3. Third Visit, April 3, 2007:

3. Third Visit, April 3, 2007:

The original symptoms had significantly eased. At the same time, the patient continued radiation therapy for two weeks. Symptoms included fatigue, poor appetite, and dry mouth with oral ulcers. The right neck was still numb and lacked flexibility. The complexion was dull, bowel movements were not hard but were sluggish, and nocturnal urination occurred 1–2 times. The pulse was deep and fine, the tongue was red, and the coating was white and thick. The middle burner was damaged; therefore, continue using the above formula to clear heat and detoxify, resolve phlegm, open the orifices, and tonify both qi and yin. Another formula was used in alternating treatment, focusing on warming the middle burner and replenishing deficiency with Buzhong Yiqi Tang, to boost the spleen’s function. Add Fishy Herb and Wild Chrysanthemum to clear heat and detoxify. Add Zhe Bei Mu and Chuan Xiong to resolve phlegm and blood stasis. Formula: Pueraria 15g, Huang Qi 30g, Jin Yin Hua 15g, Wu Wei Zi 3g, Huang Jing 20g, Yuan Shen 10g, Ban Xia 6g, Dan Nan Xing 10g, Bai Zhi 6g, Xin Yi 10g, Cang Er Zi 10g, Chen Pi 6g, Gan Cao 6g, Jiang Huang 10g, Huang Qin 10g, Chai Hu 3g. Follow-up until the end of 2008, the patient’s condition remained stable, and his daily life returned to normal.

Case 2:

Patient, female, 55 years old. During a physical examination in 2010, she was found to have enlarged lymph nodes in the left supraclavicular region. A nasopharyngoscope and cytological biopsy confirmed the diagnosis of nasopharyngeal cancer. She underwent two courses of radiation therapy at a hospital in Gansu Province.

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6g, turmeric 10g. Decocted in water and taken as one dose per day, for 14 doses. For the second consultation, after taking the medication, symptoms such as dry mouth, thirst, and hoarseness improved; shortness of breath and fatigue were alleviated; the tongue was red with a thin coating, and the pulse was deep and fine. The original formula included cinnamon twig, fresh ginger, and jujubes, with an additional 10g of butterfly bush and 10g of polygonum cuspidatum. The medication was continuously adjusted and taken in succession. By March, the symptoms had significantly improved, with both mental clarity and appetite returning to normal. The patient was prescribed the above herbs ground into a fine powder, taken at 10 grams per dose, three times daily, to consolidate the therapeutic effect. 2. Gao, female, 60 years old, presented with sore throat accompanied by cough and blood in sputum for two weeks. After treatment, she was admitted due to cervical lymph node enlargement and pain, and a cranial CT scan revealed nasopharyngeal carcinoma. A biopsy revealed high-grade adenocarcinoma. As the patient was elderly and declined surgery, she chose traditional Chinese medicine treatment. She experienced throat pain, nasal congestion, headache, dizziness, dry mouth and thirst, fullness and discomfort in the chest and abdomen, a red tongue with a white, greasy coating, and a wiry, slippery pulse. Diagnosis: Nasopharyngeal carcinoma (high-grade adenocarcinoma). TCM diagnosis: Phlegm-damp accumulation, lung-yin deficiency, and toxic heat attacking the throat. Treatment principle: Eliminate phlegm and disperse nodules, nourish yin and clear heat. The prescription used was Zilong Xiaoliu Tang (a formula from Pei Zhengxue’s experience), composed of 30g of purple grass, 10g of gentian root, 15g of prunella vulgaris, 1 seed of belladonna, 10g of trichosanthes fruit, 10g of salvia miltiorrhiza, 30g of rehmannia root, 10g of polygonum cuspidatum, 10g of eucommia bark, 15g of cassia bark, 20g of raw oyster shell, 10g of fritillaria cirrhosa, and 10g of curcuma longa. The herbs were decocted in water and taken as one dose per day, for 30 doses. At the second consultation, after taking the medication, throat pain and dry mouth were reduced, along with fatigue and sweating; the tongue was red with a thin coating, and the pulse was fine and rapid. The diagnosis was yin deficiency with excess fire. The original formula was modified to remove purple grass, prunella vulgaris, and gentian root, adding 10g each of ophiopogon japonicus, tripterygium wilfordii, and curcuma longa, along with 15g each of codonopsis pilosula and paridis. The formula was continued to be adjusted and taken for over a year, during which the condition improved; the CT scan showed a reduction in tumor size. The treatment remained unchanged, and the patient continued to take the medication to consolidate the therapeutic effect.

