The differentiation of syndromes of internal organs is often used for Diabetes mellitus by traditional Chinese medicine .
The therapeutic methods commonly used are nourish yin to clear away heat, benefit qi to nourish yin, strengthen the spleen and invigorate the kidney, nourish blood and activate blood circulation, nourish yin to support yang, eliminate evil wetnes s to resolve phlegm .
Pattern Differentiation and T reatment
(1) Deficient Yin with Dry-Heat Syndrome
Symptoms and Signs: Dry mouth and throat, excessive thirst, polydipsia, polyuria, weight loss, or constipation, reddish tongue with yellowish dry coating, floody and rapid pulse or floody and slippery pulse .
Therapeutic Method: Nourish yin to clear away evil heat, produce body fluid to quench thirst .
Formula: Select modified Zeng ye Tang ( decoction) , Xiaoke Fang ( decoction) and Baihu Tang (decoction) . The medicines used are: Shengdihuang, Xuanshen, Maimendong, raw Shigao , Gegen, Tianhuafen,Digupi and Danshen .
Modification: For patients with constipation, raw Dahuang powder and Mangxiao should be added .
(2) Deficiency of both Qi and Yin
Symptoms and Signs: No apparent symptoms of polydipsia, polyphagia and polyuria, but dry mouth and throat, lassitude, palpitation, shortness of breath, spontaneous perspiration, night sweat, dysphoria with feverish sensation in the five parts ( chest, palms and soles) ,
insomnia, dreamfulness, scanty dark urine, constipation, reddish tongue with scanty saliva, or pale flabby tongue with teeth prints on the border , thin or partial peeled coating, wiry and thready pulse, or rapid and slippery pulse .
Therapeutic Method: Benefit qi to nourish yin
Formula: Select modified Shengmai San ( powder) and Zengye T ang (decoction) with such medicines as T aizishen , Shengdihuang, Xuanshen, Maimendong, Wuweizi, Gegen, Tianhuafen, Baishaoyao and Huangjing, etc .
Modification: For patients with deficiency of spleen qi , Qiwei Baizhu San ( powder) is recommended instead to strengthen the spleen qi . For patient chiefly with deficiency of yin essence, and marked symptoms of polydipsia, polyphagia and polyuria, Baihu Tang (decoction) plus Renshen should be chosen instead . For patient with marked short breath and lack of vigor, Taizishen should be replaced by Renshen or Huangqi, so as to enhance the function of benefit qi .
( 3) Deficiency of Spleen Qi with Accumulation of Evil Heat
Symptoms and Signs: Heavy sensation in the body , lassitude, soreness and weakness of the loins and knees, weight loss, quick hunger , polyphagia, polydipsia, dry mouth and throat, reddish tongue with yellowish and greasy coating , forceless and rapid pulse .
Therapeutic Method: Strengthen the spleen to benefit qi . Clear away heat to produce body fluid .
Formula: Select modified Yuquan Wan ( pill ) and Renshen Baihu Tang ( decoction) with such medicines as Taizishen, raw Huangqi, Baizhu, Huaishanyao , Gegen, Tianhuafen, Shigao , Zhimu, Maimendong, Shengdihuang , Huanglian, etc .
(4) Deficiency of Spleen with Accumulation of Dampness
Symptoms and Signs: Las situde, weak limbs, abdominal distention, poor appetite, nausea, vomiting, dizziness, fullness in the chest, loose stools, thick white coating, deep and soft pulse .
Therapeutic Method: Strengthen the spleen to dissolve dampness, warm the spleen yang to promote transportation .
Formula: Select modified Qiwei Baizhu San( powder) and Pingwei Shan ( powder ) with such medicines as Dangshen, Baizhu, Cangzhu, Chenpi, Houpo ,Huoxiang, Banxia, Gegen, Muxiang, Zexie, Fuling, honey-fried Jineijin, etc .
Modification: For patient with retention of dampness due to hypofunction of the spleen and loss of appetite, Huanglian and Longdancao should be added; For patient with stagnation of qi , Chaihu and Xiangfu should be added .
