Giving Treatment According to Syndrome Differentiation

-Diabetic Peripheral Neuropathy

2013-03-07 02:09:07

Giving treatment according to syndrome differentiation

(1)Essentials
in
syndrome
differentiation
a

Identifying
the
location
of
disease
Diabetic
peripheral
neuropathy
is
resulted
from
diabetesmainly related with the spleen stomachliver and
kidneyThe intensity of deficiency of spleen and stomach and
weakness of the liver and kidney varies according to clinical
signs Usually the disease is mainly 10 cated in the spleen
and stomach at the early stage and located in the liver and
kidney
at
the
later
stage

bDistinguishing Biao(manifestation of disease) and Ben(root

of disease)
The disease takes deficiency of qi and blood as Ben(root of
disease)and blockage of the collaterals by blood stasis as Biao
(manifestation of disease)the two aspects may interact as both
cause and effect their conditions often change because of the
duration
of
disease
and
intensity
of
diseaseUsuallydeficiency of qi and blood is predominant at
the early stage Later along with the aggravation of
disease both yin and yang decline Qi deficiency fails in
promoting blood circulationand yang deficiency fails to warm
blood circulation blockage of the collaterals by blood stasis
would appear at this moment

(2)Principle
of
treatment
Deficiency of qi and blood is the cause of diabetic peripheral
neuropathy and spleen deficiency is the crux of
pathogenesis So building up the earth strengthening the
spleen tonifying the kidney are the fundamental principles in
treating diabetic peripheral neuropathy In Yi Xue Ru
Men(Elementary Medicine)it indicatesIn the treatment for
Ke(diabetes)the heartkidney and spleen are important If
the spleen is strengthened body fluid will be produced
naturally In addition diabetic peripheral neuropathy takes
numbness and pain as its main symptoms which are the signs
of blood deficiency and blood stasis thus qi and blood should
be regulated to associate the main principles during the
treatment
(3)Giving
treatment
according
to
syndromes
Diabetic peripheral neuropathy is one of the complications of
diabetes integrating treatment of both Chinese medicine and
western medicine should be applied actively to treat
diabetesBlood glucoseblood pressure and blood fat should
be controlled strictly and the daily intake of salt and protein
should be limited On this basis treat diabetic peripheral
neuropathy accordingly by building up the earthstrengthening
the spleen and tonifying the spleen and kidney
aBlockage of the collaterals due to yin deficiency of the liver
and kidney
Clinical manifestations Numbness and aching of limbs or

muscular atrophy or difficulty of walking due to muscular

trembling soreness and weakness in the lumbar region and
knees dizziness vertigo fragile nails looseness of
teethloss of hair dark red tongue with little coating deep
thready pulse
PathogenesisPersistent diabetes leads to yin deficiency of the
liver and kidney The liver stores blood and the kidney stores
essence Insufficiency of essence fails in filling and irrigating
the limbs and deficiency of blood is not able to nourish the
tendons and bones
Principle of treatmentTonify the liver and kidneyeliminate
blood stasis and remove obstruction from the collaterals
Points and manipulation Taixi(KI 3) Sanyinjiao(SP
6) Xuanzhong(GB 39)and Zusanli(ST 36)are punctured with
the reinforcing method by lifting and thrusting the needle slowly
and rapidly Xuehai(SP 10) Yanglingquan(GB
34) Taichong(LR 3) Quchi(LI 11)and Hegu(LI 4) are
punctured with even methodRetain the needles for 30 minutes
and give treatment once or twice a day
ExplanationTaixi(LR 3)the Shu-Streatm and Yuan-Primary
points of Kidney Meridian of Foot-Shaoyin is a special point
for nourishing kidney yinXuanzhong(GB 39) is the influential
point of marrow it can fill essence replenish marrow and
nourish the liver and kidney Sanyinjiao(SP 6) the crossing
point of three yin meridians of footmay strengthen the spleen

