A Research On The Pathological Changes And Transmission Rules Of DPN Diseases Treated With Classical Prescriptions

Diabetic peripheral neuropathy (DPN) is the commonest complication of diabetes. It may lead to the dysfunction of the sensory nerve, motor nerve, and autonomic nerve. Currently, there are no effective measures to prevent such adverse development. Zhang Zhong-jing's Shanghan (Treatise on Exogenous Febrile Diseases) is a treasure trove. It ranks first in the science of TCM prescription not only for its perfect match, fine composition, and precision in the use of herbs but also its healing effects. This research adopts an analytical approach on the review of past medical literatures together with modern statistical methodology. Conducting a conclusive analysis on the treatment of diabetic peripheral neuropathy, I summarize my research and findings below:â… . TCM Literature StudyStarting from a comprehensive review and consolidation of TCM literatures on diabetic peripheral neuropathy,1summarized and analyzed: the pathogenic factors, pathogenesis, clinical diagnosis and treatment (including special treatment, external treatment, acupuncture&moxibustion etc.) in the context of Zhang Zhong-jing's historic background and development. This coupled with other TCM literatures and modern clinical development formed the basis of this research.â…¡ Research on the Routines of Syndrome Differentiation&Treatment1. Purpose of the ResearchIt was evident that the application of Zhang Zhong-jing's classical prescriptions significantly improved patient's syndromes and physique thus elevating the patient's quality of life. Nowadays, renowned clinical and laboratory results were achieved. Collating the massive successful cases of DPN treated with traditional prescriptions, it is the aim of this research to consolidate and to conclude a stage of achievement to facilitate possible future research development and advancement.2. Research MethodologyBased on the databanks of China National Knowledge Internet (CNKI) and China Science&Technology Journal (CSTJ), I chose Zhang Zhong-jing's three prescriptions namely:Huangqi Guizhi Wuwu Tang,(HGWT-Decoction of Five Ingredients), Danggui Sini Tang (DST-Decoction of Chinese Angeli for Restoring Yang) and Shenqi Wan (SQW-Pill for Invigorating Kidney Qi) as the representation prescriptions in the treatment of DPN. To carry out a systematic research and analysis, I have constructed a database using normative data with frequency analysis, factor analysis and Chi-squarod test etc.3. The Results of the ResearchIn the frequency analysis, it showed a frequency of>5%indicated syndromes of DPN for17cases treated with HGWT,16cases treated with DST, and22cases treated with SQW. To identify the potential affects due to prescriptions and syndromes by means of factor analysis, it showed that: HGWT caused localized limbs discomfort, Qi deficiency and stomach discomfort etc.; DST caused localized discomfort, both Qi and Yang deficiency, abdominal discomfort and blood circulation deficiency; SQW caused localized discomfort, both kidney and Yang deficiency, Qi discomfort, stomach discomfort and neuropsychi atric symptoms etc. Using Chi-square test, it showed the following9common syndromes:localized numbness and pain, ineffective limbs activities, aversion to cold, lassitude, abdominal distension, mouth thirst, dizziness, lusterless and pale complexion etc.With the changes in era, the application of classical prescriptions also varied and evolved with special characteristics. For example, the original prescription was smaller in dosages and there were frequent uses of Quizhi. Statistics also revealed that in the appropriate choice of drugs and doses: for x2>5%, there were54drugs; for paired comparison method, there were14drugs to invigorate deficiency,11drugs to regulate blood circulation,7drugs to eliminate dampness,6drugs to clear away heat,5drugs to relief exterior syndromes,4each to promote diuresis&to eliminate dampness and to warm the interior;3drugs to calm the liver and stop endogenous wind;1drug to regulate the Qi. From professional standpoints, a review on the analysis of the composition of drugs showed that classical prescriptions excelled in the treatment of DPN in4major categories, namely:to promote blood circulation and to remove blood stasis; to invigorate Qi and to nourish Yin while eliminating heat; to dispel wind and to eliminate dampness; to warm the meridians and to promote blood circulation. A further study on the meridians where the drugs took effect revealed that the treatment focused on both the liver and spleen.â…¢ Conelusion1. Classical prescriptions indicated that there were syndromes of localized numbness, localized pain and inactivity of the limbs. In Chi-square test, here was no exception and this could be viewed as an obvious symptom. These other six obvious symptoms were:aversion to cold, dispiritedness and lassitude, abdominal distension, mouth thirst, dizziness and pale complexion. All these could be summed up to signify the pathological changes and transmission rules of DPN diseases. These findings correlated with most TCM practitioners'belief that "Shanghan's primary is to save Yang"2. Using normative data with frequency analysis, factor analysis and Chi-squared test etc. it was found that the drugs of Zhang Zhong-jing's original three classical prescriptions varied only slightly. I opined that Shanghan's classical prescriptions were as effective today as they were in the past in terms of composition and modification.It was evinced that Shanghan's classical prescriptions were effective in the treatment of DPN diseases. It was intended that the findings of the TCM diagnosis and treatment in this research might serve as a guide in clinical practice.