Ang TCM ay may epektibong clinical results sa pagtutol sa diabetes. Una, sa pamamagitan ng comprehensive regulation, ito ay nagpapabuti sa five organs, enhances essence and energy, clears blood stasis, at nagtatagumpay sa both symptom and root cause, na nagpapabalik sa normal ang imbalance ng yin-yang, disorder ng qi and blood, at weakened organ function. Pangalawa, ang herbal medicine ay may tiyak na hypoglycemic effect.
Base sa yin-yang imbalance, si Dr. Lin Lan, isang kilalang diabetes expert sa China Academy of Traditional Chinese Medicine Guang'anmen Hospital, ay naitala ang diabetes sa tatlong uri: yin deficiency with heat excess, qi-yin deficiency, at yin-yang deficiency.
Yin deficiency with heat excess: intense thirst, frequent drinking, increased appetite, frequent urination, hard stool, turbid urine, red tongue with little moisture, yellow dry coating, slippery rapid pulse. Treatment principle: nourishing yin, clearing heat. Formula: Zeng Ye Tang combined with Bai Hu Tang and Xiao Ke Fang with modifications: raw rehmannia 30g, scrophularia 30g, ophiopogon 10g, raw gypsum 30g, anemarrhena 12g, astragalus 15g, trichosanthes 30g, coptis 10g, citrus aurantium 10g. One dose per day, decocted and taken twice daily.
Yin deficiency with heat excess ay karaniwang nakikita sa early stage ng diabetes. Naroon ang mga pasyente sa unang etapa, kung saan hindi pa nakakaranas ng vascular o neural complications, at ang karamihan ay may typical "three poly" symptoms: polydipsia, polyuria, polyphagia. Key diagnostic points: intense thirst, frequent urination, hard stool, red tongue with yellow dry coating and little moisture. Basic pathology: depletion of yin fluids, excessive heat. Therefore, treatment should focus on nourishing yin and clearing heat. Most formulas for this type are cold in nature, so they should not be used long-term to avoid damaging the spleen and stomach. For those with weak spleen-stomach or elderly diabetic patients, dosage should not be too high; otherwise, excessive use of cold herbs can cause gastrointestinal discomfort like epigastric distress, bloating, diarrhea.
Qi-yin deficiency: The typical "three poly" symptoms are not obvious. Dry mouth and throat, fatigue, shortness of breath, soreness in waist and knees, hard stool, possibly accompanied by palpitations and spontaneous sweating, dizziness and tinnitus, numbness or pain in limbs, blurred vision, enlarged tongue with tooth marks, white coating, deep fine pulse. Treatment principle: tonifying qi and nourishing yin. Formula: Sheng Mai San combined with Zeng Ye Tang with additions: astragalus 15g, polygonatum 15g, codonopsis 15g, ophiopogon 10g, schisandra 10g, raw rehmannia 15g, scrophularia 15g, astragalus 15g, trichosanthes 15g, yam 15g, cornus 10g.
Qi-yin deficiency is the most common pattern in diabetes, mostly evolving from yin deficiency with heat excess, though some cases appear in elderly patients newly diagnosed. Clinical features include dry mouth, fatigue, shortness of breath, pale swollen tongue with white coating, and deep fine pulse. Patients with this pattern may also use Yü Yeh Tang, Yü Quan Wan, or Jiang Tang Jia Pian.
Qi-yin deficiency with blood stasis: Three poly symptoms are not obvious. Dry mouth, fatigue, palpitations, shortness of breath, dizziness, tinnitus, soreness in waist and knees, numbness or pain in limbs, blurred vision, chest tightness or pain, possible mild edema in lower extremities, or stroke-related paralysis, abnormal blood rheology, abnormal microcirculation in nail bed, enhanced platelet aggregation, enlarged tongue, dark or purple tongue with ecchymotic spots, prominent and darkened sublingual veins, deep fine pulse. Treatment principle: tonifying qi and nourishing yin, activating blood circulation and resolving stasis. Formula: Qi-Yin Activating Blood Decoction: polygonatum 30g, astragalus 30g, codonopsis 15g, ophiopogon 12g, schisandra 10g, raw rehmannia 20g, scrophularia 30g, salvia 30g, angelica 10g, peach kernel 10g, astragalus 15g, trichosanthes 30g, citrus aurantium 10g, rhubarb 6–10g.
Qi-yin deficiency with blood stasis is the most common pattern in diabetic complications. Features include: ① longer disease duration, mostly in middle to late stages of diabetes. ② Excessive heat signs have subsided, and the classic three poly symptoms are not prominent; instead, complications such as blurred vision, dizziness, palpitations, limb numbness or pain, edema, chest tightness or pain, stroke-related paralysis are present. ③ Clinical manifestations are characterized by dry mouth, fatigue, shortness of breath, and a swollen, dark tongue. This fully reflects the pathogenesis of qi-yin deficiency with blood stasis. Treatment should focus on tonifying qi and nourishing yin, while activating blood circulation and resolving stasis.
Yin-yang deficiency: soreness in waist and knees, shortness of breath, fatigue, dry mouth but drinks little, cold intolerance, cold limbs, facial or lower extremity edema, poor appetite, alternating diarrhea and constipation, turbid urine resembling syrup, sallow and dull complexion, dry earlobes, loose teeth, hair loss, impotence, pale dark tongue with dry white coating, deep fine weak pulse. Treatment principle: nourishing yin and warming yang, tonifying kidney and activating blood. Formula: Jin Kui Shen Qi Wan combined with Shui Lu Er Xian Dan with modifications: prepared rehmannia 15g, yam 15g, cornus 12g, alisma 15g, poria and hoelen 15g each, lotus seed 15g, golden plum 15g, cinnamon twig 6g, processed aconite 8g, salvia 30g, astragalus 15g.
Yin-yang deficiency is commonly seen in the middle to late stages of diabetic complications. These patients have long disease duration, multiple complications, complex conditions, and lesions affecting all five organs, primarily heart, liver, spleen, and kidney, with the key issue being the kidney. Pathogenesis: prolonged diabetes leads to damage of yin, which then affects yang, resulting in severe organ dysfunction, impaired qi movement, obstructed blood flow, and disrupted fluid metabolism, leading to dual deficiency of yin and yang, with internal obstruction of dampness, turbidity, and blood stasis. Treatment should focus on nourishing yin and warming yang, tonifying the kidney and activating blood, while also promoting diuresis and removing dampness and turbidity. The Six Flavor Rehmannia Pill nourishes yin and strengthens the kidney; lotus seed and golden plum solidify the kidney and prevent seminal leakage; cinnamon twig and processed aconite warm and strengthen kidney yang; salvia and astragalus activate blood circulation and resolve stasis; alisma, poria, and hoelen promote diuresis and remove dampness and turbidity.
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