2. Differentiating Diagnosis and Treatment Based on Disease Type and Syndrome

2. Differentiating Diagnosis and Treatment Based on Disease Type and Syndrome

Professor Pei has unique insights into the diagnosis and treatment of this condition. He believes that when diagnosing patients with nasopharyngeal cancer, it is essential to first utilize advanced modern medical diagnostic tools—such as CT scans, MRI, and pathological biopsies—to confirm the diagnosis. Once the diagnosis is clear, a systematic evaluation should be conducted, and patients who are candidates for surgery should receive timely surgical intervention or chemotherapy. From a traditional Chinese medicine perspective, he categorizes the disease into four main syndromes: “evil toxin lung heat,” “liver qi stagnation with phlegm,” “qi stagnation with blood stasis,” and “yin deficiency with excess fire.”

1. Evil Toxin Lung Heat:

Symptoms include nasal congestion, bloody nasal discharge, sometimes dryness in the nasal cavity, hot breath, headache, cough, and cervical lymph nodes. The tongue is red with a thin yellow coating, and the pulse is slippery and rapid. Treatment focuses on clearing lung heat and resolving phlegm while dispersing blockages. Prescription: Mahuang Gui Zhi Decoction, Yin Qiao San, or an adapted version of the Anti-Cancer Five-Flavor Disinfection Drink. Formula: Mahuang 10g, Gui Zhi 10g, Xingren 10g, Sheng Shi Gao 30g, Gan Cao 6g, Chuan Xiong 6g, Bai Zhi 6g, Xi Xin 3g, Qiang Huo 10g, Fang Feng 10g, Niu Bang Zi 10g, Jin Yin Hua 15g, Lian Qiao 15g, Jie Geng 20g, Zhong Lou 15g, Bai Hua She Tiao Cao 15g, Ban Zhi Lian 15g, Hu Zhang 15g, Xia Fu Cao 15g. Adjustments: Add Jing Jie and Bo He if there is chills and fever; add Guo Lu Pi if there is cough; add Beisha Shen, Yu Zhu, Shihu, Bo He, Yuan Shen, Mu Li, Hai Zao, Kun Bu, San Ling, etc., if there is nosebleed.

2. Liver Qi Stagnation with Phlegm Congestion:

Symptoms include visible cervical lymph nodes, thick, sticky phlegm, headache and tinnitus, nasal congestion and nosebleeds, bitter mouth and thirst, irritability, constipation, red tongue with a yellowish greasy coating, and a slippery, rapid pulse. Treatment focuses on clearing the liver, resolving phlegm, unblocking qi, and softening and dispersing blockages. Use Si Ni San, Hai Zao Yu Hu Tang, or Sheng Jiao San with adjustments. Formula: Chai Hu 10g, Zhi Shi 10g, Bai Shao 10g, Gan Cao 6g, Chuan Xiong 6g, Hai Zao 10g, Kun Bu 10g, Dang Gui 10g, Jiang Huang 10g, Lian Qiao 15g, Zhe Bei Mu 10g, Ban Xia 6g, Da Huang 6g, Chan Yi 6g, Jiang Can 6g. Adjustments: If the cervical lymph nodes are hard and immobile, add Zicǎo, Long Dan Cao, Xia Fu Cao, Han San Qi, Xia Fu Cao, Ban Zhi Lian, Zhe Bei Mu, Yuan Shen, Mu Li, Hai Zao, Kun Bu, San Ling, etc.

3. Qi Stagnation with Blood Stasis:

Symptoms include nasal congestion, dark-colored bloody nasal discharge, throbbing headaches at night, and tinnitus. The tongue is red with bruising along the edges, the coating is thin and yellow, and the pulse is slow and rough. Treatment focuses on resolving blood stasis, dispersing blockages, and regulating qi to open the orifices. Formula: Tong Qiao Huo Xue Tang or Anti-Cancer Four-Pair Decoction with adjustments. Formula: Tao Ren 10g, Hong Hua 6g, Dang Gui 10g, Chi Shao 10g, Sheng Di 12g, Chuan Xiong 10g, Yi Mi Ren 30g, Cang Er Zi 10g, Yu Jin 10g, Xing Bai 6g, San Ling 10g, E Zhu 10g, Hu Zhang 15g, Zhe Bei Mu 10g, Bai Hua She Tiao Cao 15g. Adjustments: Add Man Jing Zi, Gao Ben, Huang Qin, Ju Hua, Jiang Can if the headache persists.

4. Yin Deficiency with Excess Fire:

Symptoms include dizziness, tinnitus, and hearing loss. Nosebleeds are bright red, with a dry throat and a strong desire to drink. There is restlessness and irritability, constipation with little phlegm, and fatigue. The tongue is red with little coating, and the pulse is fine and rapid. Treatment focuses on nourishing yin, clearing heat, and replenishing qi to generate fluids. Formula: Yang Yin Qing Fei Tang, Sha Shen Mai Dong Tang, or Qi Ju Di Huang Tang with adjustments. Formula: Yuan Shen 10g, Sheng Di 12g, Mai Dong 10g, Tian Dong 10g, Yu Zhu 10g, Qi Ju Zi 10g, Ju Hua 10g, Ma Tao Pi 6g, Tian Hua Fen 30g, Zhe Bei Mu 10g, Bai Hua She Tiao Cao 15g.

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