Obese Type 2 Diabetes Mellitus & Insulin Resistance Treated with Qi Wei Bai Zhu San plus Bu Yang Hua

Obese Type 2 Diabetes Mellitus & Insulin Resistance Treated with Qi Wei Bai Zhu San plus Bu Yang Huan Wu Tang with Additions & Subtractions

abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On pages 624-625 of issue #11, 2008 of Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Hu Wu-fang of the Long You County Chinese Medical Hospital published an article titled, “Clinical Research on the Treatment of Obese Type 2 Diabetes & Improvement of Insulin Resistance with Qi Wei Bai Zhu San plus Bu Yang Huan Wu Tang with Additions & Subtractions.” A summary of this article is presented below.

Cohort description:

Altogether, 128 patients were enrolled in this two-wing comparison study. All 128 cases met the 1999 WHO diagnostic criteria for type 2 diabetes mellitus, had a body mass index (BMI) of equal or greater than 25, had fasting serum insulin of equal to or greater than 15mmol/L, and had an insulin sensitivity index (ISI) score of equal to or less than 4.5. Patients who had taken cholesterol-lowering, weight-reduction, corticosteroids, and beta-blockers were excluded from this study as were those who had had an acute metabolic crisis or infection within the past month. Also excluded were those with serious myocardial infarction, cerebral infarction, or diabetic kidney disease.

These 128 cases were  randomly divided into two equal groups of 64 cases – a treatment group and a comparison group. In the treatment group, there were 36 males and 28 females with a median age of 53.5 ± 9.2 years. These patients’ disease duration had lasted from 1-22 years, with a median duration of 8 ± 6.8 years. In the comparison group, there were 38 males and 26 females with a median age of 54.8 ± 8.6 years. These patients had suffered from diabetes for from 0.5-21 years, with a median disease duration of 8.2 ± 6.7 years. Therefore, in terms of sex, age, and disease duration, these two groups were deemed statistically comparable for the purposes of this study.

Treatment method:

All 128 cases were counseled on proper diet and exercise. In addition, one half month equaled one course of treatment for both groups, and outcomes were analyzed after three such courses. All members of the treatment group were orally administered Qi Wei Bai Zhu San (Seven Flavors Atractylodes Powder) plus Bu Yang Huan Wu Tang (Supplement Yang & Restore Five [Tenths] Decoction) with additions and subtractions as follows:

Huang Qi (Radix Astragali), 30g
Dang Shen (Radix Codonopsis), 20g
Fu Ling (Poria)
Dang Gui (Radix Angelicae Sinensis), 10g each
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Ge Gen (Radix Puerariae), 15g each
Huo Xiang (Herba Pogostemonis)
Pei Lan (Herba Eupatorii)
Di Long (Pheretima), 8g each
Chi Shao (Radix Alba Paeoniae)
Chuan Xiong (Rhizoma Chuanxiong)
Tao Ren (Semen Persicae), 6g each

One packet of these medicinals was decocted in water and administered per day in divided doses. These patients were also administered 0.5 [sic; perhaps this means one-half tablet] of the Western drug Metformin Hydrochloride Tablets TID after meals.

All members of the comparison group only received the same dose of the Metformin Hydrochloride Tablets TID after meals. They did not receive nay Chinese medicinals.

Study outcomes:

A scoring system was created which assigned points to various symptoms in terms of severity. These points after treatment were subtracted from those before treatment and then divided by 100. Marked effect was defined as a decrease in this score by 70% or more. Some effect was defined as a decrease in this score of 30-69%, and no effect was defined as a decrease in this score of less than 30%. The following table shows the outcomes of the two groups based on this scoring system.

Therefore, based on these criteria, the integrated Chinese-Western  medical protocol was markedly more effective than the Western medicine protocol alone. The next table shows the mean changes from before to after treatment in a number of key biological markers in the two groups. In this table, FPG means fasting blood glucose, P2hPG means two-hour postprandial blood glucose, TC means total cholesterol, TG means triglycerides, BMI means body mass index, FINS means fasting insulin, and ISI means insulin
sensitivity index.

Therefore, mean improvements from before to after treatment were significantly greater in the treatment group than in the comparison group.

Discussion:

In Dr. Hu’s experience, patients with obese type 2 diabetes all present with varying degrees of dizziness, a heavy, encumbered head and body, being fat, fatigue, lack of strength, somnolence, a sticky, slimy feeling within the mouth and/or profuse phlegm, ductal glomus and chest oppression, soreness, pain, numbness, and/or heaviness in the extremities, and other such signs of spleen vacuity with damp exuberance. If dampness and turbidity gather and produce phlegm, this blocks and causes stagnation in the network vessels. The qi mechanism is not smoothly and easily flowing, and static blood obstructs internally. Phlegm and stasis mutually bind, and the function of the viscera and bowels loses its regularity/regulation. Therefore, Dr. Hu believes that the main disease mechanisms in obese type 2 diabetes are spleen vacuity with damp exuberance and stasis obstructing the network vessels, and, in this case, treatment should fortify the spleen and transform dampness, free the flow of the network vessels and quicken the blood.

Within the above formula, a large amount of Huang Qi greatly supplements the spleen-stomach qi, while the combination of Dang Shen and Bai Zhu fortifies the spleen, boosts the qi, and upbears the clear. Thu these three medicinals together promote the (healthy) effulgence of the qi in order to promote the movement of the blood. Huo Xiang and Pei Lan aromatically penetrate and transform turbidity and eliminate dampness, thus arousing and moving the spleen. Mu Xiang [sic, Radix Auklandiae] acridly scatters, warms, and frees the flow. Thus it helps to diffuse stagnation in the middle burner. Ge Gen engenders fluids and stops thirst. Together, these two medicinals promote the upward movement of the spleen-stomach qi. Dang Gui quickens the blood. It is able to dispel stasis but without damaging the good blood. Di Long warms the channels and frees the flow of the network vessels. The combination of Chuan Xiong, Chi Shao, and Tao Ren strengthens the functions of quickening the blood, freeing the flow of the network vessels, and dispelling stasis. This formula uses a large amount of medicinals to fortify the spleen and boosts the qi but a small amount to free the flow of the network vessels, quicken the blood, and transform stasis. In this case, because of fortifying the spleen, boosting the qi, and engendering fluids, the transformation of stasis through freeing the flow of the network vessels and the quickening of the blood is effective. In sum, this formula promotes the balance of the body’s yin and yang and the smooth and free flow of the qi and blood. It restores insulin secretion, lower insulin resistance, and thus is automatically able to lower serum glucose.

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