DIABETES TREATMENT W/CHINESE HERBS #3

HISTORICAL BACKGROUND - Continued
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

Herbs typically selected for the first stage of diabetes include glehnia, adenophora, ophiopogon, raw rehmannia, scrophularia, asparagus root, anemarrhena, dendrobium, trichosanthes root, gypsum, yu-chu, lycium bark, and pueraria. These have the qualities of nourishing the yin and fluids, draining fire, and preventing dry heat from arising. Overall, the herbs have an effect on the lungs, heart, and stomach, and are said to treat the upper burner of the triple burner system. The dominant symptoms they are intended to address are dryness of the mouth and throat which is not alleviated by drinking, and sensation of heat and dryness of the skin. In the second stage of the disease, herbs that tonify the qi are incorporated into the treatment, including ginseng (or codonopsis), astragalus, atractylodes, polygonatum, pseudostellaria, and dioscorea. These herbs treat the middle burner and address the problems of fatigue and digestive disturbance (including voracious appetite). The third stage of the disease is treated by incorporating kidney and liver tonic herbs, such as cinnamon, aconite, epimedium, ho-shou-wu, lycium fruit, alisma, and cornus. At this later stage, which involves the lower burner, most of the herbs used for the first stage of disease are deleted (rehmannia is usually retained, but a mixture of raw and cooked rehmannia replaces simple raw rehmannia) and herbs for enhancing blood circulation are included, such as moutan, salvia, persica, rhubarb, leech, and carthamus. Generalized prescriptions for treating diabetes may include some mix of the herbs for different stages; the formula to be used is selected from many choices according to how closely the therapeutic actions match the requirements of the person being treated.

The alteration of blood patterns that arises as diabetes progresses is of significance when considering treatment of the secondary effects of diabetic syndrome. The deficiency of qi and yin yields blood dryness that leads to stickiness and stagnation, and yang deficiency of late stage diabetes leads to coldness which allows blood stagnation. Some persons may have a constitutional predisposition to blood stasis which is not directly part of the diabetic syndrome, but which may make diabetes-induced symptoms show up earlier and more severely.

Blood-vitalizing herbs apparently have relatively little impact on the underlying diabetes (treatments that do not emphasize this method of therapy are about as successful as those that do for lowering blood sugar). It is found that patients with diabetes tend to have a dark-red or slightly dark-red tongue (the redness corresponds to the yin deficiency; the darkness to the poor circulation) and have increased blood viscosity. Atherosclerosis progresses faster in persons with diabetes. The nail bed circulation in diabetic patients is abnormal, but it shows improvement after treatment of diabetic syndrome and blood stasis with herbs (11). Blood-vitalizing herbs are used to treat hyperlipidemia, retinopathy, and peripheral neuropathy associated with diabetes. Modern doctors in China have added a blood stasis category to the traditional group of three basic diabetic stages or groups (by the three burners). In one study of 20 patients who were categorized as having a blood stasis type of diabetes, a blood-vitalizing herb injection produced marked improvement in 43% of the patients (12). This shows some benefits from this type of therapy, but does not suggest a high level of success.

Among a group of 625 patients showing vascular complications of diabetes (29), it was found that 11% had yin deficiency with fire syndrome (first stage), 76% had deficiency of qi and yin (second stage), and 13% had yin and yang deficiency (third stage). Of the entire group, 53% showed the traditional symptom-sign complex of blood stasis.

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