4. Reflections Radiation therapy is currently widely recognized as the preferred treatment for nasopharyngeal carcinoma [6-7]. For early-stage patients, radiotherapy alone is often employed. Before the advent of intensity-modulated radiation therapy, early nasopharyngeal carcinoma treatment involved conventional external beam radiation therapy, and combined external beam radiation with intracavitary brachytherapy achieved relatively good therapeutic outcomes. The 5-year survival rate for nasopharyngeal carcinoma after radiation therapy ranged from 47% to 55%. The standard fractionation dose for nasopharyngeal carcinoma is 2 Gy per fraction, with a total dose of 66–70 Gy administered to the nasopharynx, and a dose of 60–70 Gy to the cervical lymph nodes. Precautionary radiation to the neck was typically 46–50 Gy. When combined with traditional Chinese medicine and herbal therapies, radiation therapy for nasopharyngeal carcinoma can help alleviate the adverse effects of radiation and chemotherapy. For advanced nasopharyngeal carcinoma where surgical or radiation therapy is no longer an option, traditional Chinese medicine also demonstrates excellent therapeutic efficacy. Traditional Chinese medicine serves not only as an adjunct treatment to radiation and chemotherapy, enhancing the effectiveness of these therapies through detoxification and synergistic anti-cancer effects, but also helps improve immune function, enhance physical condition and nutritional status, thereby prolonging survival and improving quality of life. Nasopharyngeal carcinoma is a common malignant tumor in otolaryngology. In traditional Chinese medical literature, this disease was not specifically named; ancient medical texts recorded conditions such as “nasal congestion,” “headache caused by brain compression,” “tinnitus,” “suppurative abscesses,” and “loss of vision,” which share similarities with the clinical symptoms of this disease. Professor Pei believed that the primary cause of nasopharyngeal carcinoma is

