Treatment of Diabetes With Chinese Herbs and Acupuncture - 1

23/5/2016
TreatmentofDiabeteswithChineseHerbsandAcupuncture:1.LoweringBloodSugar
INTERNETJOURNALOFTHE
INSTITUTEFORTRADITIONALMEDICINE
ANDPREVENTIVEHEALTHCARE
TREATMENTOFDIABETESWITH
CHINESEHERBSANDACUPUNCTURE
bySubhutiDharmananda,Ph.D.,Director,InstituteforTraditionalMedicine,Portland,Oregon
WebPostingDate:January2003
Keymedicalterms:diabetesmellitus,NIDDM(type2diabetes,noninsulindependent)
KeyChinesemedicalreferences:deficiencyandimpairmentofqi,yin,andyang
Chineseherbs:alisma,anemarrhena,astragalus,atractylodes,dioscorea,ginseng,ho
shouwu,hoelen,lycium,platycodon,polygonatum,pueraria,rehmannia,salvia,scrophularia,
trichosanthes
Chineseformulas:BaihuJiaRenshenTang,LiuweiDihuangWan,BaweiDihuangWan,
MaimendongYinzi,FangfengTongshengSan,YuQuanWan,XiaoKeWan
SUMMARY:DiabetesisoutofcontrolintheU.S.,withincidenceratesashighas1520%insome
populationgroups(e.g.,theelderly,blacks,Hispanics,andNativeAmericans),andwithsubstantial
increasesinallageandracialgroupsinthepastfewyears.Chinesemedicine,relyingmainlyonherb
formulas,butalsoonacupuncture,hasbeenutilizedextensivelyinEastAsiatoreducebloodsugarin
personswithdiabetes,especiallythosewiththemostcommontype(noninsulindependentdiabetes
mellitus,NIDDM).Basedonextensivelaboratoryandclinicalevaluations,about20herbshaveemerged
asprimarycandidatesfortreatment.Theseherbshavebeenutilizedinasmallnumberoftraditional
formulationsforcenturies,bothfortreatingobviousdiabetesandforotherdisordersthatproducesimilar
symptoms.Acupuncturistshaveidentifiedabout20pointsonthebodythatappeartobeeffectivein
loweringbloodsugartypically,adozenofthesepointsareselectedfortreatmentatonetime.Although
moreclinicalresearchneedstobedonetodemonstratethelevelofeffectivenessoftheherbsand
acupuncture,thesemethodsoftherapyarecurrentlyavailableinmanylocationsintheWesternculturesas
aresultoftheincreasingacceptanceofChinesemedicineduringthepastthreedecades.Thisarticle
outlinesthehistoryanddevelopmentofChineseapproachestodiabetesandrevealsthecurrently
acceptedconcepts.Asecondarticlewillpresenttreatmentforsecondaryeffectsofdiabetes,suchas
impairmentofcirculationandresultingdamagetotheeyes,peripheralneuropathy,andincreasedriskof
heartattack.
TREATMENTOFDIABETESWITH
CHINESEHERBSANDACUPUNCTURE
I.LoweringBloodSugar
bySubhutiDharmananda,Ph.D.,Director,InstituteforTraditionalMedicine,Portland,Oregon
Diabetesisamajorhealthproblemworldwide,butparticularlyinAmerica. Itisestimatedthatabout
2.1% of the world's population has diabetes, but the disease is out of control inAmerica. In the U.S.,
current estimates are that over 6% of the adult population has the disease, 99% of them with the type 2
diabetes mellitus (late onset or noninsulindependent: NIDDM). Type 2 diabetes usually appears around
http://www.itmonline.org/journal/arts/diabetes.htm
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theageof50orlater,thoughitcanoccurduringteenyearsinsomecasesofobesity.Theincidencerate
becomesquitehighamongelderlyAmericans(20%forthoseovertheageof65)andingroupswithgenetic
or other predispositions including blacks (14%), hispanics (15%), and Native Americans (19%).
Furthermore,theoverallincidenceofdiabetesisgrowing,apparentlybecauseofincreasedratesofobesity.
CDCdataonprevalenceofdiabetesacrosstheUnitedStatesin1994(left)andin2000(right).
The rise in diabetes rates is striking. In the year 2000, no states had less than 4% of the
populationwithdiabetes,andonly10stateshadunder5%.
Despitethemajormedicaladvancesinrapidandeasymonitoringofbloodsugarandtreatmentwith
drugs,diabetesremainsaseriousproblem.Bloodsugarregulationthatcanbeattainedbystandardmethods,
particularlywhenpatientsarenotfullycompliantwithallmedicalrecommendations,isoftennotadequateto
avoid common secondary effects of diabetes, including cardiovascular diseases, degenerative eye
conditions,limbnumbnessandpain,skinulceration,andkidneyfailure.Thus,investigatingotheravenuesfor
aidingthetreatmentofdiabetesanditssecondaryconsequencesisanimportantundertaking.
AlthoughtheincidenceofdiabetesisfarlowerinChinathanintheU.S.,predictionsarethatChinaand
therestofsoutheastAsiawillrapidlybecometheworld'smainsiteofdiabetescases(bytheyear2025)due
tothecombinedhighpopulationandchangeinlifestyleasthecountriesmodernize.The disease has been
knownsinceancienttimesandithasbeenasubjectofconsiderablelaboratoryandclinicalresearchinthe
Orient.So,themethodsofChinesemedicinewillnodoubtplayanimportantroleinthecomingyearsinthe
populationofEastAsia. Chinesemedicaltreatmentofdiabetesincludesherbalprescriptions,acupuncture,
anddietaryrecommendations.Thereisnotasingleestablishedtreatmentfordiabetes,soitisnecessaryto
reviewthetraditionalmedicalideasaboutdiabetesandtheresearchthathasbeenconductedtodatetogive
guidanceinusingthesemedicaltherapies.Thispartofthetwopartseriesfocusesontreatmentstolower
bloodsugarpartIIfocusesontreatmentofsecondarymanifestationsofdiabetes.
Practitioners of Chinese medicine in the U.S. and other Western countries often have more time to
spend consulting with their patients than do medical doctors. This extra time gives an opportunity for
exploringwiththepatientthekeyrolesofexerciseanddietarycontrolinlimitingtheimpactofdiabetesand
preventingitsdevelopmentwithagingforthosewhodonotcurrentlyhavethedisease.While acupuncture
andherbsareanimportantoptionforthesepatients,itisclearfromtheevidencethatexiststhatasmuchor
morecanbeaccomplishedthroughchangesinbehavior.Itisnecessaryforpractitionerstokeepcurrentwith
informationaboutdietaryadvice,assomeconceptsthatwerecommonjustafewyearsagohaveturnedout
tobeincorrectormisleading,andarereplacedbynewapproachesbackedbyrecentresearch.
