Keywords: diabetes, cerebrovascular disease, pathogenesis, treatment
Diabetes mellitus and cerebral vascular diseases are considered diseases frequently encountered in the world, they are difficult and intractable disease that the doctor aims to overcome the circle. These two diseases occur together, one influencing the other to make the more complicated. He brings more difficulties for the treatment and increases the fatality rate and disability rate. When they are mixed, the state of diabetes is the main factor to influence the improvement, aggravation and recurrence of the disease. Therefore, the active treatment of diabetes is key to improving the cure rate of the disease.
1. The etiology and pathogenesis
(1) Maintenance of wind phlegm and blood stasis
weakness due to age or overload and overwork, or irregular food May cause dysfunction of the spleen and stomach, the production of mucus and fluid disorder, the maintenance of the stasis of blood, causing the diabetes later a bad lifestyle causing liver wind, the wind goes up with phlegm, fluid and disorders disrupt the stasis of blood to the brain, resulting from the disease.
(2) Retention of phlegm heat in the fu organs
Diabetes occurs because of the preference of fatty food, tobacco and wine, which damage the spleen and stomach leading to retention of phlegm and turbidity of the liquid if the patient has a body of the constitution excessive yang, phlegm to be transformed into heat due to phlegm-heat, which is often held by the wind-yang to go up to block the vessels of the brain and cause disease.
(3) blood stasis due to qi deficiency
Internal injuries due to an overload and overwork, or injury of qi due to chronic disease, often causes malfunction of the spleen and stomach, which "poor origins of qi, blood and body fluid. Since the rate fails to send the essence of the lung, the lung would be affected, the spleen can not help the stomach to the distribution of liquid, dry heat is excessive in the body, spleen qi wells instead up, the gasoline supply would fall in the bladder. All these May cause thirst, frequent drinking, wasting, fatigue, weak limbs, polyorexia, profuse fresh urine and other signs of diabetes. Long time standing dysfunction of the spleen and stomach is often spleen qi deficiency, poor transport and food processing, and accumulation of moisture and mucus. Later, phlegm and stasis of blood are involved in blocking the vessels of the brain leading to disease.
(4) of the agitation of the wind due to yin deficiency
Deficit for the anti-pathogenic qi due to chronic disease and the weakness of the body due to the age of yin deficiency of liver and kidneys; empty fire is formed in the body to cause kidney failure, lung drought and stomach heat, which in diabetes. Little by little, can not control the yin yang, yin deficiency that exists in the lower body and yang hyperactivity in the upper body. The hyperactivity of yang wakes due to the wind of rebellion of qi and blood, which attacks the brain vessel resulting from stroke.
(5) Mist of the mind by mucus-damp
Yang, constitutional deficit and the maintenance of phlegm-damp, exacerbated by a malfunctioning of the spleen in transporting and processing due to poor nutrition in general lead to diabetes. If the liver yang rising internal and waving in the wind due to certain factors, phlegm-damp block the brain by using wind to cause yin yang tense stroke syndrome. If phlegm-heat turns wet, phlegm-May near the warmth of spirit and to change the tense yang syndrome syndrome of stroke. If the moisture retention and turbidity of liquid for a long time, yang and qi declines yuan (Primary) qi exhaust syndrome becomes flaccid syndrome. The syndrome is discussed here is the crisis of time, difficult to be healed normally.
2. Give the treatment of syndrome differentiation
(1) Essentials in syndrome differentiation
a. Analyzing the situation of the disease to see if the meridians are attacked or Zang organs are attacked.
The disease is developed from diabetes. The location of the disease is connected with the meridians or the Zang-fu organs. Clinically, it is safe in terms of awareness of the patient. If the patient is clearly in mind is the syndrome that the meridians and collaterals are attacked, the disease is mild with little location, if the patient has coma or trouble the mind's silence is that they of Zang-fu organs are attacked, and the disease is severe with deep location.
b. Identify tensions and flaccid syndrome syndrome
Flaccid syndrome is caused by the depletion of primary five Zang organs yang, yin and yang separates, the extreme deficiency syndrome, usually manifesting a loss of consciousness, eyes closed, mouth agape , flaccid paralysis of members to cold, incontinence of urine and feces, breathing low, but the hum ~ tendue syndrome is caused by blockage of the brain by excessive pathogenic factors, the syndrome of excess pathogens, generally showing a loss of consciousness, clenched jaws, tightly closed, hands, spasms members, constipation and urine retention. If the patient shows puffy face, coarse breathing, restlessness, noises in the throat, like a saw, is working, constipation and yellow urine, it is tense yang syndrome if the patient shows pale face with lips, silence, the profusion of dilute sputum expectoration, cold limbs, it is tense yin syndrome. In addition, the syndrome has often tense suddenly while flaccid syndrome is usually the result of tension syndrome showing signs of internal tension and external flaccidity.