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Pei Zhengxue Clinical Collection, Volume II deficiency of righteous qi, weakness of the internal organs, accumulation of phlegm-damp, stagnation of qi, blood stasis, and ultimately, lung-yin deficiency in the later stages, or a combination of qi and yin deficiency. In cases of real syndrome, treatments focus on clearing heat, transforming phlegm, softening nodules, dispersing nodules, and promoting blood circulation while resolving blood stasis. In cases of deficiency syndrome, the fundamental treatment principle is to support righteous qi and strengthen the body, emphasizing differentiation based on syndromes, balancing the promotion of righteous qi with the elimination of pathogenic factors, addressing both the symptoms and the root causes. In the early stages of nasopharyngeal carcinoma, when pathogenic toxins are rampant and phlegm accumulates with blood stasis, causing throat swelling and pain, and cervical lymph nodes become enlarged, Professor Pei often used his well-known formula, Zilong Xiaoliu Tang, for treatment. The formula includes 10g of purple grass, 10g of gentian root, 10g of prunella vulgaris, 1 seed of belladonna (fried), 20g of trichosanthes fruit, 10g of peach kernel, 20g of salvia miltiorrhiza, 15g of rehmannia root, 10g of polygonum cuspidatum, 10g of eucommia bark, 6g of cassia bark. Among the herbs, trichosanthes fruit clears heat and transform phlegm, opening the chest and dispersing nodules as the chief herb; peach kernel, salvia miltiorrhiza, and polygonum cuspidatum promote blood circulation and resolve blood stasis, reducing swelling and relieving pain as secondary herbs; purple grass, gentian root, prunella vulgaris, cassia bark, and belladonna clear heat and detoxify, reduce swelling and disperse nodules as auxiliary herbs; rehmannia root and eucommia bark nourish yin and moisten the throat as the final herbs. Together, these herbs work to transform phlegm, disperse nodules, clear heat and detoxify, and promote blood circulation while resolving blood stasis. After radiation and chemotherapy, fluid and nutrients are depleted, qi and yin are damaged, immune function declines, bone marrow hematopoietic function is suppressed, and the three-line cells decrease. Professor Pei often used the Lanzhou formula to support righteous qi and strengthen the body. The formula includes northern sand ginseng, codonopsis pilosula, lycium barbarum, and ginseng root, which tonify qi and strengthen the spleen; rehmannia root and large doses of eucommia bark nourish yin and tonify the kidneys, promoting bone marrow hematopoiesis; cinnamon twig, white peony, licorice, fresh ginger, and jujubes harmonize the camp and protect the vital energy, helping qi and blood to be generated and transformed; codonopsis pilosula, ophiopogon japonicus, and schisandra berry tonify qi and nourish yin; licorice, wheatgrass, and jujubes gather sweat and replenish qi. After radiation therapy, vocal cord strain and hoarseness occur due to damage from radiation, resulting from both qi and yin deficiency. When the lungs and kidneys are weakened, the sound cannot be produced properly. Therefore, the treatment uses a formula to nourish yin and clear the lungs, combining Si Ni San and Sheng Jiao San for adjustment and treatment. Chai Hu, Zhishi, white peony, and licorice soothe the liver and regulate the spleen, facilitating the flow of qi; rhubarb, cicada slough, silkworm pupae, and turmeric clear wind and clear heat, lifting up the clear and lowering the turbid. The combination of these three formulas not only tonifies qi and nourishes yin and supports righteous qi, but also soothes the liver and regulates qi, clears heat and transforms phlegm, eliminating pathogenic factors, achieving a holistic approach to treating both the symptoms and the root causes. References [1] Pei Zhengxue. Practical Internal Medicine Combining Chinese and Western Medicine. Lanzhou: Gansu Science and Technology Press, 2010, 12:481–483. [2] Liu Weisheng. Clinical Diagnosis and Treatment of Tumor Diseases Using Traditional Chinese Medicine, 2nd Edition [M]. Beijing: People’s Health Publishing House, 2005, 02:35–39. [3] Pei Zhengxue. Medical Notes of Pei Zhengxue [M]. Lanzhou: Gansu Science and Technology Press, 2008, 02:270–272.

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[4] Li Yanqi, Li Xiaofeng, Jiang Yuliang et al. A Brief Discussion on the Advantages of Traditional Chinese Medicine in Treating Radiation Therapy Side Effects of Nasopharyngeal Carcinoma [G]. Collection of Academic Papers on the Inheritance and Research of Traditional Chinese Medicine in Otolaryngology, 2009: 235–238.

[5] Bai Jianping, Liu Weisheng, Xu Kai. Overview of Comprehensive Treatment for Locally Advanced Nasopharyngeal Carcinoma [G]. Collection of Papers from the 2nd International Symposium on Integrated Chinese and Western Medicine and Traditional Chinese Medicine Oncology, 2004: 558–560.

[6] He Yangke, Zhang Xingping. Advances in the Comprehensive Treatment of Locally Advanced Nasopharyngeal Carcinoma [J]. Modern Biomedical Progress, 2012, 05: 124–126.

[7] Pan Jianji. Advances in Radiation Therapy for Nasopharyngeal Carcinoma [J]. Practical Oncology Journal, 2001, 01: 78–80.

“Collection of Papers from the 17th China-Korea Symposium on Integrated Chinese and Western Medicine”, September 2013.