BRIEFHISTORYOFCHINESEMEDICINEANDDIABETES
Chinesemedicineowesitscurrentstaturetothelonghistoryofitspractice,datingbackmorethan2,000
years in a form similar to that utilized today. Chinese physicians appear to have had a reasonably good
understandingofdiabetessinceancienttimes.InoneoftheoldestbooksaboutChinesemedicaltheory,the
HuangdiNeijing (1), compiled around 100 B.C., the condition known as xiaoke is mentioned. This is
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translated today as diabetes or diabetic exhaustion. The literal translation of the term is emaciationthirst,
referring to the disease manifestation when it has gone untreated: namely, one loses body weight despite
eatingnormally,andthirstispersistent.Accordingtothisancienttext,thesyndromearisesfromconsuming
toomuchfatty,sweet,orrichfood.Itissaidthatittypicallyoccursamongwealthypeople:"youaskthemto
refrain from a rich diet, advice which they may resist." The description fits that of noninsulindependent
diabetesmellitus.
Two of the traditional herbal formulas most frequently used in modern China and Japan for the
treatment of diabetes were described in the book Jingui Yaolue (2), which is about miscellaneous
diseases, written around 220A.D. The text described symptoms characteristic of uncontrolled diabetes,
includingthirst,frequenturination,andlossofbodyweight.OneoftheformulasisRehmanniaEightFormula
(Bawei Dihuang Wan also called Jingui Shenqi Wan), originally indicated for persons who showed
weakness,fatigue,andcopiousurineexcretedsoonafterdrinkingwaterinsomecases,thismayhavebeen
diabetesasweknowittoday.TheotherformulaisGinsengandGypsumCombination(BaihuJiaRenshen
Tang)itwasindicatedoriginallyforseverethirstandfatigueandisconsideredidealfordiabetesofrecent
onset.
In 752A.D., the distinguished physicianWangTao mentioned that diabetes was indicated by sweet
urine and he recommended the consumption of pork pancreas as a treatment, implying that the pancreas
wastheorganinvolvedinthedisease(3).Further,hesuggestedthattheurineofdiabetespatientsshouldbe
testeddaily(bytastingforsweetness)todeterminetheprogressofthediseaseanditstreatment.
LiuWansu(ca.11201200A.D.)propoundedthetheorythatdiseasesareusuallycausedbyheatin
thebody,whichshouldbecounteredbyherbsthathadacoldnature(4).Oneofhispublishedformulasfor
diabetes, Ophiopogon and Trichosanthes Combination (Mainendong Yinzi), is traditionally described as
clearingheatandnourishingyin.Itiscomprisedalmostentirelyofherbsthathavebeenshownbymodern
research to lower blood sugar. Another of his formulas, Siler and Platycodon Formula (Fangfeng
TongshengSan),isrecommendedbymanyJapanesedoctorsfortreatmentofobesityandaccompanying
type2diabeticsyndrome(5).
Bythelatterhalfofthe20thcentury,therewereabout200standardprescriptionsrecordedassuitable
fortreatingdiabetes(6).Themajorityofthesemaybeviewedascombinationsthatrelyprimarilyonabout
twodozenantidiabeticingredients(seeTable,page4)plusasmallnumberofauxiliaryherbs.Theseother
herbsareunderstoodtohavecomplementaryproperties(assistthefunctionofthemainherbs)orareaimed
attreatingaspecificmanifestationofthedisease.Themaintraditionalprescriptionsbroughtforwardinclude
Rehmannia Eight Formula and its simplified version Rehmannia Six Formula Ginseng and Gypsum
Combination,andOphiopogonandTrichosanthesCombination.
Atheoryhasarisenastohowdiabetesprogresses(7,41).Thediseasebeginswithadeficiencyofyin.
This seems contradictory to the appearance of the patient, who often shows obese constitution and low
metabolism,signsthatwouldcorrespondtoexcessofyinanddeficiencyofyang.However,thepatientswith
earlystageofdiabetesactuallyhaveahyperactivemetabolismthatdoesnotprovideusefulenergy.Hence,
thefoodnutrientsarenotsuccessfullyutilizedhungerpersists,sugarpoursoutintheurine,thirstdevelops,
andtheremaybeeasysweating.Thisyindeficiencythengeneratesheatthatbecomespathologicalandthen
parchestheyin.The imbalance of yin and yang eventually degrades and inhibits the qi, so that qi and yin
deficiencycoexist.Atthispoint,secondaryeffects,suchasbloodstasisanddampheat,manifest,causing
manyserioussymptoms(29).Withoutpropernourishmentofqiandyin,yangeventuallybecomesimpaired,
andthepatient,nowwithadvanceddisease,hasacombineddeficiencyofqi,yin,andyang.
MODERNHISTORYOFEVALUATINGHERBSANDFORMULAS
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Theresearchondiabetestreatmenthasbeenongoingforseveraldecades,yetremainsinthedevelopmental
stagesduetothecomplexityofthetaskathand.Initiallaboratoryanimalstudiesofbloodsugarlowering
effectsofherbswereconductedinChina,Korea,andJapanduringtheperiod19271952(6,13).Several
commonlyusedherbswereshowntolowerbloodsugar,includingyinnourishingrehmannia,scrophularia,
hoshouwu, and yuchu qi tonifying ginseng, atractylodes, and polygonatum (haungjing, which also
nourishes yin) and heat clearing herbs, such as phellodendron, coptis, lycium bark, lonicera, and alisma.
This hypoglycemic effect occurred when the herbs were used to treat blood sugar increases induced by
epinephrine,whichactsasastresshormone.
Sincethe1960s,amuchinvigoratedprogramofdiabetesresearcharose.Newlaboratoryevaluations
weremadepossiblebythefindingthatthetoxicchemicalalloxanselectivelydestroysthebetacellsofthe
pancreas.Thus,mice,rabbits,orotherlaboratoryanimalstreatedwiththiscompoundsufferfromadiabetic
syndromequitesimilartothatofapersonwhohasinsulindependentdiabetes(typeI,earlyonset).Dr.S.
NagayoshiwasabletoreportthatRehmanniaEightFormulareducedbloodsugarinalloxantreatedrabbits
ina1960journalreport(6).Comparingtheherbaleffectsinnormallaboratoryanimalswiththoseinalloxan
treatedanimalsprovidessomeindicationofthemechanismsbywhichtheherbsaffectbloodglucoselevels
furtherinformationisobtainedwhenusingthesameherbstotreatanimalsaffectedbyepinephrine.Progress
hasbeenmadewithstudiesofageneticstrainofmicefirstdescribedin1979thatgainweightunusuallyand
begindevelopingatype2diabetesafterabout10weeksofgrowth.Thesemicewereusedinastudyofthe
hypoglycemic role of ginseng and its active constituents in the traditional formula Ginseng and Gypsum
Combination(24).
