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Type 2 Diabetes & Dampness by Keywords: Chinese medicine, Chinese herbal medicine, diabetes mellitus, type 2 diabetes In the Chinese medical literature, there is long-standing tradition associating diabetes mellitus with dryness and yin vacuity. However, dryness and yin vacuity typically only become prominent after the patient has become symptomatic. It is a well known fact that most patients with type 2 diabetes are overweight, and, in Chinese medicine, fat is seen as dampness, phlegm, and turbidity. There is a well known Chinese medical statement, “Pang ren duo shi (fat people, lots of dampness).” Further, being overweight is commonly associated with spleen vacuity, since it is “the spleen which rules the movement and transformation” of fluids in the body and “the spleen is the root of phlegm engenderment.” Whether spleen vacuity was the cause or effect of excessive dampness, phlegm, and turbidity, because the spleen is averse to dampness, once there is enduring excessive dampness in the body, spleen vacuity is not far behind. Since damp evils hinder and obstruct the free flow of yang qi, dampness, over time, commonly becomes complicated by damp, depressive, or phlegm heat. If this heat smolders and endures, it eventually leads to yin vacuity dryness. In addition, because damp evils are fluids which are not available as a species of righteous qi but, rather, are locked up in an evil or pathological state, dampness, phlegm, and turbidity can also lead to yin vacuity and dryness even without heat. Therefore, in the early stages of type 2 diabetes dampness is typically an extremely important disease mechanism, and Dr. Chen Lian-sheng, in issue #1, 2002, of Hu Bei Zhong Yi Za Zhi (Hubei Journal of Chinese Medicine) has published an article on the Chinese medical treatment of type 2 diabetes via the treatment of dampness. Titled, “The Treatment of Type 2 Diabetes with Hua Shi Jiang Tang Yin (Transform Dampness & Lower Sugar Drink), this article appears on page 30 of the above-mentioned Chinese medical journal. An abstract of Dr. Chen’s article appears below. Cohort description: There were 26 patients in this study, 15 men and 11 women. The oldest of these patients was 75 and the youngest was 40 years old, with an average age of 50. The shortest course of disease was one year and the longest was 13 years. Most of these patients had full, robust bodies with accompanying fatigue, lack of strength, chest oppression, glomus, and fullness, a bland taste in the mouth, torpid intake, thick, slimy, white tongue fur, and a bowstring, slippery pulse. Fasting blood glucose (FBG) was 8-13.5mmol/L, with an average FBG of 12.5mmol/L. Postprandial blood glucose (PPBG) averaged at 14.1mmol/L. Treatment method: The basic formula consisted of: Radix Dioscoreae Oppositae (Shan Yao) and Semen Coicis Lachryma-jobi (Yi Yi Ren), 30g each, Sclerotium Poriae Cocos (Fu Ling) and Semen Dolichoris Lablab (Bai Bian Dou), 15g each, and Rhizoma Pinelliae Ternatae (Ban Xia), Pericarpium Citri Reticulatae (Chen Pi), Rhizoma Atractylodis (Cang Zhu), Rhizoma Atractylodis Macrocephalae (Bai Zhu), and Cortex Magnoliae Officinalis (Hou Po), 10g. If there was dizzines and hypertension, 10 grams each of Ramulus Uncariae Cum Uncis (Gou Teng) and Rhizoma Gastrodiae Elatae (Tian Ma) were added. If there was high cholesterol, 30 grams of Radix Salviae Miltiorrhizae (Dan Shen) and 10 grams of Radix Et Rhizoma Rhei (Da Huang) were added. If phlegm was profuse, 30 grams of Fructus Trichosanthis Kirlowii (Quan Gua Lou) and 10 grams of Fructus Perillae Frutescentis (Zi Su Zi) were added, and, if the was damp heat, 10 grams each of Rhizoma Coptidis Chinensis (Huang Lian) and Radix Scutellariae Baicalensis (Huang Qin) were added. One ji of these medicinals was decocted in water per day and administered in two divided doses, with 30 days equaling one course of treatment and 1-2 courses given. Treatment outcomes: Marked effect was defined as an FBG of less than 7.2mmol/L, a two hour PPBG of less than 8.3mmol/L, and disappearance of the sensation of fatigue. Improvement was defined as an FBG of less than 8.3mmol/L, a two hour PPBG of less than 10.0mmol/L, and a decreased in the sensation of fatigue. Based on these criteria, 12 cases were ju7dged to have experienced a marked effect, while another 10 improved. Four cases got no effect. Therefore, the total amelioration rate was 84.6%. Discussion: The importance of this article is that it addresses the frequent Chinese medical assumption that patients with diabetes mellitus suffer from yin vacuity, heat, and dryness. By the time a patient manifests the “three polys” – polydipsia, polyphagia, and polyuria – that is true. However, because most patients with type 2 diabetes are asymptomatic when initially diagnosed by routine blood analysis, this is not always true. Usually, an element of dampness precedes and may be one of the precipitating causes for yin vacuity, dryness, and heat. Hopefully, more Chinese doctors in China and in the West will realize that the Chinese medical literature was largely written before the advent of modern methods of disease diagnosis, and, therefore, frequently modern patients do not manifest the patterns described in the premodern literature under their disease. I think a similar thing holds true for hypertension, and a significant proportion of patients with type 2 diabetes also suffer from hypertension. Copyright © Blue Poppy Press, 2002. All rights reserved. For more information of the Chinese medical treatment of diabetes and all its complications, see Bob Flaws, Lynn Kuchinski & Dr. Robert Casañas’s The Treatment of Diabetes Mellitus with Chinese Medicine available from Blue Poppy Press in Spring 2002. |
