Case 1
Chen, male, 54 years old, a manager, had the first visit on Oct. 21, 2005.

Acupuncture treatment of typical cases of diabetes mellitus

Chief complaint: Massive drinking and lassitude for 6 months, which became worse recently.

History of present disease: Six months ago, the patient started to have massive drinking, massive eating and fatigue, and was diagnosed as diabetes. Oral intake of western medicine and Chinese medicinal herbs for controlling blood sugar didn't lower blood sugar satisfactorily. He visited my clinic because the above symptoms became worse recently. The present symptoms: Thirst with desire of drinking, hunger without desire of eating, low spirit, fatigue, dislike of speaking, emaciation, spontaneous sweating on exertion, pale tongue with teeth marks on the side, thin White tongue coating, and thready slow pulse. Examination showed FBG was 15.0 retool/L, P2BG was 19.4 mmol/L and GHb was 9.8%.

Diagnosis :
Chinese Medicine: Xiao Ke (diabetes   deficiency of qi and yin)

Western Medicine: Type 2 Diabetes

Etiology and pathogenesis. The patient preferred sweet and greasy food for long time. The spleen and stomach were damaged, resulting in dysfunction of the spleen in transportation and transformation.  Long-term standing of dysfunction of the spleen and stomach in ascending and descending causes poor origins of qi, blood and body fluid. Essence fails to turn into qi, and deficiency of qi and yin leads to the disease.

Principle of treatment: Strengthen the spleen, benefit qi, nourish yin to produce fluid.

The patient was asked to have Diamicron and Gliclazide continuously, and persist in taking diabetic diet.

Points: Taixi (KI 3), Sanyinjiao (SP 6), Zusanli (ST 36), Zhongwan (CV 12), Xuehai (SP 10), Yinlingquan (SP 9) and Taichong (LR 3).

Manipulation: Sterilize the selected points in a routine way and' determine the depth of needling by taking arrival of needling sensation as the standard. Then, apply reinforcing method by lifting and thrusting the needle slowly and quickly on Taixi (LR 3), Sanyinjiao (SP 6),  Zusanli (ST 36), Yinlingquan (SP 9), Xuehai (SP 10) and Zhongwan (CV 12) ; even method on Taichong (LR 3). Retain the needles for 30 minutes and give treatment once every day.

Oct. 31, 2005
After 10 days' treatment, massive drinking was a little bit better, polyorexia and tired feeling had no changes.  FBG descended to 10.0 mmol/L. The same treatment was continued.

Nov. 15, 2005
Polyorexia disappeared and spontaneous sweating decreased.  The patient felt stronger than before.  FBG descended to 8.0 mmol/L. The same treatment was continued.

Nov. 25, 2005
After a period of treatment longer than one month, the symptoms disappeared almost completely. Blood sugar was stable around 7.0 mmol/L, and GHb was 7.2%. The patient was asked to take Diamicron and Gliclazide and persist in diabetic diet continuously.

Note: In Ling Shu . Ben Zang (chapter 47 of Miraculous Pivot), it says: "The delicate spleen is liable to have Xiao Dan (diabetes)." Zheng Zhi Hui Bu (Addendum to Diagnosis and Treatment) also says: "Qi deficiency of the spleen and Stomach fails to harmonize water and fire, and transform body fluid, thirst thus occurs." These prove the spleen and stomach are the main involved zang-fu organs in diabetes. This disease is caused by damage of the spleen and stomach due to irregular food intake, which leads to dysfunction of the spleen and stomach in transportation and transformation.  Long time standing of dysfunction of the spleen in transportation and abnormal ascending and descending may exhaust the sources of qi and blood, resulting in deficiency of qi and yin. Spleen deficiency is Ben (root of disease), so how to strengthen the spleen, benefit qi, send the clear upward and the turbid downward should be taken as the basic principle of treatment. Select Zusanli (ST 36), Yinlingquan (SP 9) and Zhongwan (CV 12) to strengthen the  spleen  and  stomach,  benefit  transportation  and transformation,  regulate the  functions of  ascending and descending, so as to strengthen the middle jiao and restore the sources of qi and blood. Taichong (LR 3), Sanyinjiao (SP 6), Taixi (KI 3) and Xuehai (SP 10) are selected to nourish kidney yin, replenish essence and blood, pacify deficient fire, so as to nourish yin, produce fluid and stop thirst. The combination of these points can tonify qi and yin, treat yin deficiency and qi deficiency simultaneously, so as to make water upward, fire downward, the middle jiao strong, qi and yin abundant, and glycometabolism normal.

Case 2
Jiang, female, 60 years old, a worker, had the first visit on Dec. 5, 2005.

Chief complaint: Thirst with massive drinking, turbid urine for one week.

History of present disease: Diabetes for 10 years. Usually, the patient had intramuscular injection of NovoRapid~30;20u 30 minutes before breakfast, and 30u 30 minutes before supper to control blood sugar. Turbid urine appeared one week ago. Present symptoms: Dry mouth and throat, preference of warm drinking, profuse urine almost how much drinking how much passing out, turbid urine,  emaciation,  pale complexion, aversion to cold, cold limbs, restlessness, insomnia, soreness and weakness in the lumbar region and knees, dark pale tongue with white coating, deep thready pulse. FBG was 8.5 mmol/L, and GHb was 7.8%.

Diagnosis:
Chinese Medicine: Xiao Ke (diabetes -- deficiency of both yin and yang)

Western Medicine: Type 2 Diabetes

Etiology and pathogenesis: In persistent diabetes, yin deficiency of the spleen and kidney affects yang, resulting in deficiency of qi, blood, yin and yang. The disease thus occurs.

Principle of treatment:  Nourish yin, strengthen the spleen, warm yang and benefit the kidney.

Points: Taixi (KI 3), Sanyinjiao (SP 6), Guanyuan (CV 4), Qihai (CV 6), Mingmen (GV 4), Shenshu (BL 23), Zhongwan (CV 12), Zusanli (ST 36), Xuehai (SP 10), Diji
(SP 8), Taichong (LR 3), Yinlingquan (SP 9),