Indications:
This formula is for qi and yin dual vacuity complicated by blood stasis
resulting in diabetes mellitus.
The signs
and symptoms of qi vacuity include:
The signs
and symptoms of yin vacuity include:
The signs
and symptoms of blood stasis include:
Formula explanation:
Classical descriptions of thirsting and wasting all involve heat. However, these
descriptions typically describe the later stages of diabetes mellitus, and,
today, many people are diagnosed with diabetes without being symptomatic and
without marked signs of heat. In fact, most contemporary Chinese sources agree
that qi and yin dual vacuity is the most common early pattern of diabetes.
Typically, this evolves from a liver-spleen disharmony based on the saying from
the Nei Jing (Inner Classic), "[At] forty years, yin is automatically half." In
other words, on top of a pre-existing spleen qi vacuity, there is now a yin
vacuity as well. Although some patients develop diabetes early on in life, for
most people, diabetes is a condition associated with aging. Therefore, in
addition to qi and yin vacuity, blood stasis is a common complication. This is
based on Yan De-xin’s assertion that essentially all chronic diseases associated
with aging are complicated by at least an element of blood stasis. Blood stasis
is definitely present in most of the complications of diabetes, such as
neuropathy, nephropathy, retinopathy, and diabetic dermopathy. Thus the
appropriateness of the principles of boosting the qi, nourishing yin, and
quickening the blood.
Within
this formula, Xi Yang Shen, Huang Qi, Fu Ling, and Shan Yao fortify the spleen
and boost the qi. Shan Yao not only fortifies the spleen but also supplements
the kidney qi. Xi Yang Sheng, Xuan Shen, Sheng Di, Mai Men Dong, and Ge Gen
nourish yin and engender fluids. Xuan Shen also clears vacuity heat, while Ge
Gen also disinhibits the qi mechanism by upbearing clear yang. Because of its
cool nature, Ge Gen also clears stomach heat, the most common locus of heat in
those with diabetes. Dan Shen, Sheng Di, and Chi Shao quicken, cool, and nourish
the blood. Fu Ling additionally seeps dampness, thus leading yang into the yin
tract (via urination).
Combinations:
If yin vacuity-fire effulgence is marked, this formula can be combined with Zhi
Bai Di Huang Wan (Anemarrhena & Phellodendron Rehmannia Pills) or Da Bu Yin Wan
(Greatly Supplementing Yin Pills). If lung yin vacuity is pronounced, it may be
combined with Bai He Gu Jin Wan (Lily Secure Metal Pills) or Mai Wei Di Huang
Wan (Ophiopogon & Schisandra Rehmannia Pills). If kidney yin vacuity is
pronounced, it may be combined with Gu Ben Wan (Secure the Root Pills). If liver
blood and kidney yin is marked with more prominent vision problems, one may
consider combining this formula with Ming Mu Di Huang Wan (Brighten the Eyes
Rehmannia Pills). If heart yin vacuity is pronounced, it may be combined with
Bai Zi Yang Xin Wan (Biota Nourish the Heart Pills) or Tian Wan Bu Xin Dan
(Heavenly Emperor Supplement the Heart Elixir). If kidney qi vacuity is marked,
it may be combined with Jin Su Gu Jing Wan (Golden Lock Secure the Essence
Pills). To increase supplementation of the qi, combine it with Shen Qi Da Bu Wan
(Ginseng & Astragalus Greatly Supplementing Pills). If there is both yin and
yang vacuity, combine it with Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi
Pills). If blood stasis is more pronounced, it may be combined with either Ge
Xia Zhu Yu Tang Wan (Below the Diaphragm Dispel Stasis Decoction Pills), Shao Fu
Zhu Yu Tang Wan (Lower Abdomen Dispel Stasis Decoction Pills), Xue Fu Zhu Yu
Tang Wan (Blood Mansion Dispel Stasis Decoction Pills), or Tong Qiao Hue Xue
Tang Wan (Free the Flow of the Orifices & Quicken the Blood Decoction Pills)
depending on the location of the blood stasis.
Dosage:
Three capsules two times per day equal not less than 30 grams of raw
medicinals. However, because our extraction process is so much more efficient
than stovetop decoction, we believe that this amount of our extract is actually
more like the equivalent of 45-60 grams of bulk-dispensed herbs.
Contraindications:
Loose stools, diarrhea, or nausea and indigestion due to dampness.
My
patient does have signs and symptoms of:
Qi
vacuity Yes No
Yin vacuity Yes No
Blood stasis Yes No
Chinese
research has shown this formula to be 16.3% more effective in lowering blood
glucose than the antidiabetic drug glyburide (Micronase) in a comparison study
involving 73 patients (42 in the treatment wing, 31 in the comparison wing). [He
Nan Zhong Yi Za Zhi (Henan Journal of Chinese Medicine), #5, 2001, p. 19 & 28]