PerhapsthemostextensivelaboratoryinvestigationofChineseherbsfordiabeteshasbeencarriedout
by Huang RayLing and his coworkers at the National Research Institute of Chinese Medicine inTaiwan
(16).Dr.Huangtestedavarietyofherbextractsinbothalloxantreatedmiceandnormalmice,inorderto
compare the impacts of the herbs with or without insulin involvement. To obtain more significant results,
bloodsugarresponsesweremonitoredatdifferenttimesafteradministrationofherbs,inglucosetolerance
tests,andwithdifferingdosagesoftheherbmaterials.
Herbsthatshowedsignificanthypoglycemicactioninbothalloxantreatedanduntreatedmiceincluded
somethatwerenotcommonlyusedintraditionalformulas,suchasredatractylodes(cangzhu),cyperus,and
phaseolus (mung bean). Herbs that showed a substantial hypoglycemic effect in alloxantreated mice but
littleeffectinnormalmice,however,matchedthepatternoftraditionalherbtherapytheyincluderehmannia,
scrophularia, astragalus, coix, moutan, lycium bark, lycium fruit, trichosanthes root, alisma, and asparagus
root.TraditionalherbformulasthathadsignificanthypoglycemicactivitybythesetestsincludedRehmannia
SixFormula(LiuweiDihuangTang),RehmanniaEightFormula(BaweiDihuangTang),andGinsengand
GypsumCombination(BaihuJiaRenshenTang).
The dosages of herbs administered to the mice to obtain the significant hypoglycemic action ranged
from1.25to5.0grams/kg.Thesedosagesarequitehigh,anditisdifficulttotranslatetheeffectsseenin
these diabetes models with these herb dosages to human requirements, but human dosages would be
expectedtobeatthehighendoftherangenormallyrecommendedfortreatmentofotherdiseasesbasedon
thesefigures.
AsummaryofChineselaboratoryresearchonhypoglycemicagents,reportedinthebooks Modern
Study andApplication of Materia Medica (30) and Pharmacology and Applications of Chinese
MateriaMedica (13) yielded the following listing of herbs. Only the commonly used items are included
here there were also a small number of additional herbs that showed positive effect but are not included
repeatedlyinprescriptionsmentionedinthepublishedclinicaltrials.Notethatmostofthematerialsareroots
andrhizomesandmanyoftheherbscontainsaponinsortheiraglycones,triterpenoids.
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CommonName
PinyinName
BotanicalName
PlantPart
Comments
Alisma
zexie
Alismaplantagoaquatica
rhizome
inRehmanniaSixandRehmannia
EightFormulacontainstriterpenes
Anemarrhena
zhimu
Anemarrhenaasphodeloides
rhizome
inGinsengandGypsumCombination
andOphiopogonandTrichosanthes
Combinationcontainssaponinsthat
havehypoglycemicaction
Astragalus
huangqi
Astragalusmembranaceus
root
containsflavonoidsandsaponins
Atractylodes
baizhu
Atractylodesmacrocephala
rhizome
containsessentialoilsactionof
decoctionisslow:25hours
Atractylodes,red
cangzhu
Atractylodeslancea
rhizome
containsessentialoilsgradual
decreaseinbloodsugarforalloxan
treatedrabbits
Dioscorea
shanyao
Dioscoreabatatas
rhizome
inRehmanniaSixandRehmannia8
Formulacontainssaponins
Ginseng
renshen
Panaxginseng
root
inGinsengandGypsumCombination
andOphiopogonandTrichosanthes
Combinationcontainssaponins
Hoshouwu
heshouwu
Polygonummultiflorum
root
treatsperipheralneuropathy
containsanthraquinones
Hoelen
fuling
Poriacocos
mushroom
inRehmanniaSixandRehmannia
EightFormulaandinOphiopogon
andTrichosanthesCombination
Lyciumbark
digupi
Lyciumchinense
bark
slowandlastingactioninreducing
bloodsugar
Lycium
gouqizi
Lyciumchinense
fruit
producessustaineddecreasein
bloodglucoseincreasestoleranceto
carbohydrates
Platycodon
jiegeng
Platycodongrandifolium
root
containssaponinsreducesblood
glucoseinnormalandalloxantreated
animals
Polygonatum
huangjing
Polygonatumsibiricum
root
inhibitsepinephrineinduced
hyperglycemia
Pueraria
gegen
Puerarialobata
root
inOphiopogonandTrichosanthes
Combinationcontainsflavonoids
Rehmannia
dihuang
Rehmanniaglutinosa
root
inRehmanniaSixandRehmannia8
FormulaandOphiopogonand
TrichosanthesCombination
Salvia
Salviamiltiorrhiza
showsprolongedhypoglycemic
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danshen
Root
effectcontainsquinines
Scrophularia
xuanshen
Scrophularianingpoensis
Root
actionisweakerthanrehmannia
Trichosanthes
tianhuafen
Trichosantheskirilowii
root
inOphiopogonandTrichosanthes
Combination
Yuchu
yuzhu
Polygonatumofficinale
rhizome
containsglycosidesreducesblood
sugarinalloxantreatedrats
CLINICALAPPLICATIONS
Clinical trials of Chinese herbs for diabetes have been conducted with increasing frequency over the past
thirtyyears.Atthe9thSymposiumofOrientalMedicinein1975,Dr.TakahideKuwakireportedonpartial
successintreating15diabetespatientswithtraditionalherbformulasnineofthepatientstreated(durationof
usingherbsrangedfrom2to36months)showednotableimprovements(6).InBeijing,aDiabetesUnitwas
establishedin1975attheDepartmentofTraditionalChineseMedicineattheCapitalHospitalasummary
oftheirrecommendationshasbeenpublishedinAmerica,givinganopportunityforWesternpractitionersto
provide similar treatments to their patients (14). In Changchun, the Kuancheng Institute of Diabetes was
establishedin1989researcherstherepublishedresultsofahighlysuccessfulclinicaltrialofherbsusedfor
treating diabetic ketonuria, in which 28 of 33 patients showed marked improvements after consuming a
complexformulacomprisedalmostentirelyofherbsthatindividuallyhavehypoglycemicactions(15).These
Chinese clinics, and other facilities in China and Japan, have provided herbal treatments to thousands of
patientswithdiabetes,andtheresultshaveoftenbeenmonitoredandreported.
