-Juice Drink; in the case of concurrent gastric qi deficiency, select Soup of Zhuyi (Pancreas Suis); in the case of concurrent boil and excessive heat, drink Green Gram Gruel regularly; in the case of ulcerated carbuncle with pus, Yiyiren Gruel (Gruel of Semen Coicis) is added.
Empirical recipes
Cut seven pigs' pancreas into pieces and cook the meat well. Then, add 500 g of honey to it to make paste. Take 15 g of the paste each time.
Remove the skin of one live Shuishe (Creas Enhydris) and mince the meat. Then, soak 50 snails in water to get rid of the saliva. Make the above two ingredients, together with a small amount of Tianhuafen (Radix Trichosanthis ) and Shexiang (Moschus) respectively into pills. Take the pill with ginger soup.
Steam 30 g of Shanzhuyu (Fructus Corni), 20 g of Wuweizi (Fructus Schisandrae), 20 g of Wumei (Fructus Mume ) and 20 g of Cangzhu ( Rhizoma Atractylodis) in 2,000 ml of water until there is 1,000 ml of water left. Take the warm decoction three times in the morning, at noon and in the evening respectively. It is particularly applicable to deficiency of both yin and yang as well as non-insulin dependent diabetes.
Decoct three to five grams of Xingandujuan (Cuculus Poliocephalus Xingan ), 3 g of Dingxiang ( Flos Caryophylli), 12 g of Wuweizi ( Fructus Schisandrae ) and 1.5 g of Ganjiang (Rhizoma Zingiberis) in water for oral administration. Or make the above ingredients into granula or tablets. One course of treatment lasts for one month. It is particularly applicable to non-insulin dependent diabetes.
External application of drugs Grind 5 g of Shigao ( Gypsum Fibrosum ), 2g of Zhimu ( Rhizoma Anemarrhenae), 0.6 g of Shengdihuang ( Radix Rehmanniae), 0.6 g of Dangshen (Radix Codonopsis Pilosulae), 1 g of Zhigancao (prepared Radix Glycyrrhizae), 1 g of Xuanshen (Radix Scrophulariae), 0.2 g of Tianhuafen (Radix Trichosanthis ), 0.3 g of Huanglian (Rhizoma Coptidis) and a bit of Jingmi (Semen Oryzae Sativae) into powder. Store the powder in the shade for later use. Mix 250 rng of the powder with 40 mg of dimethyldiguanide hydrochloride each time. Then, apply the drug on the navel covered with gauze and fixed with adhesive plaster. Conduct the dressing change once every five to seven days. Six times constitute one course of treatment.
Syndrome differentiation and treatment
Dryness and heat due to yin deficiency
It manifests dry mouth or thirst with inclination to drink, potyphagia, bulimia, cloudy and sweet urine, soreness and flaccidity of the waist and knees, dizziness, tinnitus, dry skin, red tongue with a little fur, thready and rapid pulse. It is advisable to nourish yin and tonify blood, clear away heat and moisten dryness. The prescription used is the modified Dihuang Decoction (Rehmannia Decoction) in combination with Liuwei Dihuang Bolus (Bolus of Six Drugs Including Rehmannia).
Deficiency of both yin and yang
It manifests frequent urination, very turbid urine, even urination immediately after drinking in severe cases, feverish palms and soles, dry throat and tongue, wan and sallow complexion, or blackish complexion, soreness and flaccidity of the waist and knees, cold limbs, aversion to cold, even impotency in severe cases, pale tongue with whitish fur, deep and thready pulse without force. It is advisable to warm yang, nourish yin and tonify the kidney. The prescription used is the modified Jinkui Shenqi Pill.
Deficiency of splenogastric qi
It manifests thirst with the inclination to drink, coexistence of polyphagia and loose stool, or reduced appetite, listlessness, lassitude of limbs, pale tongue with whitish fur, thready and weak pulse without force. It is suitable to strengthen the spleen, supplement qi, promote the production of body fluids to quench thirst. The prescription used is the modified Qiwei Baizhu Powder (Seven-Ingredient Powder with Rhizoma Atractylodis Macrocephalae).
