Chinese Medical Diabetes

Restless Leg Syndrome & Diabetes

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

Keywords: Chinese medicine, Chinese herbal medicine, diabetes, restless leg syndrome (RLS), Bu Yang Huan Wu Tang

Restless leg syndrome refers to hard-to-describe but uncomfortable sensations felt in the legs which are temporarily relieved by movement. This is a relatively common disorder in persons over 50 years of age and typically occurs at night when resting before sleep. This discomfort may be severe enough to interfere with sleep. This condition occurs even more commonly in those with diabetes mellitus. Western medicine has no effective therapy for this complaint. Chinese medicine, on the other hand, does successfully treat this disorder in a number of patients. Fang Tuo-mei published an article titled, “The Treatment of 26 Cases of Diabetic Restless leg Syndrome with Bu Yang Huan Wu Tang (Supplement Yang & Restore Five [Tenths] Decoction),” in issue #2, 2002, of Hu Bei Zhong Yi Za Zhi (Hubei Journal of Chinese Medicine) on page 42. A precis of that article appears below.

Cohort description:

Of the 26 patients in this study, 17 were female and nine were male aged 35-71 years. Four cases had a moderate to long history of taking insulin, while another three cases had a history of interrupted use of insulin. All the other patients were taking oral hypoglycemic drugs, and all 26 patients met the 1998 WHO criteria for a diagnosis of diabetes mellitus. Clinical symptoms included unilateral or bilateral lower leg soreness, numbness, itching, distention, cramping, burning heat, formication, or a difficult-to-describe discomfort which was temporarily relieved by movement or pressure. These symptoms mainly occurred at night when the patient’s body was at rest and commonly disturbed their sleep and their mood. Neurological examination was negative.

Treatment method:

Bu Yang Huan Wu Tang with additions and subtractions consisted of: Radix Astragali Membranacei (Huang Qi), 60g, Radix Angelicae Sinensis (Dang Gui) and Lumbricus (Di Long), 20g each, Flos Carthami Tinctorii (Hong Hua), Semen Pruni Persicae (Tao Ren), Radix Ligustici Wallichii (Chuan Xiong), uncooked Radix Rehmanniae (Sheng Di), Fructus Corni Officinalis (Shan Zhu Yu), and Sclerotium Poriae Cocos (Fu Ling), 10g each, Radix Rubrus Paeoniae Lactiflorae (Bai Shao), Radix Achyranthis Bidentatae (Niu Xi), Bombyx Batryticatus (Jiang Can), Radix Dioscoreae Oppositae (Shan Yao), and Radix Salviae Miltiorrhizae (Dan Shen), 15g each, and Radix Bupleuri (Chai Hu) and Fructus Lycii Chinensis (Gou Qi Zi), 6g each. One ji of these medicinals was decocted in water and administered per day in two divided doses of 150ml each, with seven days equaling one course of treatment. During this time, all these patients also took vitamin B₁, ATP, coenzyme A, and dibazol and were instructed on a eating a balanced diet. Results were tabulated after three months of treatment.

Treatment outcomes:

Cure was defined as disappearance of all clinical symptoms and no recurrence on follow-up after one year. Some effect was defined as decrease or basic disappearance of clinical symptoms, however recurrence after cessation of the above medicinals. No effect meant that there was no apparent improvement in symptoms. Based on these criteria, 10 cases were judged cured, 14 cases got some effect, and two cases got no effect, for a total amelioration rate of 92.3%.

Discussion:

According to Dr. Fang, in Chinese medicine, the disease mechanisms of wasting and thirsting are mainly consumption of qi and damage of yin. Because the qi is vacuous, its pushing and movement of the blood lacks force, Hence there is a tendency to qi stagnation and blood stasis. This results in the sinews and vessels of the extremities of the body losing their moistening and nourishment by yin blood, and it is this which is the cause of the symptoms of restless leg syndrome. Therefore, Dr. Fang believes that the treatment principles for this condition should be to boost the qi and nourish yin, transform stasis and free the flow of the network vessels. Within this formula, a heavy dose of Huang Qi is meant to supplement the latter heaven spleen and stomach qi. Once the qi becomes effulgent and sufficient, the blood will move. Fu Ling helps Huang Qi regulate and rectify the spleen and stomach. Dang Gui, Chuan Xiong, Chi Shao, Niu Xi, Hong Hua, and Tao Ren quicken the blood and dispel stasis. If stasis is eliminated, the blood will move and it will scatter or dissipate the finest essence to construct and nourish all around the body. Di Long frees and eases the flow of the network vessels, while Shan Yao, Shan Zhu Yu, and Gou Qi Zi enrich and nourish yin blood. When all these medicinals are used together, they treat simultaneously both the tips (or branches) and the root, i.e., the restless leg syndrome and the diabetes.

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.