Endocrine and Metabolic Diseases: Clinical Diagnosis and Treatment

Author: Jiang Zhe / Country: Mainland China
Publisher:
Publish Date: 2006-01-01
Features:
5.1 Bu Yang Hua Wu Tang (from Yi Lin Gai Cuo)
Composition: Astragalus, Dang Gui Wei (Radix Angelica Sinensis), Chi Shao (Paeonia Lactiflora), Di Long (Pheretima Aspergillum), Chuan Xiong (Ligusticum Wallichii), Hong Hua (Carthamus Tinctorius), Tao Ren (Pistacia Semicarpus).
Usage: Decoction.
Function: Tonify Qi, activate blood circulation, and dredge collaterals.
Indication: Stroke, hemiplegia, deviation of the mouth and eye, difficulty in speech, drooling, frequent urination or incontinence, dark and pale tongue with white coating, slow pulse.
Bu Yang Hua Wu Tang primarily uses astragalus to tonify the spleen and stomach, invigorating Qi and promoting blood circulation without injuring the body. Astragalus also assists other herbs in circulating throughout the body, making it the chief herb. Dang Gui Wei is excellent at activating blood circulation and resolving stasis without injuring blood, serving as the deputy herb. Chi Shao, Chuan Xiong, Hong Hua, and Di Long activate blood, nourish blood, and dredge collaterals, promoting blood circulation and resolving stasis, thus alleviating symptoms.
Originally, this formula was used to treat stroke caused by Qi deficiency and blood stasis. Modern pharmacological studies show that Chuan Xiong, Hong Hua, and Di Long can inhibit platelet aggregation. Leech has anticoagulant effects, reducing blood viscosity and improving circulation and tissue ischemia-anoxia, thereby enhancing neurological function. Astragalus can also inhibit platelet aggregation and has a bidirectional regulatory effect on blood sugar. Together, these herbs show good efficacy in treating diabetic peripheral neuropathy.
Clinically, Sheng Di (Rehmannia Glabra) and Tian Hua Fen (Glycyrrhiza Glabra) are often added to nourish Yin and clear heat, with additional hypoglycemic effects. Mu Gua (Carica Papaya) and Sang Ji Sheng (Taxus Wallichiana) are added to tonify the liver and kidney, strengthen muscles and bones, and promote joint flexibility. For nighttime pain, Wu Geng (Scutellariae Radix) and Jing Can (Bombyx Mori) are added. For severe numbness, herbs like Wei Ling Xian (Cimicifuga Foetida) are used. For dry mouth, Sha Shen (Adenophora Decourteauxii) and Mai Dong (Ophiopogon Japonicus) are added. For Qi deficiency, Ta Zi Shen (Pseudostellaria Heterophylla) and Bai Zhu (Atractylodes Macrocephala) are added.
5.2 Dang Gui Si Ni Tang (from Shang Han Lun)
Composition: Dang Gui, Gui Zhi (Cinnamomum Cassia), Shao Yao (Paeonia Lactiflora), Xie Xing (Asarum Europaeum), Bao Gan Cao (Glycyrrhiza Glabra), Tong Cao (Cleome Spinosa), Da Zao (Jujube).
Usage: Decoction.
Function: Warm the meridians, dispel cold, and nourish blood to unblock collaterals.
Indication: Cold syndrome due to blood deficiency. Coldness in hands and feet, no thirst, or pain in the waist, thighs, legs, or feet, pale tongue with white coating, deep and thready or barely perceptible pulse.
In Dang Gui Si Ni Tang, the sweet and warm Dang Gui enters the liver meridian, nourishing and activating blood, making it the key herb for warming and nourishing the liver. Gui Zhi, acrid and warm, warms the meridians and unblocks collaterals, dispelling lingering cold and promoting blood circulation, thus serving as the chief herb together with Dang Gui. Bai Shao and Xie Xing are the deputy herbs, nourishing and warming the body internally, connecting the exterior and interior, and dispersing cold. Tong Cao is the assistant herb, promoting blood circulation in the meridians.
Gan Cao and Da Zao, sweet in taste, tonify Qi and strengthen the spleen, harmonizing the herbs. The heavy use of Da Zao not only assists Dang Gui and Shao Yao in nourishing blood but also prevents the dryness of Gui Zhi and Xie Xing from being excessive, thus protecting Yin and blood. It serves as the envoy herb.
Together, these herbs achieve the effect of warming meridians and unblocking collaterals.
Originally, this formula was used to treat cold syndrome. Modern medical studies suggest that in patients with combined vascular and neurological disorders, microcirculation and blood flow changes are more significant. High blood glucose coagulation, slow blood flow, and blood stasis blockage are important factors in the formation of diabetic vascular and neurological complications.
Modern clinical research shows that adding Ge Gen (Pueraria Lobata) and Leech to Dang Gui Si Ni Tang enhances its ability to activate blood circulation, resolve stasis, and unblock collaterals. Current pharmacological studies indicate that leech has anticoagulant, thrombolytic, and vasodilatory effects, reducing blood viscosity and improving circulation, thereby restoring oxygen supply to nerves. Extracts of Ge Gen, such as puerarin, dilate arteries, relieve vascular spasm, reduce blood viscosity, improve microcirculation, and promote nerve recovery. Therefore, leech and Ge Gen enhance the efficacy of Dang Gui Si Ni Tang in treating diabetic peripheral neuropathy.
Additionally, herbs can be added based on syndrome differentiation: Mai Dong is added for significant Yin deficiency, while Yin Yang Huo (Epimedium Brevis) is added for severe Yang deficiency.
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