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Pei Zhengxue Clinical Collection, Volume II Clinical Experience of Professor Pei Zhengxue in Treating Gastric Cancer Zhan Wenguo [Abstract] Objective: To introduce Professor Pei Zhengxue’s understanding of TCM-based diagnostic approaches to gastric cancer and his clinical experience. Methods: Through typical outpatient cases, we applied Professor Pei’s established formulas for differential diagnosis and treatment. Results: Professor Pei Zhengxue’s summary of gastric cancer I and “Formula No. 1” demonstrated significant clinical efficacy in treating gastric cancer. Conclusion: Traditional Chinese medicine has shown satisfactory clinical efficacy in treating gastric cancer. [Keywords] Pei Zhengxue; gastric cancer; experience. Professor Pei Zhengxue is a renowned expert in integrated Chinese and Western medicine in China, a chief physician, doctoral supervisor, lifelong director of national-level training programs, and a member of the Chinese Association of Traditional Chinese Medicine. He specializes in treating various complex and difficult diseases. I had the privilege of studying under Professor Pei, and I now present the following report on Professor Pei’s clinical experience in treating gastric cancer. Gastric cancer is a malignant tumor of the gastric epithelial tissue. In the early stages, more than 70% of gastric cancers are asymptomatic. In the middle and late stages, patients may experience upper abdominal pain, gastrointestinal bleeding, perforation, pyloric obstruction, weight loss, fatigue, metabolic disorders, and cancerous tumor dissemination. The incidence of gastric cancer in China is high, and its mortality rate ranks first among all types of malignant tumors [1]. The causes of gastric cancer are related to genetic factors, gastric diseases, environmental factors, and dietary habits. Most patients seek medical attention when the disease has already progressed to the middle or late stages, losing the opportunity for surgical cure.

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Chapter 15: Tumor Diseases I. Etiology and Pathogenesis of Gastric Cancer:

Professor Pei believes that gastric cancer arises from weakened immune function, poor dietary habits, deficiency of righteous qi, emotional imbalance, and the accumulation of pathogenic toxins within the body [2]. The liver governs the flow of qi; it prefers to be open and unblocked, but dislikes depression. When the liver’s flow is obstructed, liver qi becomes stagnant, crossing over to affect the spleen, leading to qi stagnation and blockage, and the stomach loses its ability to descend and harmonize. This results in symptoms such as nausea and vomiting, and fullness and discomfort in the epigastrium. The spleen governs the transport and transformation of water and moisture; the spleen should rise to maintain health, while the stomach should descend to harmonize. According to the “Suwen: Linglan Secret Canon,” “The spleen and stomach are the repositories of food, where the five flavors are stored.” When the spleen is deficient and its functions are impaired, phlegm and dampness accumulate internally, blood stasis and toxins coalesce, causing distension and pain in the epigastrium. As the “Yizong Biji” states, “When accumulation occurs, it is due to insufficient righteous qi; when righteous qi is deficient, pathogenic qi takes hold.” Gastric cancer is characterized by deficiency in the root and excess in the superficial aspects. The disease originates in the spleen and stomach, but also affects the liver, gallbladder, and kidneys. Deficiency of qi and blood, insufficient stomach yin, or deficiency of yang in the spleen and kidney—these are the root causes of deficiency; disharmony between the liver and stomach, qi stagnation, blood stasis, and phlegm-damp accumulation are the superficial manifestations [3]. In the early stages, the emphasis is on pathogenic excess; the pathogenic mechanism shifts to the qi level. In the later stages, the focus shifts to deficiency, often manifesting as qi and blood deficiency, dryness of fluids, and weakening of organ qi. In clinical practice, it is important to weigh the severity and urgency of the condition, depending on the different syndromes—either eliminating pathogenic factors, strengthening righteous qi, or employing both methods simultaneously. Strengthening righteous qi involves tonifying qi and strengthening the spleen, nourishing qi and blood, warming the kidneys and restoring yang, nourishing yin and nurturing the stomach; eliminating pathogenic factors involves clearing heat and detoxifying, promoting blood circulation and resolving blood stasis, softening nodules and dispersing phlegm, regulating qi and resolving dampness, and eliminating bloating and discomfort [4]. In the first and second stages, surgery is the primary treatment; in the third stage, chemotherapy and combined Chinese and Western medicine are used; in the fourth stage, anti-cancer chemotherapy is employed, alongside traditional Chinese medicine to support righteous qi and strengthen the body [5].

