Hereditary diabetes blood sugar 4 plus urine ketone bodies 4 plus blood sugar normal after how to treat the best results

?2.1 Overview

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus, and is also the main factor of disability in diabetic patients. DPN is one of the most common chronic complications of diabetes mellitus and a major factor in disability in diabetic patients. The incidence of DPN has been reported to be as high as 90%. The onset of this disease is insidious, and it may appear before the symptoms of diabetes, which is easy to be overlooked. Clinical symptoms are mainly manifested as limb pain and sensory abnormalities, characterized by symmetrical distal sensory deficits, with the lower limbs being more affected than the upper limbs. It is now widely recognized that the pathogenesis of diabetic peripheral neuropathy is related to a variety of factors such as metabolic disorders caused by hyperglycemia, microangiopathy, lack of neurotrophic factors, free radical damage and abnormal gene expression.

2.2 Pharmacological treatment

At present, Western clinical control of blood glucose, regulation of metabolism and improvement of microcirculation to correct nerve ischemia and hypoxia, and increase nerve conduction function; in addition, there are also antioxidant, supplementation of neurotrophic factors, the use of immunosuppressants, as well as physical therapy, hyperbaric oxygen and other methods. In recent years, the treatment of DPN by TCM has shown certain advantages. Xiyuan Hospital of the China Academy of Traditional Chinese Medicine conducted a phase III clinical trial on Sugar Materia Medica Granules (Astragalus, Yanhuisuo, Panax ginseng, Paeonia lactiflora, Danshen, Rhizoma Ligustici Chuanxiong, Safflower, Sambucus, and Chicken-bloodthistle), using Micronomicin tablets as a positive control, and the results showed that Sugar Materia Medica Granules had a better therapeutic effect on diabetic peripheral neuropathy, and it could improve the patient's clinical symptoms such as numbness of the limbs, pain, etc. in a shorter time, especially for the dullness of the color of the face, Self-sweating is better than the control group.

The Shenzhen Hospital of Traditional Chinese Medicine used STZ diabetic rats as a model for the study of Tongluo Gantai (leech, white mustard seed, bingshi, and yanhuisuo), and the results showed that Tongluo Gantai had a better effect on increasing nerve conduction velocity and decreasing AR activity. Tongxinluo capsule (ginseng, leech, whole scorpion, soft-shelled turtle, mealybug, cicada slough, red peony, ice tablet) treated 80 cases of diabetic peripheral neuropathy patients, the total effective rate of 92.5%, which was significantly better than the control group (67.5%), significantly improved the neurological signs and symptoms of the patients with peripheral neuropathy, and improved the peripheral nerve conduction velocity. Peking Union Medical College Hospital treated diabetic peripheral neuropathy with Sinew and Pulse Capsules (Astragalus, Radix et Rhizoma Shengdi, Salvia miltiorrhiza, leech, Cuscuta, Chasteberry, Cinnamon, etc.), and the patients took them to improve their clinical symptoms and blood glucose, increase the activity of Na+-K+-ATPase of erythrocyte membranes, and increase the speed of nerve conduction significantly.

3 Traditional Chinese medicine treatment of diabetic retinopathy

?3.1 Overview

Diabetic retinopathy (DR) is a serious microvascular complication of diabetic eye, and with the increasing incidence of diabetes, diabetic retina has become more and more common. With the increasing incidence of diabetes, the incidence of diabetic retinopathy is also increasing. The incidence of retinopathy in diabetic patients is 25% five years after the onset of diabetes mellitus, increases to 60% after 10 years, and can be as high as 75% to 80% after 15 years, of which proliferative retinopathy accounts for 25% of the most harmful, and it has become the main cause of blindness for adults in the world, especially in developed countries. Diabetic retinopathy is divided into 3 stages: early for the retinal veins uniform expansion and uneven contraction, the appearance of microvascular angiomas; medium-term for the retinal veins have exudates, hemorrhage, edema; late for the retinal proliferative lesions.

The treatment of simple diabetic retinopathy in Western medicine is mainly based on the control of blood glucose, blood pressure, blood lipids with the use of drugs to improve the retinal microcirculation, angiotensin-converting enzyme inhibitors, aldose reductase inhibitors, inhibitors of protein non-enzymatic glycosylation end-product and photocoagulation therapy. Local treatments such as laser therapy and vitrectomy must be considered for proliferative DR. Chinese medicine treatment has its unique advantages in improving vision, delaying the occurrence and development of DR, promoting the improvement of pathological changes in the fundus as well as improving the systemic symptoms of patients and improving the quality of life of patients. Chasteberry capsule (Astragalus, chasteberry, Angelica sinensis, Salvia miltiorrhiza, safflower) has the effect of aldose reductase inhibitor, which can improve the local hypoxia of retina, correct the hemodynamic and microvascular abnormalities, improve the microcirculation of retina, and stop the progression of lesions.

Yao Peiyu et al. treated 60 cases of non-proliferative diabetic retinopathy with glucose-lowering and eye-opening tablets (raw Astragalus, Pu Huang, Di Huang, Dangshen, Mo Dang Lian, Chasteberry, Red Peony, Mudan Pi, Rhizoma Cnidii, Chrysanthemum, Cassia seed, Plantago Ovata) with an overall effective rate of 90.0%, which was significantly higher than that of the control group (70.0%). Zhang Jianying et al. treated diabetic retinopathy with Qizi ginseng and turtle shell pills (Astragalus, Salvia miltiorrhiza, Chinese yam, Rhizoma Atractylodis Macrocephalae, Maitake, Oyster, Tetrapodidae, Lycium barbarum, Xuanshen, Smallpox pollen, Radix Rehmanniae Praeparata, Pueraria Mirifica), which could significantly reduce blood glucose and HbAlc, cholesterol, triacylglycerol, and low-density lipoprotein (LDL) cholesterol, and at the same time effectively reduced the patient's whole-blood viscosity, plasma viscosity, and fibrinogen, red blood cell aggregation index.

