Treatment of Type 1 Diabetic Gastroparesis Based on Differentiation of Reverting Yin Syndromes
Diabetic gastroparesis(DGP),a common chronic diabetic complication characterized by delayed gastric emptying and gastrointestinal symptoms,frequently affects the patients with type 1 or 2 diabetes mellitus and without mechanical bowel obstruction.Although the pathophysiology of DGP remains unclear,some studies point out associations of DGP with aberrant gastrointestinal hormone secretion and autonomic dysfunction on the basis of persistent hyperglycemia.Moreover,DGP will not be alleviated even when the blood glucose is under control.Western medical treatment of this complication focuses on controlling blood glucose,nourishing nerves,and improving gastrointestinal motility,which,however,demonstrate poor effects as manifested by the high incidence and lingering symptoms and pose negative effects on the physical and mental health and quality of life of the patients.DGP is a disease of stuffiness and fullness,vomiting,and diarrhoea in traditional Chinese medicine.According to the available studies,DGP is rooted in the dysfunction of the spleen and stomach and the abnormal qi movement in the middle energizer,which results in the generation of phlegm and stasis.The DGP patients mainly present five syndromes:internal obstruction by blood stasis,phlegm and dampness obstruction of middle energizer,stomach yin deficiency,cold and deficiency in the middle energizer,and qi deficiency and food stagnation.The treatment should address both the symptoms and the root cause,following the principles of tonifying deficiency,reducing excess,invigorating the spleen,and soothing the liver.In addition,the methods of clearing phlegm and removing stasis can be adopted according to the conditions of the patients.We have applied classical formulas in the treatment of this disease based on syndrome differentiation according to the Treatise on Cold Damage(Shang Han Lun),which have demonstrated definite therapeutic effects.The article explores the medication rules of DGP from the etiology,pathogenesis,clinical characteristics,and medications of this disease.
type 1 diabetes mellitusgastroparesisTreatise on Cold Damage(Shang Han Lun)reverting yin syndromesDanggui Sini plus Wuzhuyu Shengjia Decoctionmedical case
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