Examplesofclinicalrecommendationsandevaluativetrialsforthetreatmentofdiabetesarepresented
inthebookModernClinicNecessitiesforTraditionalChineseMedicine(17).Theformulasthathad
beenshowntohavehypoglycemiceffectsintheanimalstudies,RehmanniaSixFormulaandGinsengand
GypsumCombination,wererecommendedtotreatthosewhohavenormalinsulinsecretionbutsufferfrom
diabetes(thiswouldbetype2,orinsulinindependentdiabetes).Theseformulasareforthecommonqiand
yindeficiencysyndromefoundinearlystageofclinicalsymptoms.AtraditionalvariationofRehmanniaSix
Formulawasalsosuggested,madebyaddinganemarrhenaandphellodendron(toformZhiBaiDihuang
Wan).
ReducingSugarTabletA( JiangTangJiaPian),comprisedofastragalus,polygonatum,trichosanthes
root,pseudostellaria,andrehmannia,wasrecommendedforthosewithlowlevelsofinsulin,butwhoarestill
capableofproducinginsulin.The herbs were administered as extracts in tablet form, with 2.3 grams raw
materialpertablet,6tabletseachtime,threetimesdaily,foratotaldoseofover40gramsperday(raw
materialsequivalent).Theeffectsweresaidtobeenhancingsugartoleranceandelevatingthelevelofserum
insulin.Inthetreatmentof405casesofdiabeteswiththispreparationattheGuanganmenHospital,76.5%
of the patients had improved sugar tolerance. Among those patients who most closely fit the therapeutic
patternoftheherbsthosewithqiandyindeficiencytheeffectiveratewasslightlyhigher,81%.
RehmanniaEightFormulawasrecommendedforthosepatientswhoproducedlittleornoinsulin.This
is for patients with advanced disease, representing a deficiency of yin and yang (the cinnamon bark and
aconiteaddedtoRehmanniaSixFormulatoproduceRehmanniaEightFormulaaresaidtorestoreyang).In
laboratoryanimalstudies,useofthisformularesultedinreductionofwaterdemand(thirst),bloodsugar,and
sugarspillintotheurine.
JadeSpringPill(YuQuanWan),apatentformulafromChina,isrecommendedfordiabetestreatment
inthedosageof50gramsperday(theoriginalformwaslargehoneypillsofabout6gramseach),forat
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leastonemonth.Inlaboratoryanimalstudies,thisformulawasshowntoincreaseglycogeninlivercells.The
SichuanProvinceUnitedPharmaceuticalManufactory,developedasecondgenerationofJadeSpringPills
comprisedofpueraria,trichosanthesroot,rehmannia,licorice,schizandra,andotherherbsnotmentionedon
thelabel.Thesepillsareindicatedinthepackagelabelingforthe"illfunctionoftheisletsofLangerhans."The
relativelysmallpillsarepackedintosmallbottleswithatotalof6gramseach,and20bottlesarepackedin
onebox,accompaniedbyinstructionstotakeonebottleeachtime,fourtimesdaily(theboxisafiveday
supplyat24grams/day).Comparedtothefirstgeneration,itissaidonthepackageinsert,thenewproduct
had been clinically proved to have an improved rate of cure and that the dose had been reduced. Jade
SpringPillisusefulfortheearlystageofdiabetes,whenyindeficiencyanddrynessdominate.Inarecent
clinicalevaluationofaChineseherbformulafordiabetes,JadeSpringPills,usedforthecontrolgroup,was
reportedtobeeffectiveinreducingbloodsugarfor79%ofcasestreated(33).
Several clinical trials have been reported in Chinese medical journals with brief English summaries
appearing in Abstracts of Chinese Medicine (a Hong Kong publication produced from 19861996). A
representative report is one that originally appeared in the Journal of the Zhejiang Traditional Chinese
Medical College in 1989 (18). Patients were treated with a decoction containing astragalus, codonopsis,
rehmannia, gypsum, salvia, persica, carthamus, red atractylodes, anemarrhena, and tangkuei. This
combinationofqiandyintonicsplusbloodvitalizingherbsisappropriatetotreatingpatientswithamiddle
stagediseaseshowingsomesecondarysymptoms.Modificationsoftheformulawouldalsobemadeforthe
specific symptoms. The patients showed a variety of secondary manifestations of the disease, including
nephropathy,peripheralneuropathy,dermatologicaldisorders,retinitis,andlivercirrhosis.Among19non
insulindependentcasestreated,fastingbloodglucoselevelsdecreasedfromthepretreatmentrangeof160
300mg%to80110mg%.Onepatientwithinsulindependentdiabetesshowedadeclineinfastingblood
sugarfrom500mg%beforetreatmenttoreadingsof110200mg%aftertreatment.Generally,itwasfound
that blood glucose decreased after 12 weeks of treatment and became steady after one month, and the
bloodglucosechangeswerefollowedbysymptomaticimprovements.
AnewpatentformulationdevelopedbytheChengduUniversityofTraditionalChineseMedicineand
PharmacologyismadecomprisedofGuiShaoDihuangWan(RehmanniaSixFormulawithtangkueiand
redpeony)withaddedmorusleaf,litchiseed,andcoptis.Thelatterthreeherbswererecentlydemonstrated
tobeeffectiveinloweringbloodsugar(34,35,36).
DIFFERENTIALTHERAPY
Althoughcertainherbshavebeenidentifiedashavinghypoglycemicactivity,Chinesephysicianspreferusing
theminaformulationthataddressesdifferentialdiagnosisratherthanrelyingsolelyonherbsproveneffective
inlaboratorytests.As an example of how the herbs are used in this context, the following is the strategy
outlinedbyLuRenheinthetreatmentof865elderlypatientswithdiabetes(41)thelargenumberofpatients
allowedhighlydifferentiateddiagnosticcategories.Hefirstdividedthediseaseintofivestages,representinga
progressionfromsimpleyindeficiencytocompletebreakdownofthebodysystems(notethat"impairment"
ismoreseverethandeficiency,inthatitinvolvesactivedegradation):
I.Yindeficiencypreclinicalstage.
II.Yindeficiencyproducesinternalheatearlyclinicalmanifestation
III.Impairmentofbothqiandyinearlystageofcomplications
IV.Impairmentofqi,yin,andyangstageofintermediatecomplications
V.Failureofqi,yin,andyangstageofadvancedcomplications
Thefirstfourstagesweresubdividedintoatotalof16syndromesbasedontheorgansystemsaffected
andtypesofdisordersgeneratedbythebasicpattern.Withineachofthesesubcategories,thepatientscould
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furtherbegroupedaccordingtotheseverityofmanifestation,butthisdidnotinfluencethechoiceofherbsto
useintreatment.Foreachpattern,abaseformulaof812herbswaspresented(seeTablebelow).Among
the herbs used in the formulas listed in this table, there is frequent reference to a few that are known as
hypoglycemicagents.Theseare(numberofformulasthatincludeeachherbinparentheses):
pueraria(12)
rehmannia(8)
trichosanthes(7)
scrophularia(7)
salvia(7)
polygonatum(6)
hoshouwu(6)
ophiopogon(6)
Aside from these herbs, some herbs were used with less frequency, but commonly relied upon for
certainsyndromes:
coptistoclearheat
achyranthestovitalize
bloodcirculation
hoelentoremovedampness
rhubarbtopurgethe
intestines
Inthecaseofrhubarbcontainingformulas,therhubarbwouldbeincludedonlysolongasconstipation
remainsaproblemafterthat,itcouldberemoved.
