Diabetic Neuropathy |
Chinese Medicine, Acupuncture, Diabetic Neuropathy
Although acupuncture was traditionally forbidden in patients with diabetes due to fear of infection and subsequent gangrene, modern advances in needle manufacture and sterilization have allowed practitioners to perform acupuncture safely on patients with diabetes. Peripheral neuropathy is one of the main complications of diabetes mellitus for which Western medicine has relatively little to offer. Therefore, patients and practitioners alike are always on the lookout for effective alternatives and complementary therapies. Zhang Xiao-qin and Cheng Zong-peng have developed an acupuncture protocol which shows promise in the treatment of this condition. They describe this protocol in an article titled, “Clinical Observations on the Treatment of Diabetic Peripheral Neuropathy with Acupuncture.” This article was published in issue #3, 1999 of Zhong Guo Zhen Jiu (Chinese Acupuncture & Moxibustion) on pages 236-237. A precis of that article is given below.
Cohort description:
Altogether there were 90 patients described in this study. Of these, 53 were male and 37 were female. The youngest was 14 and the oldest was 76 years old. In addition, the shortest duration of disease was one year and the longest was 12 years, with an average of 4.1 years. All these patients were out-patients at the Su Song County Chinese Medical Hospital in Anhui. These 90 patients were randomly divided into two groups of 45 patients each, a so-called treatment group and a comparison group. All these patients met WHO diagnostic criteria for diabetes mellitus and all met the criteria for diabetic peripheral neuropathy established by Gao Yan-bin. There was no significant difference (P < 0.05) in results of routine examinations of blood, urine, and stool, hepatic or retinal functions, blood glucose, blood lipids, or urine sugar before treatment between these two groups. Likewise, the make-up of both groups were statistically comparable in terms of sex, age, and disease duration.
Treatment method:
Patients in the comparison group were asked to adhere to a relatively rigid diet and to engage in proper physical exercise. They were also administered 7.5-15mg of glyburide orally per day and 100mg of vitamin B1 and 500mg of vitamin B12 intramuscularly per day. Thirty days of this regime equaled one course of treatment.
Patients in the treatment group received the same Western medical treatment described above. In addition, they also received acupuncture at the following acupoints: Yi Shu (M-BW-12), Shen Shu (Bl 23), Ming Men (GV 4), Pi Shu (Bl 20), Wei Shu (Bl 21), Zu San Li (St 36), and San Yin Jiao (Sp 6). Shou San Li (LI 10), Qu Chi (LI 11), Wai Guan (TB 5), and He Gu (LI 4) were added for neuropathy of the upper extremities, while Yang Ling Quan (GB 34), Yin Ling Quan (Sp 9), Xuan Zhong (GB 39), Tai Xi (Ki 3), and Huan Tiao (GB 30) were added for neuropathy of the lower extremities. Four to six acupoints were chosen each treatment, and treatment was given once per day. Even supplementing-even draining hand technique was used with moderate stimulation. After withdrawal of the needles, warming moxibustion was applied on the acupoints with a warming_moxibustion instrument for 20 minutes. Thirty days of this regime also equaled one course of treatment.
Treatment outcomes:
Marked effect was defined as a fasting blood glucose of less than 6.7mmol/L, disappearance of symptoms such as numbness, stabbing pain, spasm, and other abnormal sensations, and restoration of normal tendon reflexes. Some effect was defined as fasting blood sugar less than 7.2mmol/L, decrease in the area and degree of numbness, stabbing pain, spasm, and other abnormal sensations, and the ability to work and carry on other normal daily activities. No effect was defined as no obvious improvement in the signs and symptoms. Based on these criteria, in the treatment group, 31 cases (68.89%) got a marked effect, 13 cases (28.89%) got some effect, and one case (2.22%) got no effect. Therefore, the total effectiveness rate in the treatment group was 97.78%. In the comparison group which was treated only with Western medicine, 20 cases (44.44%) got a marked effect, 15 cases (33.33%) got some effect, and 10 cases (22.23%) got no effect, for a total effectiveness rate of only 77.77%. Follow_up after six months found that the therapeutic effect in the treatment group was stable.
Discussion:
This study is like so many other contemporary studies done in China on the treatment of diabetes and its complications with Chinese medicine in that it conclusively shows that Western medicine combined with Chinese medicine is more effective than Western medicine alone. Most Western patients with diabetes are going to be on some sort of Western medical treatment, and studies such as this show that it is not necessary to discontinue these treatments in order to make use of Chinese medicine. Further, not only was the combined acupuncture and Western medication regime more effective for the relief of the symptoms of peripheral neuropathy, it also was more effective for lowering the blood glucose levels. Hence this integrated Chinese-Western medical regime can be seen as treating both the root and the tip or branches of this disease.
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