Traditional Chinese Medicine in the Treatment of Diabetes
Total Page：16
File Type：pdf, Size：1020Kb
In Brief Traditional Chinese medicine (TCM) is a system of healing that is thousands of years old. It has long been utilized in the Chinese culture to treat the com- plex of symptoms that Western medicine terms diabetes mellitus. This article will outline the key concepts and therapies of TCM that play a role in the evaluation and treatment of diabetic patients. Traditional Chinese Medicine in the Treatment of Diabetes Diabetes is one of the most prevalent ent system of medicine that uses sever- chronic diseases in the United States. al modalities to treat and prevent ill- The morbidity and mortality associated ness. The most commonly employed Maggie B. Covington, MD with the disease is significant and therapeutic methods in TCM include derives primarily from complications of acupuncture/moxibustion, Chinese persistent hyperglycemia. Longstanding herbal medicine, diet therapy, hyperglycemia has been shown to lead mind/body exercises (Qigong and Tai to vascular complications involving Chi), and Tui Na (Chinese massage).3 large and small blood vessels, such as TCM views the human body and arteriosclerosis, glomerulosclerosis, and its functioning in a holistic way. From retinopathy. Diabetic neuropathy, char- this perspective, no single body part acterized by pain and paresthesias, is or symptom can be understood apart among the most frequent complications from its relation to the whole. Unlike of longstanding, poorly controlled dia- Western medicine, which seeks to betes and is often associated with a uncover a distinct entity or causative reduction in physical activity and with factor for a particular illness, TCM sleep disturbances.1,2 looks at patterns of disharmony, Western or conventional therapies which include all presenting signs and for diabetes have been geared toward symptoms as well as patients’ emo- regulating blood glucose with a combi- tional and psychological responses. nation of diet modification, insulin Humans are viewed both as a reflec- and/or oral pharmacological agents, tion of and as an integral part of weight loss when appropriate, and nature, and health results from main- exercise. Although Western medicine taining harmony and balance within and Traditional Chinese medicine the body and between the body and (TCM) share the diabetes treatment nature.3 goals of reducing symptoms and pre- Two basic TCM theories explain venting complications, their approach- and describe phenomena in nature, es to conceptualizing, diagnosing, and including human beings: Yin-Yang treating the disease are very different. Theory and the Five Phases Theory or This article will outline the key con- Five Element Theory. cepts and therapies of TCM that play Yin and Yang are complementary a role in the evaluation and treatment opposites used to describe how things of diabetic patients. function in relation to each other and to the universe. They are interdepen- Traditional Chinese Medicine dent—one cannot exist without the TCM is a system of healing that origi- other, and they have the ability to nated thousands of years ago. It has transform into each other.3 The tradi- evolved into a well-developed, coher- tional Yin-Yang symbol (Figure 1) 154 Diabetes Spectrum Volume 14, Number 3, 2001 Within the model of Five Phases, the body. There are 12 regular meridi- to Practice Research From / Complementary & Integrative Medicine each element is associated with an ans and 8 extra or “curious” meridi- organ. Wood is associated with the ans. The 12 main meridians corre- liver, fire with the heart, earth with spond to 12 major functions or the spleen-pancreas-stomach, metal “organs” of the body (such as liver, with the lungs, and water with the kidney, heart). kidneys. In addition, other phenome- The Chinese concept of organs cor- na, such as seasons, cardinal direc- responds only loosely to the Western tions, weather, color, and emotions, concept. TCM associates specific are associated with each element. functions, symptoms, emotions, col- Within the TCM model, diagnostic ors, and tastes with each organ, information is gained by finding out whereas the Western view is limited patients’ favorite season, color, and primarily to function. predominant emotion(s). Qi must flow in the correct quanti- ty and quality through the meridians Figure 1. The Yin-Yang symbol Key Concepts Within TCM and organs for health to be main- Qi tained. Acupuncture, the insertion of depicts the Yin (the dark side) flowing Qi (pronounced “chi”) is translated thin, solid metal needles, is performed into the Yang (the light side) and vice into English as vital energy. It is on 1 or more of the 361 acupuncture versa. The dots within each side sym- defined in terms of function rather points distributed along the meridians bolize that there is always a bit of Yin than as a discrete substance, and it is in order to regulate and promote the within Yang and a bit of Yang within what animates us and allows us to proper flow of