🌿 Folk Prescriptions

Diabetes complicated with hyperlipidemia falls within the scope of traditional Chinese medicine's "Xiaoke." Research indicates that type 2 diabetes can cause significant lipid metabolism disorders, ultimately predisposing patients to atherosclerosis and other cardiovascular diseases. Professor Li Ji from the Department of Formulas at Heilongjiang University of Traditional Chinese Medicine proposed treating "Xiaoke" from the perspective of the heart. Li Ji summarized the theoretical evolution of treating "Xiaoke" based on deficiency and blood stasis, compiled extensive ancient prescriptions, and selected representative classical formulas. Through formula dissection, combination therapy, and animal experiments, he elucidated the internal connection between Qi-tonifying and Yin-nourishing methods and blood-activating therapy in treating the Qi-Yin deficiency type of "Xiaoke" complicated with hyperlipidemia. Li Ji classified the relationship between "Xiaoke" and the heart into seven syndromes, elaborating on symptoms, etiology, pathogenesis, treatment principles, herbal formulas, and formula mechanisms, thereby establishing a foundational theoretical framework for treating "Xiaoke" from the heart. He also collected over 30 classic formulas created by ancient physicians, such as Huangqi Tang, Shenli San, Jiangxin Tang, and Pingbu Wan, and conducted syndrome-based modifications, formula dissection, and animal experiments. Additionally, he developed multiple dosage forms including capsules, decoctions, pills, and tablets, primarily using herbs like ginseng, Astragalus membranaceus, Chinese yam, raw Rehmannia glutinosa, Ligusticum chuanxiong, and Salvia miltiorrhiza. By applying formula dissection analysis, these herbs were categorized into three groups: blood-activating herbs, Qi-tonifying and Yin-nourishing herbs, and combined Qi-tonifying and Yin-nourishing plus blood-activating herbs. Results showed that the optimal ratio of Qi-tonifying and Yin-nourishing herbs to blood-activating herbs was 2:1, yielding the best effects on blood glucose, lipid levels, and hemorheological parameters. Neither pure Qi-tonifying and Yin-nourishing therapy nor pure blood-activating therapy alone could effectively lower blood glucose, lipids, or blood viscosity. Using only blood-activating herbs actually increased blood glucose levels, while combining them with Qi-tonifying and Yin-nourishing herbs significantly enhanced hypoglycemic, hypolipidemic, and anticoagulant effects. The combination of both therapies also significantly improved the "three reductions" (lowering glucose, lipids, and viscosity). This suggests that for patients with diabetes and hyperlipidemia, treatment should combine Qi-tonifying and Yin-nourishing therapy with blood-activating therapy, prioritizing the former and using the latter as an adjunct. It is crucial to carefully control the dosage of blood-activating herbs—neither omitting them nor allowing them to replace the entire formula—thereby objectively refuting the notion that blood-activating therapy alone treats "Xiaoke." Based on this principle, the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine has adopted Qi-tonifying and Yin-nourishing plus blood-activating therapy as the primary treatment for "Xiaoke," particularly showing remarkable efficacy in patients presenting with symptoms such as shortness of breath, fatigue, soreness in waist and knees, dry mouth and throat, frequent urination, and laboratory evidence of elevated triglycerides and cholesterol. Li Ji explained that "Xiaoke" is closely related to all five zang organs; although most physicians focus on the lungs, stomach, and kidneys, some also treat it from the liver and spleen perspectives. The Department of Formulas at Heilongjiang University of Traditional Chinese Medicine, designated as a key discipline by the State Administration of Traditional Chinese Medicine, emphasizes the role of the heart in the development of "Xiaoke" in clinical practice. They have elaborated on the theory, method, formula, and pharmacology of "Xiaoke" from seven aspects, providing broader insights into treating diabetes complicated with hyperlipidemia through deficiency and blood stasis, and offering new theoretical foundations for rational selection of Chinese herbs, enhanced clinical efficacy, and scientifically accurate formula combinations.<Diabetes>