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The Integrated Chinese-Western Medical Treatment of Diabetic Retinopathy abstracted & translated by Keywords: Chinese medicine, Chinese herbal medicine, acupuncture, integrated Chinese-Western medicine, diabetic retinopathy, diabetes mellitus
Liu Xue-min of the Tianjin Municipal Chinese Medical Hospital recently published a study on the integrated Chinese-Western medical treatment of diabetic retinopathy using both acupuncture and internally administered Chinese medicinals. The article was titled, “A Clinical Audit of the Treatment of 60 Cases of Diabetic Retinopathy with A Combination of Acupuncture & Medicinals,” and appeared in issue #2, 2002, of Shang Hai Zhong Yi Yao Za Zhi (Shanghai Journal of Chinese Medicine & Medicinals) on page 23. A precis of that study is given below.
Cohort description:
All the patients in this study were between 50-65 years of age. Twenty-eight were male and 32 were female. Thirty-two cases had suffered from diabetic retinopathy for 5-10 years, 18 cases had suffered from 11-15 years, and 10 cases had suffered from 16-20 years of more. Visual acuity was rated at 0.02-0.1 in 12 cases, 0.15-0.3 in eight cases, 0.4-0.5 in 32 cases, and 0.6-0.8 in eight cases. Five cases had eye ground hemorrhage of 75%, 45 cases had eye ground hemorrhage of 50%, and 10 cases had eye ground hemorrhage of 25%. In 36 cases, fasting blood glucose was 6.1-10mmol/L, while in the other 24 cases, it was more than 10mmol/L. In 36 cases, Chinese medical pattern discrimination was yin vacuity dryness and heat, and, in the other 24 cases, it was qi and yin dual vacuity.
Treatment method:
All the patients in this study continued taking their normal Western medicines and oral hypoglycemic agents. When the Chinese medical treatment got some result, these dosages were gradually lowered.
At the same time, patients continued on their restrictive diets. The basic Chinese medicinal formula prescribed was composed of: uncooked Radix Rehmanniae (Sheng Di), 30g, Rhizoma Imperatae Cylindricae (Bai Mao Gen), 30g, Herba Seu Radix Cirsii Japonici (Da Ji), 15g, Radix Rubiae Cordifoliae (Qain Cao), 15g, Tuber Asparagi Cochinensis (Tian Men Dong), 15g, and Tuber Ophiopogonis Japonici (Mai Men Dong), 15g. If there was yin vacuity dryness and heat forcing the blood to move frenetically, Radix Scrophulariae Ningpoensis (Xuan Shen), Radix Trichosanthis Kirlowii (Tian Hua Fen), Cortex Radicis Moutan (Dan Pi), Radix Puerariae (Ge Gen), and Rhizoma Anemarrhenae Aspheloidis (Zhi Mu) were added. If there was qi and yin dual vacuity with blood spilling over outside the vessels, Radix Astragali Membranacei (Huang Qi), Radix Pseudostellariae Heterophyllae (Tai Zi Shen), Rhizoma Polygonati (Huang Jing), Radix Scrophulariae Ningpoensis (Xuan Shen), Radix Trichosanthis Kirlowii (Tian Hua Fen), Thallus Algae (Kun Bu), uncooked Concha Ostreae (Mu Li), and Sclerotium Poriae Cocos (Fu Ling) were added. One ji of these medicinals was decocted in water and administered per day in two divided doses, with 30 days equaling one course of treatment.
As for acupuncture, the following points were needled bilaterally: Jing Ming (Bl 1), Tai Yang (M-HN-9), Shen Ting (GV 23), Qu Chi (LI 11), Zu San Li (St 36), Xue Hai (Sp 10), Yin Ling Quan (Sp 9), San Yin Jiao (Sp 6), Tai Chong (Liv 3), and Tai Xi (Ki 3). These points were needled once every other day. The points on the head and face did not receive any hand technique. The points on the body received even supplementing-even draining technique. The needles were retained for 20 minutes each trearment, and 15 treatments equaled one course of treatment.
Treatment outcomes:
If eye ground hemorrhage resolved and the visual acuity was 1.0, this was considered a cure. Marked effect meant that the largest part of eye ground hemorrhage resolved and visual acuity improved by three steps. Some effect was defined as partial resolution of eye ground hemorrhage and improvement in visual acuity 1-2 steps. No effect meant that, although there was some resolution of eye ground bleeding, the bleeding recurred and there was no improvement in visual acuity. Based on these criteria, four cases (6.6%) were judged cured, 36 cases (60.0%) got a marked effect. Fourteen cases (23.3%) got some effect, and six cases (10.0%) got no effect, for a total amelioration rate of 90.0%. Before treatment, median visual acuity was 0.380 ± 0.239, while after treatment, it was 0.555 ± 0.315. Hence there was a significant statistical improvement from before to after treatment in median visual acuity.
Discussion:
According to Dr. Liu, diabetes mellitus mainly presents the patterns of A) yin vacuity dryness and heat or B) qi and yin dual vacuity. Therefore, the basic, internally administered Chinese medicinal formula used in this protocol nourishes the blood and boosts yin, cools the blood and quickens the blood. The additions for yin vacuity dryness and heat are then meant to further enrich yin and clear heat, while those for qi and yin dual vacuity are meant to fortify the spleen and supplement the qi as well as to enrich yin and soften the hard. The principle of softening the hard is included because it is Dr. Liu’s opinion that blood stasis plays a very important role in the pathological changes associated with this condition. As for acupuncture, Qu Chi, San Yin Jiao, Tai Xi, and Tai Chong enrich yin and drain heat. Xue Hai quickens the blood and transforms stasis. Zu San Li and Yin Ling Quan fortify the spleen and seep dampness, while Jing Ming, Tai Yang, and Shen Ting regulate and smooth the flow of the qi and blood to and through the eyes. It is Dr. Liu’s opinion that, when acupuncture and Chinese medicine are used in conjunction with standard Western medical care for diabetes, the effects of the acupuncture and herbs complement each other very well.
Copyright © Blue Poppy Press, 2002. All rights reserved.
For more information on the Chinese medical treatment of diabetes and its many complications, see Bob Flaws, Lynn Kuchinski & Robert Casañas’s The Treatment of Diabetes Mellitus with Chinese Medicine available from Blue Poppy Press in late Spring 2002. |
