Chinese Medical Diabetes

Diabetic Nephropathy & Integrated Chinese-Western Medicine

abstracted & translated by
Bob Flaws, Dipl. Ac. & C.H., FNAAOM, FRCHM

Keywords: Chinese medicine, Chinese herbal medicine, diabetes, nephropathy, diabetic nephropathy

In issue #12, 2001 of Si Chuan Zhong Yi (Sichuan Chinese Medicine), Zhang Zong-li and Si Fu-quan published an article titled, “The Treatment of 42 of Diabetic Nephropathy with Chinese Medicine Combined with Western Medicine,” on pages 33-34. This article and its outcomes are fairly representative of the kind of research being done in the People’s Republic of China in the integrated Chinese-Western medical treatment of diabetic nephropathy.

Cohort description:

Altogether, there were 68 patients in this study, all of whom met WHO criteria for diabetes as well as criteria for diabetic nephropathy. With treatment, these patient’s fasting blood glucose (FBG) was equal to or above 7.8mmol/L and their 24 hour albuminuria was more than 300mg. Forty-two patients were divided into the treatment group in which there were 200 men and 22 women with a median age of 52.7 ± 8.1 years and a median disease duration of 9.2 ± 7.8 years. Twenty-six patients were divided into a comparison group in which there were 12 men and 14 women with a median age of 53.4 ± 7.5 years and a median disease duration of 9.4 ± 6.7 years. Hence, in terms of age, sex, disease duration, FBG, and 24 hour albuminurua, there was no marked statistical difference between these two groups.

Treatment method:

The basic Chinese medicinal formula to supplement the kidneys and quicken the blood consisted of: Fructus Ligustri Lucidi (Nu Zhen Zi), 30g, Cordyceps Chinensis (Dong Chong Cao), 3g, Radix Salviae Miltiorrhizae (Dan Shen), Radix Ligustici Wallichii (Chuan Xiong), and Rhizoma Curcumae Zedoariae (E Zhu), 15g each. If there was qi and yin dual vacuity, Radix Panacis Quinquefolii (Xi Yang Shen), 6g, uncooked Radix Rehmanniae (Sheng Di), Radix Dioscoreae Oppositae (Shan Yao), Fructus Corni Officinalis (Shan Zhu Yu), Cortex Radicis Moutan (Dan Pi), Sclerotium Poriae Cocos (Fu Ling), and uncooked Radix Astragali Membranacei (Huang Qi), 15g each, were added. If there was spleen-kidney qi vacuity, Fructus Rosae Laevigatae (Jin Ying Zi), Semen Eurylais Ferocis (Qian Shi), Radix Codonopsitis Pilosulae (Dang Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Radix Dioscoreae Oppositae (Shan Yao), and uncooked Radix Astragali Membranacei (Huang Qi), 15g each, were added. If there was a spleen-kidney yang vacuity, Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), 6g, Rhizoma Atractylodis Macrocephalae (Bai Zhu), Sclerotium Poriae Cocos (Fu Ling), and Radix Albus Paeoniae Lactiflorae (Bai Shao), 15g each, and uncooked Rhizoma Zingiberis (Sheng Jiang), 3g, were added. If there was liver-kidney yin vacuity, Herba Ecliptae Prostratae (Han Lian Cao), uncooked Radix Rehmanniae (Sheng Di), Fructus Corni Officinalis (Shan Zhu Yu), Sclerotium Poriae Cocos (Fu Ling), Cortex Radicis Moutan (Dan Pi), and Radix Dioscoreae Oppositae (Shan Yao), 15g each, were added. If there was yin vacuity with yang hyperactivity, the ingredients of Er Jia Fu Mai Tang (Two Shells Restore the Pulse Decoction) and Qi Ju Di Huang Tang (Lycium & Chrysanthemum Rehmannia Decoction) were added. If there was a yin and yang dual vacuity, the ingredients of Gui Fu Di Huang Tang (Cinnamon & Aconite Rehmannia Decoction or Sheng Ji Shen Qi Wan (Aid the Living Kidney Qi Pills) were added. If there was edema, Semen Plantaginis (Che Qian Zi), Radix Stephaniae Tetrandrae (Fang Ji), Semen Phaseoli Calcarati (Chi Xiao Dou), and Pericarpium Benincasae Hispidae (Dong Gua Pi), 15g each, were added. If there was constipation with dry, bound stools, Radix Et Rhizoma Rhei (Da Huang), 10g, and Fructus Citri Aurantii (Zhi Ke), 15g, were added. If there was nausea and vomiting, Caulis Bambusae In Taeniis (Zhu Ru), 6g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, and Rhizoma Coptidis Chinensis (Huang Lian), 15g, were added. One ji of these medicinals was decocted in water down to 400ml administered per day in two divided doses to the members of the treatment group.

In addition, all members of both the treatment and comparison groups received the same doses of the same oral hypoglycemic medications, hypertensive medications, and cholesterol-lowering medications. All members of both groups also received a low protein, diabetes diet. On top of this, the members of the comparison group received 24 tablets per day of Shen Yan Kang Fu Pian (Nephritis Health-restoring Tablets, presumably a Chinese manufactured Western medical pharmaceutical). Treatment of both groups lasted six weeks.

Treatment outcomes:

Marked effect was defined as disappearance of clinical symptoms, and FBG below 7.2mmol/L, a reduction of albuminuria by 50% or more, and normal or basically normal kidney function. Some effect was defined as marked improvement in clinical symptoms, FBG below 8.3mmol/L, albuminuria reduced by one stage or step, and normal or basically normal kidney function. No effect meant that none of these criteria were met after six weeks of treatment. Based on these criteria, in the treatment group, 12 cases were judged to have gotten a marked effect, 19 got some effect, and 11 got no effect. Thus the total amelioration rate in the treatment group was 73.8%. In the comparison group, five cases were judged to have gotten a marked effect, 10 got some effect, and 11 got no effect, for a total amelioration rate of 57.6%. Hence there was a marked statistical difference in the outcomes between these two groups suggesting that the integrated Chinese-Western medical protocol was more effective than Western medicine used by itself.

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.