(5) Deficiency of Both Qi and Blood
Symptoms and Signs: Lingering disease, lassitude, shortness of breath, pale nails and lips, lustrousles s hair , emaciation, thirst dry mouth, turbid sweetish urine, polyphagia but still emaciation, abdominal distension after a little food, preference in sitting and dislike in physical
movement, palpitation, insomnia, whitish tongue coating, dry mouth, thready and weak pulse .
Therapeutic Method: Tonify blood to benefit qi , moisten the mouth and produce body fluid .
Formula: Select modified Guipi Tang ( decoction) and Senyu Tang ( decoction ) with such medicines as Huangqi , Dangshen, Baizhu, Sanyao, Fuling, Shudihuang , Shengdihuang, Danggui , Baishaoyao , Gegen, Tianhuafen, etc .
Modification: For patient with deficiency of blood, Ajiao , Ziheche, Renshen and Huangqi in heavy dose shoudi be added to tonify blood and qi ; For patient with poor appetite and loose stools due to weaknes s of the spleen and stomach, Zexie, Yiyiren and Sharen should be added . Danggui and Muxiang should be previously fried .
6) Deficiency of Kidney Essence
Symptoms and Signs: Lingering disease, listlessness, polyuria, turbid and greasy urine, sorenes s and weakness of the loin and knees, tinnitus and poor memory . In paients with deficiency of yin, it is manifested by feverish sensation in palms, soles and chest , insomnia, dreamfulness, reddish flushed cheek, dry eyes, blurred vision, dry mouth and throat , reddish tongue with scanty fluid, hready and rapid pulse . In patients with deficiency of yang, it is manifested by chilly sensation of the whole body and the limbs, early morning diarrhea, polyuria at night , impotence, sexual disorder, slight reddish tongue, deep thready and feeble pulse .
Therapeutic Method: Consolidate the body resistance . Reinforce kidney yin essence ( for deficiency of kidney yin) or invigorate kidney yang ( for deficiency of kidney yang) .
Formula: Select modified Zuogui Wan ( pill ) or Liuwei Dihuang Wan ( pill ) to nourish kidney yin, with such medicines as Shudihuang, Shanzhuyu, Huangjing, Heshouwu, Gouqizi, Nü zhenzi , Xuanshen, Hanliancao , Gegen, Tianhuafen, etc . For patients with internal heat
due to yin deficiency, honey-fried Bieja, Zhimu, Huangbai, Mudanpi and Digupi should be added .
Select Shenqi Wan ( pill ) and Lurong Wan ( pill) to invigorate kidney yang with such medicines as Shudihuang , Shanzhuyu, Gouqizi, Shanyao , Buguzhi , Tusizi ,Yinyanghuo, Lujiaojiao , Bajitian, Tianhuafen, etc . For patients with cold symptoms due to yang deficiency , Fuzi and Rougui should be added . If the effect is not remarkable, Lurong Fen ( powder) 0 .5 g should be taken orally once a day .
(7) Stagnation of Accumulation of Phlegm
Symptoms and Signs: Obese body figure , heavy sensation in the head and body , localized pricking pain, purple lips or extremities, numbness of the limbs, greasy saliva, poor appetite, purple and dark tongue with ecchymosis and thick greasy coating , slippery or uneven pulse .
Therapeutic Method: Activate blood flow and remove stasis, dissolve phlegm and clear the meridians .
Formula: Select modified Wendan Tang ( decoction) and Taoren Honghua Siwu Tang ( decoction) with such medicines as Huanglian, Zhuru, Dannanxing, Zhishi , Taoren, Honghua, Danggui , Chuanxiong, Guijianyu, Shuizhi , Zelan, honey-fried Baijiangchan, etc .
Modification: For patients with stagnation in the cerebrum, Yujin and Shichangpu should be added to cause resuscitation . or patients with stagnation in the heart, Gualou and Gegen should be added . For patients with stagnation in the shoulder and back, Pianjianghuang and
Guizhi should be added . For patients with stagnation in the lower extremities, Niuxi and Haiercha should be added . For patients with qi deficiency , Huangqi and Taizishen should be added; For patients with qi stagnation, Chenpi , Zhike and Muxiang should be added; For pa-
tients with depression of liver qi , Chaihu and Xiangfu should be added .