II. Differentiation and Treatment: Professor Pei divided gastric cancer into four syndromes, with adjustments made according to the specific pattern: (1) Spleen and Stomach Qi Deficiency Type

Patients experience distension and pain in the epigastrium, cold hands and feet, nausea and vomiting, fullness and discomfort in the epigastrium, weight loss, a red tongue with a white or white-yellowish, thick coating, and a weak pulse. Treatment principle: Warm the center and tonify deficiency. Prescription: Xiangsha Liu Junzi Tang, with modifications to Formula No. 1 for gastric cancer. Ingredients include: 6g of wood fragrance, 6g of amomum villosum, 6g of tangerine peel, 6g of pinellia, 10g of poria, 6g of licorice, 10g of codonopsis, 10g of atractylodes, 20g of wuzhi, 10g of chicken gizzard, 10g each of Ji San Xian, salvia miltiorrhiza, 15g of prunella vulgaris, 10g of seaweed, 10g of kelp. When cold and heat are combined, add Pinellia to treat fullness and discomfort in the epigastrium; when vomiting occurs, add 10g of Flos Callicarpae, 15g of red ochre, 6g of cloves, 10g of persimmon seeds; when diarrhea occurs, add 6g of aconite, 6g of dried ginger.

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Pei Zhengxue Clinical Collection, Volume II (2) Liver-Stomach Disharmony with Qi Stagnation and Blood Stasis Type

Patients experience distension and pain in the epigastrium, belching, poor appetite, sour and bitter regurgitation, constipation, a red tongue with a white-yellowish coating, and a wiry, slippery pulse. Treatment principle: Soothe the liver and regulate qi, promote blood circulation and resolve blood stasis. Prescription: Chaihu Shugan San, with additions to the Xuefu Zhu Yu Tang. Ingredients include: 10g of chaihu, 10g of zhishi, 10g of white peony, 6g of licorice, 6g of chuanxiong, 6g of fragrant angelica, 6g of tangerine peel, 10g of peach kernel, 6g of safflower, 10g of angelica sinensis, 6g of rehmannia root, 10g of horsetail, 20g of prunella vulgaris, 10g of sea lettuce, 10g of kelp. When there is bitterness or dryness in the mouth, add 10g of scutellaria, 6g of pinellia, 15g of codonopsis; when gastrointestinal bleeding occurs, add 6g of rhubarb, 10g of scutellaria, 6g of coptis, 15g of red ochre, 15g of trichosanthes, 3g of sanqi; when epigastrial pain occurs, add 10g of fried sophora flower, 10g of pentaphylla; when there are masses in the flank, add 10g of tripterygium, 10g of polygonum cuspidatum, 10g of ligusticum. (3) Stomach Yin Deficiency Type

Patients experience dryness in the mouth, epigastrial pain, weight loss and fatigue, vomiting upon eating, dry stools, a red, dark red tongue with little coating, or even cracked tongue surfaces, and a weak, thin pulse. Treatment principle: Nourish yin and tonify qi. Prescription: Ye’s Stomach Nourishment Soup with additions. 10g of northern sand ginseng, 10g of ophiopogon japonicus, 10g of bamboo shoots, 10g of rehmannia root, 10g of turmeric, 10g of salvia miltiorrhiza, 10g of white peony, 6g of pinellia, 10g of magnolia bark, 10g of chuanxiong, 30g of rice, 10g of poria, 10g of citron, 15g of codonopsis, 10g of chaihu, 15g of red ochre, 10g of wood fragrance. (4) Phlegm-Damp Blockage with Qi Stagnation and Blood Stasis Type