to produce blood clear damp resolve phlegm and drain the

turbid meanwhile the point can also tonify yin of the
liver spleen and kidney directly to achieve the effect of
benefiting the congenital foundation by strengthening the
acquired conditionit is good for nourishing kidney yinThe
combination of these three points can tonify yin of the liver and
kidney directly Zusanli(ST 36)is an important point for
tonifying the spleen and stomachbenefiting qi and nourishing
blood it is selected to tonify the acquired condition so as to
promote the congenital foundationXuehai(SP 10) is the sea of
blood it can either nourish blood or activate
blood Yanglingquan(GB 34)is good in soothing the liver and
relaxing depressionTaichong(LR 3)works to regulate the liver
and soothe the liverthe combination of these two points may
soothe the liver regulate and promote qi activate
bloodeliminate blood stasis and remove obstruction from the
collaterals Ouchi(LI 11) and Hegu(LI 4) are characterized by
promoting without stop they can promote the distribution of
qi blood and body fluid The combination of all the points
above may make essence and blood abundant blood
circulation free blood stasis and pathogenic factors
eliminatedtendons and meridians nourished
Giving Treatment According to Syndrome Differentiation
-Diabetic Peripheral Neuropathy
2013-03-07 02:09:07

bBlockage of the collaterals due to deficiency of qi and blood

Clinical manifestations Numbness and pain of
limbs limitation of movement thin muscles sallow

complexion

pale
lips
and
nails listlessness lassitude dislike
of
speaking palpitation shortness of breath dizziness pale
tongue with thin white coating thready weak pulse
Pathogenesis Persistent diabetes consunles qi and
blood Furthermore spleen deficiency fails in transporting
and transforming water and food qi and blood may lose their
origins muscles tendons and limbs are deprived of
nourishment

Principle of treatment Replenish qinourish bloodresolve

blood stasis and remove obstruction from the collaterals
Points and manipulation Sanyinjiao(SP 6) Xuanzhong(GB
39) Zusanli(ST 36) Zhongwan(CV 12)and Yinlingquan(SP
9)are punctured with reinforcing method by lifting and thrusting
the needle slowly and rapidly Xuehai(SP10) Diji(SP
8)Yanglingquan(GB 34)Taichong(LR 3)Quchi(LI 11)and
Hegu(LI 4)are punctured with even methodRetain the needles
for 30 minutes and give treatment once or twice a day
Explanation Sanyinjiao(SP 6)may strengthen the
spleennourish blood and also tonify yin of the liver spleen
and kidney directly Xuanzhong(GB 39)can fill
essence benefit marrow nourish and tonify the liver and
kidneyZusanli(ST 36) is an important point to strengthen the
spleen and stomach benefit qi and nourish blood The
combination of these three points can tonify both congenital
foundation and acquired conditionso as to build up abundant
origins for qi and bloodYinlingquan(SP 9)the He-Sea Point
of Spleen Meridian can strengthen the spleen raise
yang promote the function of the middle jiao and resolve

damp Zhongwan(CV 12)is located on the place where the

essential qi of Stomach Meridian accumulatesit has the effect
of strengthening the spleen and stomach benefiting
transportation and transformationand regulating the functions
of ascending and descending combined with Zusanli(ST 36)
and Yinlingquan(SP 9) the point can regulate the function of
spleen and stomach Xuehai(SP 10) an important point in
treating blood syndrome can either nourish blood or activate
bloodDiji(SP 8)the XiCleft Point of Spleen Meridianis
located at the place where blood accumulatesand taken as the
key point for activating blood and nourishing blood
Yanglingquan(GB 34)and Taichong(LR 3)are effective in
promoting qithese four points are used together to clear stasis
from
blood
and
remove
obstruction
from
the
collaterals Quchi(LI 1 1)and Hegu(LI 4)are characterized by
promoting constantly without stop they can help the
distribution of qiblood and body fluidAll the points above
are used together to get abundant qi and blood and free
circulations to nourish the various parts of the body
eRetention of cold in the collaterals due to yang deficiency of
the
spleen
and
kidney
Clinical manifestations Cold pain of limbs worse at
night which is often aggravated by cold and alleviated by
warmth aversion to cold or soreness and weakness in the
lumbar region and knees dark complexion hesitant bowel
movement loose stool dark pale tongue with white
coating deep thready and hesitant pulse
Pathogenesis Persistent diabetes leads to deficiency of both
yin and yang weakness of Mingmen fire fails in warming