If the above syndromes have the complications of cataract, night blindness and deafness, it is suitable to nourish and tonify the liver and kidney, strengthen essence and nourish blood. The selected prescriptions include Mingrnu Dihuang Bolus (Sight-Improving Bolus with Radix Rehmanniae), Shihu Yeguang Pill (Nyctalopia-Curing Pill with Herba Dendrobii), and Qiju Dihuang Bolus (Bolus of Six Drugs, Rehmannia with Wolfberry and Chrysanthemum), etc. In the case of the complication of boil, it is advisable to clear away heat and remove toxic substances. The prescription used is the modified Wuwei Xiaodu Decoction (Antiphlogistic Decoction of Five Drugs).
Rehabilitation Methods
The basic rehabilitation principle of the disease mainly lies in supplementing qi, nourishing yin, clearing away heat and promoting body fluids production. In the case of complications, the treatment should be based on the syndromes accordingly.
Regulating emotions and recreation therapy
Please refer to the relevant part of the section of "Coronary heart disease".
Physical training
Physical training can improve the regulatory function of central nervous system, enhance the metabolic function of body, reduce the factors which easily cause diabetes (such as obesity, hyperlipemia and arteriosclerosis), consequently reducing blood-sugar. The patients may select events like walking, jogging, swimming, boating, cycling, Taijiquan and eight-section brocade, of which walking is the most common method. Take a walk once or twice a day, with a daily amount of exercise less than 5km.
The patients with the administration of insulin should avoid excessive training during the maximal action period. Otherwise, the training may aggravate the hypoglycemic reaction. When having physical training at ordinary times, the patients should take some sweet with them for later use so as to prevent hypoglycemic reaction.
Acumox and massage
Acumox: In the case of dryness and heat due to yin deficiency, select Shuigou (GV 26), Chengjiang (CV 24), Jinjin (EX-HN 12), Yuye (EX-I-IN 13), Lianquan (CV 23), Quchi (LI 11), Laogong (PC 8), Taichong (LR 3), Xingjian (LR 2), Shangqiu (KI 7), Rangu (KI 2), Yinbai (SP 1), Sanyinjiao (SP 6), Shenshu (BL 23), Sanjiaoshu (BL 22), etc. Select three to five acupoints each time and adopt the reinforcing method and reducing method simultaneously. In the case of deficiency of both yin and yang, select Mingmen (GV 4) and Guanyuan (CV 4) in addition; in the case of splenogastric qi deficiency, select Pishu (BL 20), Weishu (BL 21), Qihai (CV 6) and Zusanli (ST 36).
In the case of concurrent night blindness, select Chengqi (ST 1), Sibai (ST 2), Juliao (ST 3), Sanyinjiao (SP 6), Zusanli (ST 36) and Neiting (ST 44). Retain the needle for ten minutes. Apply the method once every other day. In the case of concurrent boil, select Quchi (LI 11), Chize (LU 5), Sanyinjiao (SP 6) and Zusanli (ST 36). Retain the needle for 15 minutes or so. Apply the method once every other day.
Ear acupuncture: Select the main acupoints of Yi (MA- SC 6) and Neifenmi (MA- IC 3) and the adjuvant acupoints of Shen, Sanjiao (MA- IC 4), Ermigen, Ershenmen (MA- TF 1 ), Xin and Gan (MA- SC 5). Apply the therapy with the filiform needle once every other day, or adopt the pill-pressing method. The return visit should be followed once every three to seven days. Select three or four acupoints each time.
In the case of concurrent cataract, select Yanqu and retain the needle for fifteen to thirty minutes. Apply the therapy once every other day. Twenty times make up one course of treatment. Or select the sensitive spots from Yan (MA - SC 5), Gan (MA - SC 6), Shen, Shenshangxian, Xin and Jiaogan (MA-AH 7). Then, apply Wangbuliuxingzi (Semen Vaccariae) on the spots. Select two or three such spots each time. Replace these spots with new ones once every three to five days. Apply the method on the two ears alternately.
