To cure diabetes complications study thinking

China's traditional Chinese medicine reported

-LiangXiaoChun Beijing union medical college hospital

Traditional Chinese medicine to diabetes (XiaoKeBing) understanding has a long history, has a long history. "/" problems and causes and mechanism of the theory in the first spring and autumn and warring states period of the yellow emperor; XiaoKeBing accurate definition from the ancient and modern record prescription "; And treatment based on syndrome differentiation formed in synopsis of golden chamber; Syndrome classification began in the cause of the syndrome "; SanXiao partition began in tang and song dynasties. Nest yuan party proposed first physical exercise therapy, The sun simiao focused on diet; modulation The traditional XiaoKeBing from different aspects and its complications of the etiology, pathogenesis, among the therapeutic, supplements and development, has accumulated rich experience.

Since new China was founded, the Chinese medicine and combine traditional Chinese and western medicine workers in traditional Chinese medicine therapy complications of diabetes in a large number of clinical and experimental research, the initial display of combining traditional Chinese and western medicine in the treatment of diabetes and its complications, and the advantages of many problems also existed.

etiology

TCM holds that the development of diabetes and innate physical factors, eating disorders, the day after tomorrow I labor, the room sentiment excessive, pathogenic agents, and hurting and other relevant. Healing stone The basic pathogenesis is Yin scorching, Yin for this, hot and dry for standard, they are the cause, hot and dry them what is more, the Yin Yin deficiency is hot and dry what the virtual. Nourish Yin deficiency, the upper energizer slipped from the body fluid loss, the stomach but lost cloth embellish, kidney AIDS help deficient; Sheng heat, burns ChiCheng stomach fluid, the burning on lung tianjin, kidney Yin consumption; Kidney Yin deficiency, XuHuo under-focusing the lung and stomach, cause inflammation nourish, stomach heat, deficiency of the kidney with triple warmer disease. Due to qi deficiency and do not handsome blood; Yang blood sluggish haemorrheological nature; Yin deficiency fire burning Fried the body fluid, which can lead to the formation of the qi stagnant blood stasis.

Double deficit, qi and Yin qi stagnant blood stasis bi resistance context was chronic diabetes complications (XiaoKeBing and card) happen the pathology base. For long, liver and kidney deficiency, thirst, JingXie can't bear in the yard, and MuWu have to raise, can lead to the blind, NaZhang finches, even blindness (diabetic eye disease). The camp was burning, inside the "Yin poison into warm fermented, pus, hair is sore, reveling YongJu (diabetes skin infection). Yin scorching, LianYe into phlegm, and phlegm obstruction meridian or blind blinds our eyes and for stroke PianKu (diabetes cerebrovascular disease). Phlegm and blood stasis, heart chakras lost a block, appear obstruction, heartache, such as critical to take off heart Yang card (diabetes cardiovascular disease). Blood stasis bi resistance of main and collateral channels do not see limbs general body not temperature, insensitive (diabetic peripheral neuropathy); Blood stasis, long, yu and turn heat, heat to warm and take off in poison into jaundice (diabetes foot). Kidney Yin deficiency and Yang, YinSun, spleen and kidney failure, Yang, become wet water flooding edema (diabetic nephropathy); Warm glow is insufficient, e. function division, cause diarrhea, constipation alternate (diabetes bowel disease). The essence of reproductive lack appear impotence (diabetes erectile dysfunction); Yin fluid loss in extreme, Yin and Yang wu, fountain see god knows not clear, the skin is dry, cold extremities faint, pulse subtle desire unique and dangerous wait (diabetes acute complications).

Therapeutic advantage

Diabetes chronic vascular nerve complications mechanism is not at all clear, research and DuoYuan metabolic pathways that alcohol of activation, protein enzymes of the glycosyl final products (AGEs) and the formation of the protein kinase C activation, lipid peroxidation damage, autoimmune, hemodynamic changes related to such factors as the, the researchers are different from the pathogenesis of the intervention measures and looking for drugs, such as aldose reductase inhibitors, protein the enzyme inhibitors, the sugar and antioxidants, vasodilators and so on. In traditional Chinese medicine, Chinese traditional medicine pay attention to integral regulation has many targets the characteristics of the regulation. Many traditional Chinese medicine and compound with lipid metabolism, regulate sugar suppression, improve blood rheology sorbitol volume, resistance to free radical damage, microcirculation, protect liver and kidney function functions. Such as ginseng can not only reduce blood sugar, also can be directly scavenging free radicals, resistance of lipid peroxidation. Golden cabinet can inhibit the kidney shot aldose reductase activity, reduce sorbitol concentration, improve the Na +, K +-ATP enzyme activity, added fast nerve conduction speed, with the protection in renal function. Orange peel in STZ nucleoside reduce diabetic rats kidney tissues AGEs at the same time, can reduce LPO content. Chinese rhubarb can significantly inhibited lipid peroxide renal tissues of the generation, improving sod and catalase activity, significant inhibitory cause the in vitro culture in mice mesangial cells glucose transporter protein expression and excessive l glucose intake higher abnormal status, etc.

