While blood stasis is not one of the main patterns associated with type 2 diabetes in the Chinese medical literature, blood stasis commonly complicates many cases of diabetes and especially if the patient has gone on to develop such complications as neuropathy, cerebral vascular disease, peripheral vascular diseases, coronary artery diseases, retinopathy, nephropathy, or a number of the common diabetic dermatological conditions.Zhou Miao-yin of the Guangzhou Municipal First People’s Hospital in Guangdong recently published a clinical audit on the treatment of 38 cases of type 2 diabetes who presented a pattern of blood stasis. Titled, “The Treatment of 38 Cases of Blood Stasis Pattern Type 2 Diabetes Mellitus with Fu Yuan Huo Xue Tang Jia Wei (Restore the Source & Quicken the Blood Decoction with Added Flavors),” this article appeared in issue #2, 2002 of Shang Hai Zhong Yi Yao Za Zhi (Shanghai Journal of Chinese Medicine & Medicinals) on page 20. A precis of this report is given below.
Cohort description:
All 38 cases in this study were diagnosed with type 2 diabetes mellitus. Among them, there were 17 males and 21 females aged 42-78 years, with an average age of 63.4 year. These patients’ fasting blood glucose was 9.2-24.4mmol/L, with a median ranged of 16.6 ± 7.3mmol/L. Fifteen cases also had high cholesterol, 12 cases also had cerebral vascular disease, and four cases had accompanying nephropathy. Twenty-six cases had taken Western oral hypoglycemic medications, such as glyburude, for a long time, however, without satisfactory results, their blood sugar still remaining higher than 11.1mmol/L. Twelve cases were trying to control their diabetes solely with diet.
Treatment method:
The basic formula consisted of: Radix Bupleuri Chai Hu), 15g, Radix Trichosanthis Kirlowii (Tian Hua Fen), 15g, Radix Angelicae Sinensis (Dang Gui), 10g, Flos Carthami Tinctorii (Hong Hua), 10g, Squama Manitis Pentadactylis (Chuan Shan Jia), 10g, Radix Et Rhizoma Rhei (Da Huang), 10g, Radix Salviae Miltiorrhizae (Dan Shen), 20g, Radix Dioscoreae Oppositae (Shan Yao), 20g, and Rhizoma Atractylodis Macrocephalae (Bai Zhu), 15g. If there was high cholesterol, 30 grams of Radix Puerariae (Ge Gen), 12 grams of Radix Albus Paeoniae Lactiflorae (Bai Shao), and 10 grams each of Tuber Curcumae (Yu Jin) and Fructus Crataegi (Shan Zha) were added. If there was accompanying cerebral vascualr disease, 10 grams each of Hirudo Seu Whitmania (Shui Zhi) and Lumbricus (Di Long) and 30 grams of Radix Astragali Membranacei (Huang Qi) were added. If there was accompanying nephropathy, 10 grams of Semen Plantaginis (Che Qian Zi), 15 grams each of Herba Ecliptae Prostratae (Han Lian Cao) and Herba Leonuri Heterophyll (Yi Mu Cao), and 30 grams of Radix Astragali Membranacei (Huang Qi) were added. One ji of these medicinals was decocted in water and administered per day.
Treatment outcomes:
Cured was defined was disappearance of clinical symptoms and fasting blood glucose of under 6.4mmol/L which remained stable for at least a half year. Marked effect meant that there was marked decrease or disappearance in clinical symptoms and fasting blood glucose of less than 7.2mmol/L which remained stable for half a year. No effect meant that the symptoms continued as before and fasting blood glucose was more than 8.5mmol/L. Based on these criteria, 24 patients (63.16%) were judged cured, 12 patients (31.58%) got a marked effect, and two patients (5.3%) got no effect, for a total amelioration rate of 94.74%.
In Chinese medicine, most Chinese doctors think of yin vacuity dryness and heat and qi and yin dual vacuity as the two main patterns of this condition. However, patients with accompanying high cholesterol, cerebral vascular, or microvascular disorders typically have arteriosclerosis, high blood viscosity, and disturbances in blood flow. In Chinese medicine, these mostly have to do with loss of regulation of the viscer and bowels and unsmooth flow of the movement of the qi and blood resulting in blood stasis obstructing the network vessels. Fu Yuan Huo Xue Tang was originally designed to treat traumatic injuries, static blood lodged under the rib-side, and unendurable pain. This formula’s functions are that it quickens the blood and dispels stasis, courses the liver and frees the flow of the network vessels. Within it, Dang Gui, Hong Hua, Tao Ren, and Chuan Shan Jia quicken the blood and dispel stasis, break the blood and free the flow of the network vessels. Da Huang sweeps and washes away static, vanquished blood which has become lodged. Tian Hua Fen enters the blood aspect where it disperses stasis and scatters nodulation. However, it is also able to engender fluids and moisten dryness. Chai Hu courses the liver and regulates the qi, thus strengthening the free and smoothly flowing movement of the qi and blood. When all these medicinals are used together, their effect is that they dispel stasis and engender the new, move the qi and free the flow of the network vessels. Thus they promote the circulation and improve endocrine dysfunction. Consequently, the blood sugar also goes down. In Dr. Zhou’s opinion, this is an example of the saying, “To treat disease, address the root.”