DifferentialTreatmentofDiabetesbyStageandSyndrome
Stage
Syndrome(#ofpatients)
PrincipleofTreatment
MainHerbs
I.Yindeficiencycausing
hyperactiveyang(9)
nourishyin,checkexuberance
ofyang
rehmannia(raw),hoshouwu,
ophiopogon,pueraria,
trichosanthes,haliotis,motherof
pearl,coptis,achyranthes
I.Deficiencyofyinwith
exuberanceofliver(11)
replenishliveryin
rehmannia(raw),scrophularia,
ophiopogon,peony,hoshou
wu,pueraria,trichosanthes,
licorice,salvia
II.Retainedheatinthestomach dispelevilheatfromthe
gypsum,calcite,chihshih,
andintestines(70)
stomachandintestine,protectqi adenophora,yuchu,rehmannia
andyin
(raw),pueraria,trichosanthes,
coptis,rhubarb
II.Stagnantqioftheliver
transformingtoheat(65)
dispersestagnancyofqiofthe
liverandremoveevilheat
bupleurum,peony,redpeony,
chihko,chihshih,magnolia,
pueraria,trichosanthes,coptis,
scrophularia,rhubarb
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II.Deficiencyofspleenwith
accumulationofdampnessand
heat(50)
invigoratethefunctionofthe
spleen,resolvedampness,
assistedbyremovalofheatand
diuresis
redatractylodes,phellodendron,
achyranthes,coix,polyporus,
hoelen,magnolia,citrus,
capillaris,pueraria,trichosanthes
II.Retainedheatinthelung
formingtoxicheat(20)
clearheatinthelung,remove
toxin
adenophora,ophiopogon,scute,
morusbark,lonicera,forsythia,
scrophularia,hoshouwu,
pueraria,trichosanthes,chin
chiu
III.Unrelieveddrynessandheat reinforcethekidney,replenish
leadingtoimpairmentofqiand qi,overcomedryness,
yinofthekidney(80)
invigoratebloodcirculation
polygonatum,rehmannia(raw),
hoshouwu,scrophularia,
pueraria,trichosanthes,salvia,
achyranthes
III.Impairmentofqiandyin
causinglackofnourishmentto
thechannelsandconduits(90)
reinforcethekidney,replenish
qi,invigoratebloodcirculation,
strengthenthepulsetorestore
flowofqi
polygonatum,rehmannia(raw),
hoshouwu,pueraria,red
peony,salvia,dipsacus,
chaenomeles,achyranthes,chin
chiu
damagingthespleenandlung
(80)
reinforceqi,invigoratethe
spleen,replenishtheqiofthe
lung
astragalus,atractylodes,siler,
morusbark,adenophora,
ophiopogon,scrophularia,
persica,apricotseed,pueraria,
chihshih
damagingtheheartandspleen
(50)
reinforcethekidneyand
replenishqiofspleenandheart
polygonatum,pseudostellaria,
ophiopogon,schizandra,
rehmannia(raw),coix,hoelen,
salvia
resultingfrompersistent
dampness(60)
regulatethecentertoresolve
platycodon,atractylodes,
dampness,protectingtheqiand magnolia,hoelen,citrus,pinellia,
yin
codonopsis,pueraria,coptis,
capillaris,scrophularia,rhubarb
causingstagnancyintheliver
withbloodstasis(65)
replenishqi,nourishyin,remove pseudostellaria,polygonatum,
stagnancyoftheliver,resolve
scrophularia,rehmannia(raw),
bloodstasis
bupleurum,peony,chihko,
salvia,persica,polygonumfruit,
schizandra,crataegus
IV.Impairmentofyin,yang,and regulateandreplenishyinand
qileadingtostagnationof
yangandactivatetheblood
phlegmandqi(50)
polygonatum,tangkuei,
cibotium,dipsacus,
chaenomeles,rehmannia(raw),
redpeony,clematis,gleditsia,
centipede,pueraria,
trichosanthes
IV.Impairmentofyin,yang,and reinforcetheqi,replenishthe
qicausinglackofnourishment kidney,invigoratetheyang,
Americanginseng,deerantler
gelatin,tortoiseshellgelatin,
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forthepectoralenergyand
sinews(30)
strengthenthesinews
pipefish,seahorse,cardamom,
aquilaria
IV.Impairmentofyin,yang,and reinforceqi,invigoratethe
qicausinglackofnourishment spleen,nourishtheliverand
tothetendonsandmuscles(30) kidney
Astragalus,tangkuei,
pseudostellaria,atractylodes,
polyporus,hoelen,salvia,
cnidium,lycium,epimeidum,
ophiopogon,pueraria,
chaenomeles
IV.Impairmentofyin,yang,and regulateandreinforceqi,move
qicausinglackofnourishment thebowels
tothestomachandintestines
(40)
polygonatum,tangkuei,
scrophulari,hoshouwu,peony,
licorice,chihshih,salvia,
schizandra,cistanche
V.Failureofyin,yang,andqi
(85)
addressspecificmanifestations
offailure
attemptemergencytreatment
DOSAGEANDFORMOFADMINISTRATION
Thedosageofherbsappliedtotreatmentofdiabetesisoftenquitehigh.Asrevealedbytheexperiencewith
ReducingSugarTabletAandJadeSpringPills,aformulathatisconsideredhighlyeffectivemustbetakenin
dosages of about 1224 grams per day even when presented as a highly condensed extract (made from
about 4080 grams of crude herbs) in convenient form. This apparent requirement is reflected in several
booksthatrecommendherbsindecoctionform.
InthebookClinicalExperiences(19),anumberofdifferentdecoctionsaresuggested.Thedosages
of the formulas range from that of an "experiential prescription" containing three herbs (astragalus,
rehmannia, and dioscorea, 30 grams each in decoction) at a total dose of 90 grams per day, to a dozen
herbs in each of three formulas for yin deficiency syndrome (each prescription contains rehmannia,
ophiopogon,andscrophularia),withabout120150gramsforoneday.Thereisalsopresentedinthisbook
amodifiedRehmanniaEightFormulaforadvancedcasesshowingyangdeficiency,withabout170gramper
daydosage.Added to Rehmannia Eight Formula are the antidiabetes herbs trichosanthes root, pueraria,
salvia,andatractylodes.Regardingefficacy,itisstatedthattheearlyonsettypeofdiabetesrespondspoorly,
buttheinsulinindependenttypewithslowonsetrespondsfavorably.