problems

The current domestic control diabetes complications in traditional Chinese medicine research, whether compound, or single drug, which has made some progress, but there are still many problems, such as high quality of clinical trials less, repetitive basic research partial. Many clinical trials was a strict randomized controlled; Dosage forms and treatment, no unified standard; The curative effect of observation and mechanism of will stay on the middle or alternative index that the index level. In the clinical study should be in strict accordance with the RCT, establish a scientific evaluation system, from the traditional Chinese medicine curative effect curative effect (the end and the related death), health economics, improving quality of life three aspects.

Attention should be paid to the study of animal models of choice, the traditional Chinese medicine research animal model of diabetes are for reference, the method of western medicine is usually cause sex animal diseases models, such as animals, or surgical removal pancreas with chemicals (four oxygen pyrimidines, chain with urea had an) damage animal islet cell, and so on, this kind of animal model the pathogenesis and symptoms and human diabetes is not identical. Traditional Chinese medicine should be combined with features, disease, a synchronous accords with the pathogenesis, clinical practice and in conformity with the animal model of traditional Chinese medicine in order to objectively evaluate the effects of TCM and explore the control mechanism.

Orientation and thinking

Traditional Chinese medicine in the treatment of diabetes complications should be very good location, something to do it. Not all of the complications and any stage are fit for Chinese medicine treatment. Such as diabetic nephropathy uremic stage, diabetic retinopathy proliferation period, diabetes foot gangrene period is not suitable for such as traditional Chinese medicine, treatment should lose no time to use the method of western medicine for processing. And for diabetes early kidney disease, background issue of the diabetic retinopathy, diabetes of peripheral neuropathy, diabetes cognitive impairment, etc can use traditional Chinese medicine therapy.

The author thinks that Chinese medicine in the treatment of diabetes complications, in "Hyman health.inclinical data fluctuation kongfu, diabetes, and most chronic complications early no clinical symptoms and signs, if the intervention and treatment based on syndrome differentiation, will face" unlicensed discernible "awkward, so have to pay attention to the diabetes complications of TCM pathogenesis, clinical treatment to guidance.

The study found that people with diabetes in recent years many phlegmy wet many blood stasis, in a chronic complications is more marked. Our past the study found that people with diabetes and blood stasis syndrome throughout the duration of diabetes, and always in clinical blood stasis syndrome appear before the abnormal blood rheology, so I wish ChenYu professor offered to early application to remove blood stasis drugs to nip in the bud, "is not ill prevention first", further study found that diabetes have vascular lesions than those without the abnormal vascular lesions blood rheology and thrombosis, B2 increased levels more significant, so treatment propose to strengthen the blood stasis of strength, in order to "Hyman health.inclinical data. Type 2 diabetes patients, sugar metabolism disorders of obesity and also with lipid metabolism abnormalities. TCM holds that "fat people much phlegm". The Ming dynasty ZhangJingYue said: "all of the five zang-organs disease can ShengTan, so all of the spleen, phlegm, and of all the phlegm in the kidney." A fat GanHou taste food in the valley of the spleen, the lost health for sluggish qi stagnant, endogenous, resistance in winding way, blood run suffocate suffocate, cause blood stasis formation. Should say phlegm and blood stasis are turbidity diabetes complications in the process of the pathology of produced products. Qi stagnant, long, angry machine block, do not free, blood stasis, leading to increased resistance context and blood stasis; Qi and blood stasis, body fluid run suffocate suffocate, and get together and become sputum. As TangRongChuan qing dynasty the fact the theory of speech: "yu blood is long, also can expectorant." Qi stagnant and blood stasis though not the same pathological product, but the forming reason identical. Two, one in the body was born, mutual influence, and ultimately leads to phlegm and blood stasis and see. Clinical therapy for diabetes complications, more attention to invigorate the application of phlegm, also get some preliminary results. But Chinese medicine can prevent diabetes complications of chronic, has been complications to delay the development research can reduce the end the occurrence of event, how to improve the living quality of patients will be further research ChongDianKe