(2) Give the treatment of syndromes
a. Meridians and collaterals are attacked
a) The blockage of meridians by the wind, phlegm
RINCIPLE treatment: Resolve phlegm, eliminate wind, activate blood and remove the obstruction of the meridians.
Points and manipulation: Fengfu (GV 16), Fengchi (GB 20), Zhongwan (CV 12), Quchi (LI 11), Hegu (LI 4), Huantiao (GB 30), Yinlingquan (SP 9), Zusanli (ST 36 ) Xuehai (SP 10), Fenglong (ST 40), Sanyinjiao (SP 6) and Taichong (LR 3). Applying the method, even on all points. Retain the needles for 30 minutes and give treatment once or twice a day.
b) the retention of phlegm heat in the fu-bodies
Principle of Treatment: Clear heat, resolve phlegm, remove the obstruction of the fu organs and eliminate stasis.
Points and manipulation: Applying the reduction method of lifting and thrusting the needle slowly and quickly Fengfu (GV 16), Fengchi (GB 20), Quchi (LI 11), Hegu (LI 4), Zhigou (SJ 6), Tianshu (ST 25), Zusanli (ST 36) and Fenglong (ST 40), same method on Zhongwan (CV 12), Yinlingquan (SP 9), Sanyinjiao (SP 6) and Taichong (LR 3). Theneedles Maintain for 30 minutes and give treatment once or twice a day.
c) Blood stasis due to qi deficiency
Principle of treatment: Nourish qi and blood, activate blood and eliminate the obstruction of the meridians.
Points and manipulation: Apply the method of enhancing lifting and pushing the needle slowly and quickly Zusanli (ST 36), Yinlingquan (SP 9), Xuehai (SP 10) and Sanyinjiao (SP 6), same method on Fengchi (GB 20), Binao (LI 14), Quchi (LI 11), Waiguan (SJ 6), Hegu (LI 4), Huantiao (GB 30), future (ST 32), Yanglingquan (GB 34), Xuanzhong (GB 39) and Taichong (LR 3). Retain the needles for 30 minutes and give treatment once or twice a day.
b. Zang-fu organs to be attacked
a) Tense syndrome
Principle of eliminating pathogenic factors, control the wind, the effect of resuscitation and clear mind.
Head of points and manipulation: Apply "sparrow-pecking" moxibustion on Shuigou (GV 26), reduction of the method of lifting and pushing the needle slowly and quickly Neiguan (PC 6), Taichong (LR 3 ) and Fengchi (GB 20); bite method to cause bleeding on the twelve Jing-well points or Shixuan (EX-UE 11). Retain the needles for 30 minutes and give treatment once or twice a day.
b) the syndrome of flaccid
Principle of treatment: Benefit qi, stabilize Yuanqi (primary qi), rescue and yang form collapse.
Points and handling: First, apply a strong moxibustion on Shenque (CV 8), Guanyuan (CV 4) and Zusanli (ST 36) and ~ Shuigou needle (GV 26) and Neiguan (PC 6) to reduce of the method, then the needle Fengchi (GB 20) the reduction of the method. Retain the needles for 30 minutes and give treatment 2 - 3 times per day.
(3) Selection of points according to symptoms
a. Abnormal speech
Select Yamen (GV 15), Lianquan (CV 23) and Tongli (HT 5) for slurred speech; Dicang (ST 4), Jiache (ST 6), Xiaguan (ST 7) and Quanliao (SI 18) for the deviation of the mouth; Shuigou (GV 26) and Fcngfu (GV 16) or stinging Jinjin (EX-HN 12) and Yuye (EX --
HN 13) to cause bleeding of the rigidity of the tongue; Chengjiang (CV 24) and Hegu (LI 4) for the saliva flowing from the angle of the mouth. Apply the method to enter Dicang (ST 4) and Jiache (ST 6) (the puncture with a needle to one another horizontally). Apply the same method on the other.
Add Binao (LI 14), Quchi (LI 11), Waiguan (SJ 5), Hegu (LI 4), Huantiao (GB 30), future (ST 32), Yanglingquan (GB 34), Weizhong (BL 40) and Xuanzhong (GB 39) for
hemiplegia; Dazhui (GV 14) and the three key points around the shoulder joint for limiting the movement because of pain from the shoulder; Chizé (LU 5) and Quze (PC 3) for the spasms of the shoulder; Yangchi (SJ 4) and Wangu (SI 4) to paralysis of the wrist; Baxie (EX-UE 9) and SIDU (SJ 9) of the contraction of the fingers; Shenshu (BL 23) and Dachangshu (BL 28) of numbness and heaviness of lower limbs; Ouquan (LR 8) and Yingu (KI 10) for the spasms knee Feiyang (BL 58), Jinggu (BL 64) and Qiuxu (GB 40 ) for strephenopodia; Jiexi (ST 41) for foot drop; Bafeng (EX-LE 10) for the spasms toes. Applying the method, even on all points.
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