Herbal medicine has been an integral part of TCM for more than 2,000 years. Many herbal formulations have been developed and are used in the treatment of diabetes. The Huang Di Nei Jing (Yellow Emperor’s Inner Classic), which dates from the Han Dynasty 206 B.C.–220 A.D., listed 13 herbal formulations, 9 of which were patent medicines including pills, powders, plasters, and tinctures.12 The sources of Chinese remedies are varied and include plants, minerals, and animal parts.3
Chinese herbs have specific functions (i.e., warming, heat-clearing, eliminating dampness, and cooling) and can be classified according to those functions. They are also classified according to four natures (cool, cold, warm, and hot) and five tastes (sweet, pungent, bitter, sour, and salty).4 Herbs may be prescribed individually or as part of a formula.
Formulas promote the effective use of herbs.3 A typical formula has four components, including:
The Chief (principal) ingredient, which treats the principal pattern of disease,
The Deputy (associate) ingredient, which assists the Chief ingredient in treating the major syndrome or serves as the main ingredient against a coexisting syndrome,
The Assistant (adjutant) ingredient, which enhances the effect of the Chief ingredient, moderates or eliminates the toxicity of the Chief or Deputy ingredients, or can have the opposite function of the Chief ingredient to produce supplementing effects, and
The Envoy (guide) ingredient, which focuses the actions of the formula on a certain meridian or area of the body or harmonizes and integrates the actions of the other ingredients.3
Herbal prescriptions for diabetes are formulated or prescribed based on the patient’s predominant symptoms. For instance, a patient presenting primarily with excessive thirst (lung Yin deficiency) might be given a single herb, such as radix panacis quinquefolii; or a combination of herbs in a patent formulation such as yu chuan wan, which is used in general to treat diabetes of mild to moderate severity and specifically to treat excessive thirst due to Yin deficiency,12 and ba wei di huang tang (“eight-ingredient pill with rehmannia”), which was originally used to treat people exhibiting weakness, fatigue, and copious urine soon after drinking water.13
Some of the most commonly used herbal substances for diabetes in TCM include:
Panax ginseng (Korean ginseng), which has a long history of use as a hypoglycemic agent. At least five constituents of this herb have been shown to exert hypoglycemic effects. In one study, treatment with ginseng lowered blood glucose levels and improved mood and psychological performance as compared with placebo. Recommended dosage is 100–200 mg/day.14
Momodica charantia (balsam pear), which is dried, powdered, and made into pills. A dosage of 18 g/day has been shown to reduce blood glucose.15
Lagenaria siceraria (bottle gourd), given as a decoction or pills. The recommended dose is 3 g/day. This, too, has been shown to reduce blood glucose levels.15
Psidium gnajava, taken in the form of fresh leaves or as an infusion and drunk as a tea. The dosage is 9 g/day. It acts to reduce blood glucose levels.15
The above herbs do not appear to increase insulin levels, but rather enhance carbohydrate utilization.15 Patients should have their type of diabetes and any other diagnoses confirmed before initiating any herbal treatment. In addition, one should first ascertain the credibility of the herbal therapist by inquiring about where and for how long the person received training and about membership in herbal associations such as the American Herbalists Guild. To become members, herbalists must submit three letters of reference from other professional herbalists, a description of their training, and an account of at least 4 years of experience working with medicinal herbs. As part of their training, TCM practitioners learn about the proper use of herbals.
Many Chinese herbs and formulations have been used safely for centuries in the hands of trained TCM practitioners. It is important to recognize, however, that data on drug-herb interactions are scarce, and there are clear contraindications to the use of specific herbs in certain populations, such as pregnant women.13
Discontinuing conventional medications in favor of herbal formulations may lead to serious complications such as significant hyperglycemia, and combining conventional hypoglycemic agents with herbal preparations without proper monitoring could lead to hypoglycemia.
The Food and Drug Administration (FDA) does not regulate herbs, minerals, animal products, and patent formulas that come into the United States from China. Herbal products are considered dietary supplements according to the Dietary Supplement and Health Education Act (DSHEA) of 1994; therefore, the manufacturers do not need FDA approval or evaluation for safety, purity, and efficacy before bringing their products to market. There have been reports of some formulas imported from China containing heavy metals such as lead and mercury and of others being deliberately adulterated with conventional Western pharmaceuticals, such as corticosteroids, anti-inflammatory agents, and benzodiazepines.16
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02/11/2009 11:38:03 AM