Professor Zhu Chenyu's Jiangtang Shengmai Formula

The late Professor Zhu Chenyu, former head of the TCM department at Peking Union Medical College Hospital, produced many research findings on the TCM treatment of diabetes, and his commonly used Jiangtang Shengmai Fang (Blood-Sugar-Lowering Pulse-Generating Formula) is one of them. Jiangtang Shengmai Fang is a modification of the ancient formula Shengmai San, used to treat diabetic patients with the syndrome of qi and yin dual deficiency.

Professor Zhu Chenyu's Jiangtang Shengmai Fang consists of Sheng Huangqi (raw Astragalus), Shengdi (raw rehmannia), Shudi (processed rehmannia), Shashen (Glehnia), Maidong (Ophiopogon), Wuweizi (Schisandra), Sheng Shanzha (raw Crataegus), and Tianhuafen (Trichosanthes root). Zhu used it for diabetes complicated by chronic conditions such as hypertension, coronary heart disease, and hyperlipidemia, when symptoms include palpitations, chest oppression, breathlessness, angina, headache and dizziness, or irregular pulse.

This formula works fairly well for complications such as heart failure in mid- to late-stage diabetes. In it, Sheng Huangqi, Shashen, Maidong, and Wuweizi constitute Huangqi Shengmai Yin (Astragalus Pulse-Generating Drink); Shengdi and Shudi nourish yin and clear heat; Sheng Shanzha activates blood and resolves stasis while lowering lipids and blood sugar; and Tianhuafen both clears heat and resolves toxin and generates fluids to quench thirst. Zhu's empirical formula can relieve diabetic symptoms such as thirst, palpitations, breathlessness, dizziness, polyuria, and fatigue. For patients with more severe heart failure, when I use Zhu's formula I often replace Shashen with Xiyangshen (American ginseng).

Professor Zhu Chenyu's Jiangtang Shengmai Fang can also be modified according to the patient's specific condition. For angina, one may add Changpu (Acorus), Yujin (Curcuma aromatica), Qianghuo (Notopterygium), and Juhua (chrysanthemum); for high blood pressure, add Niuxi (Achyranthes), Xiakucao (Prunella), Huangqin (Scutellaria), and Gouteng (Uncaria); for high lipids, add Zhi Shouwu (processed Polygonum), Danshen (Salvia), Juemingzi (cassia seed), and Zexie (Alisma).

For diabetic patients with only heart-failure symptoms and nothing else, I often directly use Huangqi Shengmai San to relieve them. My common dose is: Sheng Huangqi 30 g, Xiyangshen 3–6 g, Wuweizi 10 g, Maidong 10 g. Zhu's Jiangtang Shengmai Fang may be dosed as: Sheng Huangqi 30 g, Bei Shashen (northern Glehnia) 10 g, Shengdi 10 g, Shudi 10 g, Wuweizi 10 g, Maidong 10 g, Sheng Shanzha 10–30 g, Tianhuafen 10 g. One packet a day, decocted twice, taken once after the morning and once after the evening meal.

In clinical practice, Professor Zhu Chenyu found that, besides controlling high-sugar foods in the diet, diabetic patients should also eat less of such foods as huixiang (fennel), jiucai (garlic chives), xiangchun (cedrelia shoots), and xihongshi (tomatoes), because these too can cause fluctuations in blood and urine sugar. TCM holds that diabetic patients mostly have qi-yin dual deficiency, and the above foods are pungent-warming in nature, so diabetic patients should avoid them.

I have also had some success combining Huangqi Shengmai San with Zexie Tang to treat diabetes complicated by hyperlipidemia in patients with qi-yin dual deficiency who also have dizziness. My empirical formula is: Sheng Huangqi 30 g, Xiyangshen 3–6 g (or Bei Shashen 10–15 g), Maidong 10 g, Wuweizi 10 g, Zexie (Alisma) 6 g, Baizhu (Atractylodes) 6 g. Or use reduced doses as a tea substitute: Sheng Huangqi 6 g, Xiyangshen 1 g, Maidong 2 g, Wuweizi 2 g, Zexie 1–2 g, Baizhu 1–2 g. Huangqi Shengmai Yin improves the symptoms of qi-yin dual deficiency, while Zexie Tang lowers lipids and relieves dizziness.

If the patient has other symptoms, a clinician may add or subtract according to the patient's condition.