Inthebook100 Famous and Effective Prescriptions ofAncient and ModernTimes (20),the
DecoctionforDiabetes(YiTangTang)ismentioned.Itcontainsrehmannia,trichosanthesroot,dioscorea,
gypsum, ophiopogon, dendrobium, and seven other herbs. Taken as a decoction, the standard formula is
madewith226gramsofherbsforadailydose.Thisformulaisusuallyprescribedwithadditionalherbsto
address specific symptoms, so that the total daily dosage often reaches 250 grams. In a study with 215
diabeticpatients,itwasreportedthat62caseswererelievedofthirst,overeating,polyuria,andsugarinthe
urinethefastingbloodglucosedeclinedtobelow130mg%.Additionally,88othershadsomedegreeof
improvement(totaleffectiverate:70%).
InthebookIntegratingChineseandWesternMedicine(21),fourherbformulasaredescribed:
eachoftheformulas,atwodaysupplyofherbs,ismadewithover250gramsofherbmaterials(thus,over
125grams/day).Allfourformulascontaintwelvetothirteenherbs,andtheyallincludepueraria,rehmannia,
andsalvia.Nothingissaiddirectlyaboutthedegreeofeffectivenessoftheformulas,butthetextendswith
thecommentthatcertainpills"arealsoveryeffective,"citingRehmanniaSixFormula,JadeSpringPills,and
DiabetesPills(XiaoKeWan).
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In A Clinical Guide to Chinese Herbs and Formulas (22), three formulas for diabetes are
presented.Theformulasarecomprisedoftypicalhypoglycemicherbsasmentionedabove,andthedosage
isusually1015gramsofeachmajoringredient,with67majoringredients,andatotaldosageofabout100
gramsperday.Theformulascanbemodifiedforspecificsymptoms,whichmightaddabout10to30grams
ofherbs.
Thelargeamountofrawmaterialsapparentlyneededfortreatingdiabetesmaybeareflectionofthe
need to consume several hundred milligrams of mixed nontoxic active components (e.g., flavonoids,
saponins, alkaloids, iridoids, anthraquinones) derived from herbs to attain substantial physiological
improvementswithinatypicaltreatmentperiodofthreemonthsorless.Itisexpectedthatmostoftheanti
diabeticactiveconstituentsarepresentatalevelofapproximately2%(orless)ofthedriedherbmaterial.
Decoctionsthathave90150gramsofmaterials(ormore),mightyieldonlyabout2gramsofhypoglycemic
constituents,perhapsanaverageof250mgofeachchemicaltype.
Condensingtheactivecomponentswillyielddriedmaterialsthatmustbetakenatalevelthatisoften
stillregardedasinconvenientbymany.Forexample,drieddecoctions(manufacturedmainlyinTaiwanand
Japan)ofmixedherbstypicallyyieldaproductthatisabouta5:1concentrationfactor(500gramsofraw
materialsyields100gramsoffinishedproduct).SuchmaterialsareavailableintheWestandoftenpackaged
inunitsof100grams.Toobtaintheequivalentofadosageof100gramsofcrudeherbsindecoction,one
wouldconsumeabout20gramsofthedriedextracts(aonedaydose),andabottleofherbswouldbea5
daysupply.ThisissimilartothedosingforthesecondgenerationJadeSpringPillsdescribedabove,made
ofcondensedextracts.
Attempts have been made to isolate active constituents, as one way of making treatment more
convenient,butonethenlosesseveralofthepurportedadvantagesofwholeherbsandformulas.Oneitem
of current interest is the alkaloid berberine, which has many therapeutic uses, including treatment of
hyperglycemia.Ratstreatedwithalloxanandwithberberinewerelesslikelytoshowbloodglucoseriseand
pathological change in the beta cells. Insulinindependent diabetes patients treated with 300500 mg of
berberine daily for one to three months (along with dietary control), showed definite reduction of blood
sugar (23). Berberine is an active component of coptis and phellodendron, used in several diabetes
prescriptions.
Aflavonoidrichfractionisolatedfromguavaleaveswasextracted,madeintotabletswith400mgof
theconcentrateineach,andadministeredatadosageof612tabletseachtime,threetimesdaily(totaldaily
doseis7.214.4grams),toproducehypoglycemicaction(17).Flavonoidsareactivecomponentsofmany
herbs,thoughnotnecessarilythekeycomponentsofmostantidiabetesherbs.
Ginseng and its saponins have been studied in alloxantreated, genetically diabetic, and normal mice
(24), revealing a hypoglycemic effect ginseng saponins also stimulate the production of insulin. In elderly
patients with hyperglycemia, the saponins reduced serum glucose (25). Ginseng saponins are typically
providedintabletsof50mgeach,withadoseof12tabletseachtime,twotothreetimesperday.Other
saponins, such as those in platycodon and the Indian herb gymnemma, have been shown to lower blood
sugar,andthedosingappearstobeinarangeofabout300mg/dayormore.
Still,anarticleintheJournalofTraditionalChineseMedicine(26)suggeststhatacondensedblendof
herbscanbeprescribedinmoderatedosage.Thisarticledescribedtreatmentof102casesofnoninsulin
dependent diabetes, using the Gan Lu Xiao Ke capsule, with rehmannia, codonopsis, astragalus,
ophiopogon,asparagus,scrophularia,cornus,tangkuei,hoelen,alisma,andcuscuta.Patientsweretreated
withtheherbsforthreemonths.Thegroupaveragebloodglucoselevelfellfromaninitialvalueof200mg%
to154mg%.Thedosageofmaterialinthecapsuleswasonly5.4gramsperday.However,theresultswere
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alsomodest(30%weremarkedlyimproved,57%wereimproved,buttheaveragebloodsugarremained
quitehigh),andpatientswouldreceiveadditionalherbstotreatspecificsymptoms:thoseherbs,addingto
thetotaldosage,mightalsocontributetothehypoglycemicaction.
Another example, was a report about treatment of persons with vascular complications of insulin
independent diabetes (e.g., coronary heart disease, vascular disease of the lower extremities, stroke,
retinopathy, etc.). They were treated with a sugarreducing, pulseinvigorating formula. Unfortunately, the
ingredientswerenotspecifiedotherthanastragalusandrehmanniatheformulaissaidtotonifyqi,nourish
blood,andvitalizeblood.Theherbsweresimplypowderedandgivenincapsules,atadosageof23grams
eachtime,threetimesdaily(29).Thetreatmenttimewasthreemonths,andifthetreatmentwasdeemed
effective,itwouldthenbecontinued.Improvementsinbloodparameterswerenotedin82%ofthecases
thatfitthepatternofqiandyindeficiency(whichtheformulamainlyaddressed),butonlyabout63%for
othercases(yindeficiencywithfire,oryinandyangdeficiencythemoreadvancedcases).Fasting blood
sugarwasmaintainedbelow150mg%for77%ofthosetreated.