4.1 Overview

In recent years, the close relationship between cardiovascular disease and diabetes mellitus has been more and more widely emphasized. Diabetic patients are at high risk of developing cardiovascular diseases, and cardiovascular complications such as coronary atherosclerosis, myocardial infarction and stroke are one of the major causes of disability and death in diabetic patients. The pathogenesis of cardiovascular complications in diabetes mellitus includes: genetic polymorphisms and mutations, both of which are risk factors for cardiovascular disease in combination with type 2 diabetes mellitus; endothelial cell dysfunction, abnormalities in lipid metabolism, and abnormalities in the functioning of vascular smooth muscle cells (VSMCs), all of which lead to the formation of atherosclerosis; the formation of immune complexes, which can accelerate the destruction of the arterial wall; activation of protein kinase C （Activation of protein kinase C (PKC) and impaired platelet function ultimately lead to thrombosis and affect cardiomyocyte function.

4.2 Pharmacological treatment

A large number of evidence-based medical studies have shown that, in the prevention and treatment of diabetic cardiovascular disease, it is necessary to comprehensively control a variety of related risk factors (hyperglycemia, hyperinsulinemia and insulin resistance, high blood pressure, lipid metabolism disorders, blood rheology abnormalities, etc.). Sugar Pulse Ning (Astragalus, Rhizoma Polygonati Odorati, Radix Rehmanniae Praeparata, Radix et Rhizoma Polygonati Odorati, Radix et Rhizoma Polygonati Odorati) not only lowers blood glucose, but also reduces blood lipids, blood viscosity, and plasma ET levels, improves the activity of SOD in cardiac and renal tissues, reduces the level of LPO, and blocks the formation of vascular complications. Songling Blood Vein Kang Capsules (pine needles, Pueraria Mirifica, pearl powder) has a significant lowering effect on fasting serum cholesterol (TC), triacylglycerol (TG), and low-density lipoprotein (LDL-C), and it can raise high-density lipoprotein (HDL-C), and prevent and control the occurrence of diabetic vascular complications by regulating lipid metabolism.

Diabetic foot (DF), also known as diabetic gangrene, is a general term for lower limb lesions caused by diabetes mellitus with concomitant neurological and vascular lesions, and it is one of the main causes of disability in diabetic patients. The incidence of diabetic foot ulcers is 2.2% to 15%, and about 50% of the patients who undergo amputation each year worldwide are diabetic foot patients, and diabetic foot has become the leading cause of non-traumatic amputation. Clinically, it is characterized by limb numbness, abnormal sensation, pain, ulceration and gangrene. Currently there is general agreement on the pathogenesis of the diabetic foot is the ternary theory of the diabetic foot: i.e., diabetic ischemic lesions, diabetic neuropathy and local infection. In addition, there must be an initiating factor for ulceration to occur, such as physical or mechanical irritation.

In recent years, Chinese medicine has achieved some results in the treatment of diabetic foot. Huang Zhengde et al. observed the efficacy of dragon blood exhaust capsule (the main ingredient is blood exhaust) in the treatment of diabetic foot ulcers, the results show that the effective rate of the treatment group was 83.3%, which is better than the control group's 51.5%, and the apparent efficiency of the treatment group reached 55.5%, which is significantly better than the control group's 24.2%, indicating that the dragon blood exhaust capsule is an effective drug for the treatment of diabetic foot ulcers. According to the analysis of modern pharmacological research, it may be related to the inhibition of platelet aggregation of blood exhaustion, so that vasodilatation, blood flow increases, and also has antibacterial effect and so on. Wu Teng Yong et al. treated early diabetic foot with the Songling blood circulation Kang capsule, the efficacy of the treatment is remarkable, the lower extremity vasculopathy symptoms, hemorheology and other related indicators improved significantly.

Pueraria Mirifica and pearl powder in Songling Blood Vein Kang Capsules have the effects of lowering blood lipids, blood pressure, and blood glucose, inhibiting platelet aggregation, dilating blood vessels, and improving microcirculation, thus lowering blood viscosity, preventing atherosclerosis and thrombosis, and treating lower limb vascular pathology while improving the circulation of the cardiac, cerebral, and renal blood vessels, thus reducing the occurrence of cardiovascular and cerebrovascular events. Wang Sumei's treatment of diabetic foot with Sugar Pulse Capsule (Angelica sinensis, Rhizoma Ligustici Chuanxiong, Rhizoma Dioscoreae, Centipede, Astragalus Membranaceus, Pueraria Lobata, Gui Zhi, Smallpox Pollen, Ophiopogonis Macrocephalae, Paeonia lactiflora, Peach Kernel, Safflower, Shenquan and Hirudinea officinalis) can significantly improve the glucose level of patients with diabetic foot, improve the speed of nerve conduction, lower blood viscosity and erythrocyte accumulation, and peripheral circulatory disorders have been improved significantly.

To summarize, there is a large number of literature reports on the study of Chinese medicine for the treatment of diabetic complications, and greater progress has been made in the research of compounding and clinical diagnosis and treatment. Chinese medicine has the characteristics of multi-target and multi-mechanism, and the treatment of diabetic complications attaches importance to the overall regulation, with low toxicity and side effects, high safety, and cleverly combines the benefit of qi and yin with the activation of blood circulation and bruising, which has the incomparable advantages of chemically synthesized drugs.