Qi.5 Other techniques Yin; there are no absolutes. All physi- move and maintain the activities of may be used to stimulate acupuncture ological functions of the body, as well life. The origins of Qi include “con- points, such as moxibustion, in which as the signs and symptoms of disease, genital”’ (prenatal) Qi—that which is the herb “moxa” (Artemesia vulgaris) can be differentiated on the basis of inherited from our parents—and is used to warm the acupuncture point Yin and Yang characteristics. “acquired” Qi—that which is incor- either above or on the skin. Applied The Chinese character for Yin orig- porated from food and air.4 pressure (acupressure), lasers, and inally meant the shady side of a slope. Two major patterns of disharmony magnets also may be used to stimulate Qualities characteristic of Yin include are associated with Qi. Deficient Qi acupuncture points. cold, stillness, darkness, inwardness, occurs when there is insufficient Qi to passivity, decrease, and downward- perform the functions of life. Deficient Jing ness. In contrast, the Chinese charac- Qi may affect one or more organs or Jing, usually translated as “essence,” ter for Yang originally meant the the entire body. If the latter occurs, is the substance that is the underpin- sunny side of the slope, and qualities then the patient may experience ning of all organic life. Qi is responsi- characteristic of Yang include heat, lethargy, fatigue, and lack of desire to ble for the ongoing day-to-day move- movement, brightness, outwardness, move. Stagnant Qi refers to impair- ments and function of the body, stimulation, excitement, increase, and ment of the normal movement of Qi whereas Jing can be considered an upwardness.4 Illnesses that are charac- through the meridians (see discussion individual’s constitutional makeup. terized by coldness, weakness, slow- below) and may result in aches and According to TCM, Jing is stored in ness, and underactivity are considered pains in the body.4 the kidneys.4 Yin (e.g., hypothyroidism: cold limbs, fatigue, slowed metabolism). Illnesses Meridians Shen that manifest strength, forceful move- Meridians are the channels or path- Shen is considered to be the psyche or ment, heat, and overactivity are Yang ways through which Qi is constantly spirit of the individual. Shen is the (e.g., acute infections with fever and flowing and circulating throughout vitality behind Jing and Qi in the sweating). human body. The three elements The theory of Five Phases, Wu together—Qi, Jing, and Shen—are Xing, is a means of classifying phe- referred to collectively in TCM as the nomena in terms of five basic process- “Three Treasures” and are believed to es represented by the elements wood, be the essential components of life.5 fire, earth, metal, and water. There exists a dynamic balance and relation- Blood ship among the elements such that if According to TCM, the major activity the balance is interrupted or of the blood is to circulate through destroyed, pathological changes may the body, nourishing and moistening occur. The clockwise movement of the various organs and tissues. one element into the next (wood, fire, Disharmonies of the blood may mani- earth, and so forth) whereby one ele- fest as “deficient” blood or “con- ment generates, acts on, or promotes gealed” blood. If deficient blood exists the following element, is referred to as and affects the entire body, the patient the Sheng cycle. The Ke cycle repre- Figure 2. Diagram of The Five may present with dry skin, dizziness, sents an element acting on or control- and a dull complexion. Congealed Phases, illustrated are the Sheng and ling another element in a different blood may manifest as sharp, stabbing order (Figure 2).3 Ke cycles pains accompanied by tumors, cysts, 155 or swelling of the organs (i.e., the and all three are associated with Yin Yin deficiency along with lung Yin liver).4 The key organs associated with deficiency. At some point during the deficiency and “internal heat that con- blood are the heart, liver, and spleen. course of their illness, most people sumes fluids, thus bringing on wasting with diabetes manifest symptoms of and thirsting.”7 Fluids all three types. Fluids are bodily liquids other than According to TCM, Xiao-ke is TCM Therapies blood and include saliva, sweat, urine, attributed to three main factors: Unlike Western medicine, TCM is not tears, and semen. Fluids act to moist- improper diet (consuming large quan- concerned with measuring and moni- en both the exterior (skin and hair) tities of sweets, fatty or greasy foods, toring blood glucose levels in diabetic and the internal organs. Disharmonies alcohol, and hot drinks such as hot patients. Treatment is individualized of fluids may result in dryness and coffee or tea), emotional disturbances and geared toward assessing and treat- excess heat. The key organs involved (stress, anxiety, depression,) and a ing the symptoms that compose pat- in the formation, distribution, and constitutional Yin deficiency (fatigue, terns of deficiency and disharmony.