Furtherinvestigationisnecessarytodeterminetheminimumformulasize(numberofingredients)and
the proper dosage of those ingredients, as well as the best form (powdered herbs, extracts, or a
combination)togetthedesiredeffects.Theuseofnutritionalsupplements(9)andOrientaldieteticpractices
(10)mightaddtothebenefitsofherbalmedicineprescriptions,afactorthathasnotyetbeenthesubjectof
study.
COMBININGDIABETESDRUGSWITHHERBS
ThereisnoevidencethatdiabetesdrugsandChineseherbtherapiesareincompatible,butthereisaconcern
thatwhencombiningthetwo,thebloodsugarmaydeclinetoofar.Iftheherbsareaddedgraduallyovera
fewdayswithcontinuedmonitoringofbloodsugar,thisproblemcanbeavoided.Whenherbssuccessfully
contributetoloweringbloodsugar,drugdosagemaybereducedunderaphysician'sinstructions.
WhileChineseliteraturesometimesmentions,inpassing,theuseofChineseherbsalongwithmodern
drugs,specificstrategiesforcombiningthetwoarenotcommonlypresented.AreportonintegratedChinese
andWesterntreatmentofdiabeteswaspublishedin1987(27).Forinsulindependentdiabetics,aformula
made with codonopsis, astragalus, atractylodes, rehmannia, ophiopogon, and lycium fruit was given (the
formulatonifiesqiandnourishesyin).Forthosewithnoninsulindependenttype,theyweretreatedwiththe
samemixtureeitheraloneorwithtolbutamideorglyburide.Theherbs,preparedinliquidform,weregiven
twicedailyforthreemonths.Itwasreportedthattheherbsexhibitedahypoglycemiceffectandsynergized
withinsulinandotherdrugs.Forthegroupof53patientstreated,theaveragefastingbloodglucoseatthe
beginningwas177andattheendofthethreemonthswas135.Inanotherclinicaltrial(18),agroupof10
patientswasidentifiedwhohadrespondedpoorlytoWesterndrugsandalsofailedtorespondtoChinese
herbs.Theywerethengivenboththeherbsanddrugsconcurrently.Significantimprovementswereobserved
ineightofthetenpatients.Further,ginsengisreportedtoreducethedosageofinsulinneededbypatients
andtoprolongtheactionofadoseofinsulin(13).
ACUPUNCTUREFORDIABETES
Acupuncture therapy is a common approach to treating diabetes in China. ManyAmericans assume that
acupuncture is only suitable for treating pain, perhaps because the initial introduction of acupuncture was
mainlyforthisapplication.Indeed,thegeneralopinionhereappearstobethatacupunctureoughttobeused
mainly for treating chronic back pain. Therefore, relatively few people have turned to acupuncture for
treating the disease. Increasingly, people with pain and other health problems for which acupuncture is
selectedalsohavediabetes.
A report in the 1994 Journal of Traditional Chinese Medicine (37) serves as a model of Chinese
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research on acupuncture. The researchers recruited 60 patients with diabetes and divided them randomly
intotwogroups:theacupuncturegroup(38patients)andthecontrolgroup(22patients)thetwogroups
werefoundtobewellmatchedforsymptomsandlaboratoryresults(bloodandurinetests).Both groups
followedaregulateddietduringthestudy,butonegroupreceivedacupuncture.Electricalstimulationofthe
needleswasused(thismethodreplacestwirlingtheneedlebyhandandprovidesapulsatingstimulusthat
canbecontinuedfortheentiretreatmentperiod).Acupuncturewasadministeredonceadayfor30days.
The main acupuncture points used were quchi (LI11), sanyinjiao (SP6), zusanli (ST36), and yishu
(special diabetes point located at 1.5 cun lateral to the lower border of the spinous process of the 8th
thoracicvertebra).Supplementalpointsincludeyuji(LU10),guanyuan(CV4),andbaihui(GV20).
Forthecontrolgroup,awellknownherbalpill,XiaokeWanorDiabetesPill,wasadministered.This
pillhadbeenthesubjectofearlierstudyandthelevelofeffectivenesswasalreadyestablished.Thepatients
werenotusingdiabetesdrugsduringthetrialexceptfor8patientswhorequiredinsulininjections.
Toevaluatetheeffectsoftreatment,threelevelsofresponsesweredefined.Patientswhoexperienced
markedlyeffectiveresultswerethosewhohadtheirinitialsymptomsessentiallydisappearbytheendofthe
onemonthtreatmentandtheirfastingbloodsugarlevelshaddroppedbelow130(orthebloodsugartwo
hoursafteramealwouldbebelow150).Further,the24hour,urinesugarcontentwasreducedby30%or
more at the end of treatment compared to beginning of treatment. These patients were not "cured" of
diabetesbuttheyshowedveryevidentimprovements.Forthosedeemedeffectivelytreated(notmarkedly
effective),symptomswereimprovedbutnotgone,andfastingbloodsugarlevelsdroppedtobelow150(or
twohoursaftermealsbelow180),andthe24hour,urinarysugarexcretiondeclinedbyatleast10%from
initial values (but not up to 30%). If these standards could not be met, then the treatment was deemed
ineffective. All but two of the patients showed declines in blood sugar and urinary sugar excretion and
improvementsinsymptoms.Morethanonethirdofthepatientshadmarkedimprovement.
Forthe38participantsintheacupuncturegroup,therewere25casesratedmarkedlyeffectiveand10
casesratedeffective:nearly2/3ofthepatientstreatedshowedmarkedimprovementandonlythreepatients
failedtorespond.Further,itwasreportedthatthepatientsreceivingacupunctureexperiencedastatistically
significant decline in cholesterol, triglycerides, and betalipoproteins. The drop in triglycerides was most
substantial,withadecline from an average value of 151 at the start to 117 one monthlater(adeclineof
more than 20%). There were significant improvements in "nailfold microcirculation," which is a
measurementofbloodcirculationthroughcapillarybeds(poorcirculationthroughthesebedsisonereason
personswithdiabetessufferfromskinulceration),whichhasalsobeenobservedinotherdiabetesstudies
(11,12).Amongthosewhowereusinginsulin,theamountneededafterthe30daysofacupuncturedeclined
insixoftheeightindividualsintwoofthosecases,theinsulincouldbestoppedaltogether.