Massage: Push the two sides of the spine, rub and scrub the back from the upper part to the lower part, knead the acupoint of the back, pinch and twirl the toes. In the case of concurrent ocular diseases, press, push and rub Shangdantian, digitally press the inner canthi and gently knead the upper and lower eyelids.
Self massage Ask the patients to massage Chengjiang (CV 24), Zhongwan (CV 12), Guanyuan (C V4), Qimen (LR 14) and Shenshu (BL 23) regularly. Massage each acupoint for eighteen to thirty-six times with the coordination of abdominal breathing.
Dietary therapy
Control the intake of sugar. Suddenly or gradually limit the intake of sugar in the staple food. At the beginning of the control over the diet, the patients may feel hungry. Then, they may eat some proper vegetables (except the melons with a high content of carbohydrate). If the conditions permit, it is advisable to eat for more times with less amount of food at a time. This can lessen the burden of islet cells. If the control over the diet alone fails to check the development of the state of illness, adopt other therapeutic methods. The patient should not depend on merely reducing food intake unlimitedly. Otherwise, it may give rise to ketoacidosis.
Eat more coix seeds, bran, pumpkins, red beans, celery, cabbage, chives, packchoi, spinach, wax gourds, tomatoes, soybeans, eggs, lean meat, etc. Onions, rice-field eels, soft-shelled turtles, etc. can help the organism make better use of glucose and have the action of reducing blood sugar. Therefore, eat them regularly.
The prescriptions of the dietary therapy include Thick Soup of Zhuji (Medulla Suis ), Seamed Crucian Carp with Tea, etc. In the case of marked dryness and heat, select Five-Juice Drink; in the case of concurrent gastric qi deficiency, select Soup of Zhuyi (Pancreas Suis); in the case of concurrent boil and excessive heat, drink Green Gram Gruel regularly; in the case of ulcerated carbuncle with pus, Yiyiren Gruel (Gruel of Semen Coicis) is added.
Empirical recipes
Cut seven pigs' pancreas into pieces and cook the meat well. Then, add 500 g of honey to it to make paste. Take 15 g of the paste each time.
Remove the skin of one live Shuishe (Creas Enhydris) and mince the meat. Then, soak 50 snails in water to get rid of the saliva. Make the above two ingredients, together with a small amount of Tianhuafen (Radix Trichosanthis ) and Shexiang (Moschus) respectively into pills. Take the pill with ginger soup.
Steam 30 g of Shanzhuyu (Fructus Corni), 20 g of Wuweizi (Fructus Schisandrae), 20 g of Wumei (Fructus Mume ) and 20 g of Cangzhu ( Rhizoma Atractylodis) in 2,000 ml of water until there is 1,000 ml of water left. Take the warm decoction three times in the morning, at noon and in the evening respectively. It is particularly applicable to deficiency of both yin and yang as well as non-insulin dependent diabetes.
Decoct three to five grams of Xingandujuan (Cuculus Poliocephalus Xingan ), 3 g of Dingxiang ( Flos Caryophylli), 12 g of Wuweizi ( Fructus Schisandrae ) and 1.5 g of Ganjiang (Rhizoma Zingiberis) in water for oral administration. Or make the above ingredients into granula or tablets. One course of treatment lasts for one month. It is particularly applicable to non-insulin dependent diabetes.
External application of drugs Grind 5 g of Shigao ( Gypsum Fibrosum ), 2g of Zhimu ( Rhizoma Anemarrhenae), 0.6 g of Shengdihuang ( Radix Rehmanniae), 0.6 g of Dangshen (Radix Codonopsis Pilosulae), 1 g of Zhigancao (prepared Radix Glycyrrhizae), 1 g of Xuanshen (Radix Scrophulariae), 0.2 g of Tianhuafen (Radix Trichosanthis ), 0.3 g of Huanglian (Rhizoma Coptidis) and a bit of Jingmi (Semen Oryzae Sativae) into powder. Store the powder in the shade for later use. Mix 250 rng of the powder with 40 mg of dimethyldiguanide hydrochloride each time. Then, apply the drug on the navel covered with gauze and fixed with adhesive plaster. Conduct the dressing change once every five to seven days. Six times constitute one course of treatment.
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