and yang qi is not able to reach the limbs

Principle of treatment Warm yang disperse cold activate
blood and remove obstruction from the collaterals
Points and manipulation Apply warm reinforcing method or
moxibustion after needling on Guanyuan(CV 4)Mingmen(GV
4) Shenshu(BL 23)and Zusanli(ST 36) reinforcing method
by lifting and thrusting the needle slowly and rapidly on
Xuanzhong(GB 39) even method on Yanglingquan(GB
34) Taichong(LR 3) Xuehai(SP 10) Jiexi(ST
41) Quchi(LI 11)and Hegu(LI 4) Retain the needles for 30
minutes and give treatment once or twice a day
Explanation Kidney yang is the foundation of yang qi of the
whole body kidney yang deficiency would cause systemic
yang qi defidency Guanyuan(CV 4)warms yang qi of the
whole body Mingmen(GV 4)warms kidney yang
Shenshu(BL 23)tonifies both kidney yin and kidney yang the
three points are used together to invigorate yang qiwarm yang
and benefit the kidneyXuanzhong(GB 39)can fill essence and
replenish marrowtry to get yang from yinZusanli(ST 36)is
used to tonify the spleen and stomach aimed at tonifyng the
congenital
foundation
by
nourishing
the
acquired
condition Yanglingquan(GB 34)works to soothe the liver
Taichong(LR 3)to regulate the liver and Xuehai(SP 10)to
nourish blood and activate blood the three points are used
together to promote qiregulate qiactivate blood and remove
obstruction from the collaterals Jiexi(ST 41)is the Jing-River
Point of Stomach Meridian,in whichthe meridian qi runs like

water flowing in river needling the point may remove

obstruction from the meridian to free the meridian and
collaterals Quchi(LI 11)and Hegu(LI 4)can help the
distribution of qiblood and body fluidAll the points above
are used together to warm and tonify yang qi of the spleen and
kidney to make yang yi strong enough to keep smooth
circulation and warm the limbs
Giving Treatment According to Syndrome Differentiation
-Diabetic Peripheral Neuropathy
2013-03-07 02:09:07

d Blockage of the collaterals by stagnation of qi and blood

Clinical manifestations Numbness of limbs accompanied by
distending pain or pricking pain,which could be alleviated by
pressingrough skindark complexionpurple lipsa tongue
with purple spots thin and slightly dry coating and hesitant
pulse

Pathogenesis Stagnation of qi and blood blocks the

collaterals qi and blood fail to reach the limb
Principle of treatmentPromote qiactivate blood and remove
obstruction
from
the
collaterals

Points and manipulation Apply even method on Zhigou(SJ

6) Yanglingquan(GB 34) Taichong(LR 3) Xuehai(SP
10) Diji(SP 8) Qiuxu(GB 40) Jiexi(ST 41) Quchi(LI
11)and Hegu(LI 4)Retain the needles for 30 minutes and give
treatment
once
or
twice
a
day

Explanation: Zhigou(SJ 6), the Jing-River Point of the sanjiao

Meridian of Hand-Shaoyang is effective in removing
obstruction from qi circulation of the Sanjiao to help their
functionsthe point is an important point for treating abnormal

circulation of qi since it is good in regulating qi

Yanglingquan(GB 34) the He Sea Point of Gallbladder
Meridian mainly works to soothe the liver and relax
depression Taichong(LR 3) the Shu Stream and
YuanPrimary points of Liver Meridiancan soothe the liver
and regulate the liverthe combination of these three points iS
the basic prescription for soothing the liver and regulating
qi Blood flowing while qi circulating the three points
associate to promote qi and activate blood Xuehai(SP 10)and
Qiji(SP 8)can activate and nourish blood resolve blood stasis
and remove obstruction from the collateralsJiexi(ST 4 1)the
Jing-River Point of Stomach Meridian of FootYangming wherethe meridian qi runs like water flowing in
riverQiuxu(GB 40)the Yuan-Primary Point of Gallbladder
Meridian of Food-Shaoyang where Yuanqi(primary qi) is
infased can promote meridian qi to remove obstruction from
the collaterals Quchi(LI 11) and Hegu(LI 4) work to help
distribution of qiblood and body fluidAll the points above
are used together to normalize qi circulation and promote blood
circulationso as to nourish the limbs
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