Theobjectiveofthestudywastoshowthebenefitsofacupuncture,usingacommonpatentpillforthe
controlgroup.Amongthe22participantswhotookthediabetespill,therewere8casesratedasmarkedly
effectiveand12casesaseffective(2ineffective).Inboththeacupunctureandherbpillgroups,mostpatients
respondedwell.Theauthorsofthestudyconcluded:"thetherapeuticeffectsofacupunctureondiabetesare
similar to those of the diabetes pills, however, acupuncture excels in the prevention of complications,
especiallycardiovasculardiseases."
Inanotherstudy,theacupointsanyinjiao(SP6)wasusedastheprimarytreatment,withadjunctive
pointsaccordingtosyndromedifferentiationfor30patientswithdiabetes(38).Amongthecommonadjunct
pointswerefeishu(BL13)plussanjiaoshu(BL22)forthirstanddrynessofthemouthzusanli(ST36)
forhungerandtaixi(KI3)plusshenshu(BL23)forpolyuria.Treatmentwasadministeredoncedailyfor
12daysasacourseoftreatment,thena23daybreakbeforestartinganothercourse.Needleretentionwas
for 30 minutes following getting the qi sensation. The author noted that the effectiveness of treatment
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(evaluatedasreductionofbloodsugartonormalornearnormal)wasbetterforyoungerpatientsthanfor
olderpatientsandthatitgenerallytook23coursesoftreatmenttogetoptimalresults.Hepointedoutthat
diabetesmaybeduetoacombinationofdeficiencysyndromeofqiandyincomplexedwithbloodstasis:
"Sanyinjiao is the crossing point of the liver channel, spleen channel, and kidney channel, which has the
actions of supplementing qi, nourishing yin, and removing blood stasis. Acupuncture of sanyinjiao can
thereforeregulatethelevelofbloodsugarinthebody."
Differentiation of the disease manifestation with corresponding acupuncture for each syndrome was
reportedbyLiuZhichengandSunFengminoftheNanjingCollegeofTraditionalChineseMedicine(39).
Theirtreatmentpatternsaresummarizedinthetablebelow:
Syndrome
(NumberofPatients)
Dryheatinthelungand
stomach(33)
PrincipleofTreatment
clearawayheat,moistenand
promoteproductionofbody
fluids
MainPoints
(BodyPoints)
feishu(BL13),weishu(BL
21),neiting(ST44),zusanli
(ST36)
Dryintestinesandimpairmentof nourishyin,irrigatetheintestines quchi(LI11),fenglong(ST

bodyfluids(13)
40),zhigou(TB6),zhaohai
(KI6)
Dampheatofspleenand
stomach(7)
clearawayheat,resolvedamp, zhongwan(CV12),zusanli
activatethestomach,strengthen (ST36),tianshu(ST25),
thespleen
neiguan(PC6)
Stagnationofliverqi(10)
relievethedepressedliver,
regulatecirculationofqi,
promotebloodcirculation,
removestasis
taichong(LV3),quguan(LV
8),ganshu(BL18),xuehai
(SP10)
Deficiencyofspleenqiand
kidneyqi(4)
invigoratethespleenand
replenishqi
pishu(BL20),weishu(BL
21),zhongwan(CV12),
zusanli(ST36)
Deficiencyofliverandkidney
yin(6)
nourishliverandkidney
taichong(LV3),taixi(KI3),
shenshu(BL23),guanyuan
(CV4)
Deficiencyofspleenyang(6)
warmandinvigoratethespleen
andkidney
mingmen(GV4),guanyuan
(CV4),zusanli(ST36),
yinlingquan(SP9)
Deficiencyoflungqiandspleen warmthespleenandnourishthe feishu(BL13),pishu(BL20),

qi(5)
lungtoreplenishqi
taibai(SP3),taiyuan(LU9)
The authors concluded that the best results were attained in younger patients and those with milder
disease manifestation. In a review article on acupuncture treatment of diabetes (40), Hu Hui, of the
DongzhimenHospitaloftheBeijingTCMUniversity,observedthatpointsareusuallyselectedamongback
shupoints(e.g.,thebladdermeridianpoints),frontmupoints(e.g.,theconceptionvesselpoints),andlimb
points(e.g.,spleen,stomach,kidney,andliverpoints).Helistedthemostcommonlyusedpointsas:feishu,
pishu,shenshu,zusaanli,sanyinjiao,guanyuan,taixi,zhongwan,geshu,yishu,quchi,hegu,shenmen,
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diji,neiguan,xuangzhong,fuliu,jinjin,yuye,andchengjiang.
APPLYINGTHEACUPUNCTURETECHNIQUESHERE
IntheU.S.,itisuncommonforpeopletoreceiveacupuncturetherapyeveryday,asisthemethodusedin
theclinicalstudiesreportedintheChinesemedicaljournals.Instead,onemayundertakeacourseoftherapy
withacupunctureonceortwiceperweek.Needlesstosay,theimpactoftheintermittenttreatmentisnotas
greataswithdailyacupuncture.However,throughthecombinationofthelessfrequentacupunctureandthe
dailyingestionofherbs,onemightreasonablyexpecttoaccomplishresultscomparabletothosereportedin
Chinawherethemajorityofpatientsgetsomedegreeofbloodsugarnormalizationandreliefofsymptoms.
Bestresultsareexpectedforyoungerindividualsandthosewhohavehaddiabetesforonlyafewyears.
MostacupuncturistsintheU.S.havenotbeencalledupontotreatmanypatientswithdiabetes,mainly
becauseofthemisconceptionthatacupunctureisnotsuitableforthatdisorder.Nonetheless,acupuncturists
areinapositiontoprovideexperttreatmentbecausethepointstobeneedledarealsoused(invariousother
combinations)fortreatingotherdisorders.Forexample,theacupuncturepointzusanli(calledStomach36
located on the lower leg) is one of the most commonly used points for chronic diseases and is used
especially when the disease is obviously affected by dietary factors. All of the acupuncture points listed
abovehavebeenusedintheU.S.andothercountries.The needling techniques reported for the diabetes
treatmentsarealsoessentiallythesameasusedworldwide,withoutrequiringspecialadditionaltraining.
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ACCESS:SevenForestsherbformulasareavailableonlybyprescriptionfromalicensedhealthcare
professional.YoucanfindapractitionerwhocanprescribeChineseherbshere
Furtherinformationlinks:CDCsitefordiabetesinformationandotherhelpfullinks:
http://www.cdc.gov/diabetes/faqs.htm
FormoreinformationaboutLiuweiDihuangWan,seethearticle:RehmanniaSixFormula.
Toprovideyourcomments[nomedicalconsultationscanbeoffered],email:itm@itmonline.org
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