A Chinese Medicinal Protocol for Type 2 Diabetes

There are many published studies in the contemporary Chinese medical literature on the Chinese medicinal treatment of type 2 diabetes. Below is a precis of one representative study. Titled, “The Treatment of 150 Cases of Type II Diabetes Mellitus with Yu Yin Tang (Foster Yin Decoction),” this study was authored by Ji Yun-hai and Ji Rui-yun and appeared on page 48 of issue #12, 2001, of Si Chuan Zhong Yi (Sichuan Chinese Medicine).

Cohort description:

Of the 150 out-patients seen in this study, 84 were male and 66 were female. These patients ranged in age from 31-70 years, with 18 cases being 30-40 years of age, 24 cases being 41-50 years of age, 63 cases being 51-60 years of age, and 45 cases being 61-70 years of age. The shortest course of disease was five months and the longest was six years, Twenty-seven cases had been diagnosed within one year, 30 had been diagnosed 1-2 years prior, 51 cases had been diagnosed 3-4 years before, and 42 cases had been diagnosed with type 2 diabetes for 5-6 years. There were 54 cadres, 66 workers, and 30 agricultural workers (or peasants). Thirty cases had accompanying vascular conditions, 36 cases had retinopathy, 48 cases had hypertension, 24 had cerebral vascular disease, and 18 had coronary artery disease.

In terms of clinical symptoms, these included oral thirst, polydipsia, polyphagia, frequent, copious urination, and emaciation, although the three polys were not obvious in those in the initial stages of this disease. Those whose disease had been enduring also had dizziness, chest oppression, windstroke, sparrow vision (i.e., night blindness), and ulcerous sores. Fasting blood glucose waqs greater than 7.2mmol/L, or two hour postprandial blood glucose was greater than 11.1mmol/L.

Treatment method:

The basic formula consisted of: Herba Dendrobii (Shi Hu), 20g, Tuber Ophiopogonis Japonici (Mai Men Dong), 15g, uncooked Radix Rehmanniae (Sheng Di) and Lignum Suberalatum Euonymi (Gui Jian Yu), 30g each, Radix Scrophulariae Ningpoensis (Xuan Shen), Radix Trichosanthis Kirlowii (Tian Hua Fen), and Radix Dioscoreae Oppositae (Shan Yao), 12g each, Radix Astragali Membranacei (Huang Qi), Rhizoma Anemarrhenae Aspheloidis (Zhi Mu), Rhizoma Atractylodis (Cang Zhu), and Radix Salviae Miltiorrhizae (Dan Shen), 10g each. If there was chest and/or rib-side distention and fullness, 15 grams of Radix Bupleuri (Chai Hu) and 12 grams of Fructus Citri Aurantii (Zhi Ke) were added. If there was frequent urination, 15g of Fructus Alpiniae Oxyphyllae (Yi Zhi Ren) and 12 grams of Ootheca Mantidis (Sang Piao Xiao) were added. If there was pruritus, 20 grams of Radix Sophorae Flavescentis (Ku Shen), 15 grams of Fructus Zanthoxyli Bungeani (Chuan Jiao), and 10 grams of Fructus Kochiae Scopariae (Di Fu Zi) were added. If there was cataracts, 15 grams of Flos Chrysanthemi Morifolii (Ju Hua) and 10 grams of Feces Vespertilionis (Ye Ming Sha) were added. If there was insomnia or impaired memory, 15 grams of Radix Polygalae Tenuifoliae (Yuan Zhi) and 12 grams of stir-fried Semen Zizyphi Spinosae (Suan Zao Ren) were added. If there was hypertension, 15 grams of Spica Prunellae Vulgaris (Xia Ku Cao) and 12 grams of Ramulus Uncariae Cum Uncis (Gou Teng) were added. If there was coronary artery disease and angina pain, 40 grams of Fructus Trichosanthis Kirlowii (Quan Gua Lou) and 20 grams of Radix Rubrus Paeoniae Lactiflorae (Chi Shao) were added. If there was constipation, 10 grams of Radix Et Rhizoma Rhei (Da Huang) and 15 grams of Semen Cannabis Sativae (Huo Ma Ren) were added. If there was numbness or pricking pain of the extremities, 20 grams of Caulis Milletiae Seu Spatholobi (Ji Xue Teng) and 15 grams of Fasciculus Vascularis Luffae Cylindricae (Si Gua Luo) were added. One ji of these medicinals was decocted in water and administered per day in three divided doses, with one month equaling one course of treatment. During the time these medicinals were taken, patients’ diets were regulated and they were counseled against sweet, fatty foods, bedroom (i.e., sexual) taxation, anger and worry, smoking tobacco and drinking alcohol, excessive labor and fatigue, and eating acrid, peppery foods.

Treatment outcomes:

Cure meant the disappearance of clinical symptoms with normalization of blood glucose on more than one test. Improvement meant improvement in the main clinical symptoms and improvement in blood glucose. No effect meant that there was no change in any of these parameters from before to after treatment. Based on these criteria, after 1-4 courses of treatment, 48 cases (32%) were judged cured, 90 cases (605) were judged improved, and 12 cases (8%) got no effect. Therefore, the total amelioration rate was 92%.

According to the authors, this condition is mostly due to dryness and heat damaging yin. Therefore, treatment should foster yin in order to engender fluids and clear heat in order to discharge fire. By fostering yin, the kidneys are able to be supplemented, and, by clearing heat, yin is able to be engendered. According to Liu He-jian (a.k.a. Liu Wan-su):

To treat wasting and thirsting, supplement the vacuity of kidney water yin cold and drain the repletion of heart fire yang heat. Eliminate the severity of intestinal and stomach dryness and heat, thus rescuing the whole body’s fluids and humors. Promote the scattering of the pathways and the network vessels and do not bind. Thus fluids and humors are engendered and not withered, qi and blood are disinhibited and not choppy and astringent, and the disease will be eliminated in days.

Therefore, within this formula, Shi Hu, Mai Men Dong, Sheng Di, and Shan Yao foster yin and moisten dryness and, by fostering yin, the kidneys are able to be supplemented. Tian Hua Fen engenders fluids and drains fire and, by draining fire, yin is able to be supplemented. Huang Qi supplements the qi in order to spread and control fluids and humors. Cang Zhu opens depression and scatters binding, courses and frees the flow of the qi mechanism, and promotes the spleen qi’s fortification and movement. Thus water fluids are diffused and moved so that they can moisten and sprinkle the intestines and stomach, urination is reduced, and the muscles and flesh obtain nourishment. Zhi Mu enriches yin and drain fire. Gui Jian Yu and Dan Shen quicken the blood and transform stasis. When stasis is transformed, fluids can be engendered. They also insure rectification of the qi without causing sliminess and supplementation without causing stagnation.