Patients experience distension and pain in the epigastrium, nausea and vomiting, poor appetite, fatigue and weakness, a red tongue with a white-yellowish, thick coating, and a wiry, slippery pulse. Treatment principle: Transform phlegm and dry dampness, regulate qi and harmonize the stomach. Prescription: Formula No. 2 for gastric cancer. 6 black plums, 6g of Sichuan pepper, 6g of dried ginger, 6g of coptis, 10g of turmeric, 10g of turmeric, 10g of salvia miltiorrhiza, 10g of white peony, 6g of pinellia, 10g of magnolia bark, 10g of chuanxiong, 30g of rice, 10g of poria, 10g of citron, 15g of codonopsis, 10g of chaihu, 15g of red ochre. III. Typical Cases

1. Liu, male, 61 years old, presented with epigastrial distension and pain for two months, weight loss, fatigue, and loss of appetite. A gastroscopy at a certain hospital diagnosed him with gastric antral cancer, with a histological examination revealing high-grade adenocarcinoma. Physical examination revealed a gaunt physique, a weight of 50 kg, a pale complexion, a red tongue with bruising at the edges, a slightly greasy white coating, and a wiry, thin pulse. Diagnosis: Gastric cancer (high-grade adenocarcinoma), stage T3N0M1. TCM diagnosis: Epigastrial pain, spleen and stomach deficiency, qi stagnation and blood stasis. Prescription: Xiangsha Liu Junzi Tang with additions. Ingredients include: 6g of wood fragrance, 6g of amomum villosum, 6g of tangerine peel, 6g of pinellia, 10g of poria, 6g of licorice, 10g of codonopsis, 10g of atractylodes, 20g of wuzhi, 10g of chicken gizzard, 10g each of Ji San Xian, 10g of salvia miltiorrhiza, 15g of prunella vulgaris, 10g of seaweed, 10g of kelp. The herbs were decocted in water and taken as one dose per day. At the second consultation, after 20 doses, epigastrial pain was reduced, the patient’s spirits gradually improved, and his appetite increased. Treatment focused on supporting righteous qi and strengthening the body, using Pei’s Lanzhou formula [2] with additions. 15g of northern sand ginseng, 15g of codonopsis, 15g of ginseng root, 15g of lycium barbarum, 12g of rehmannia root, 30g of mountain yam, 10g of chuanxiong, 30g of rice, 10g of poria, 10g of citron, 10g of turmeric, 10g of wood fragrance, 10g of grass, 10g of Ji San Xian, 10g of prunella vulgaris, 10g of red ochre, 10g of seaweed, 10g of kelp. The patient continued to take the formula for two years; epigastrial pain disappeared, gastroscopy showed no signs of tumor, and the condition healed. He is still alive today.

2. Li, male, 65 years old, presented with upper abdominal pain for three months, accompanied by nausea and vomiting for a week, progressive weight loss, and bloody vomitus. A gastroscopy revealed grade III atrophic gastritis, stage III gastric cancer, with adenocarcinoma identified through pathological biopsy. A CT scan showed enlarged abdominal lymph nodes, CEA levels of 75 μmol/L, Hb levels of 75 g/L. Examination revealed abdominal distension, a red tongue with a white-yellowish, thick coating, and a wiry, slippery pulse. Diagnosis: Gastric cancer, clinical stage: stage III. TCM diagnosis: Epigastrial pain, associated with phlegm-damp blockage, qi stagnation and blood stasis, and the stomach’s inability to descend and harmonize. Treatment principle: Transform phlegm, regulate qi, promote blood circulation, resolve rebellious qi, and harmonize the stomach. Prescription: Formula No. 1 for gastric cancer. 6 black plums, 6g of Sichuan pepper, 6g of dried ginger, 6g of coptis, 10g of turmeric, 6g of pinellia, 10g of magnolia bark, 30g of rice, 10g of poria, 10g of citron, 10g of turmeric, 10g of safflower, 10g of rehmannia root, 10g of white peony, 15g of codonopsis, 10g of chaihu, 15g of red ochre, 6g of wood fragrance. The herbs were decocted in water and taken as one dose per day. At the second consultation, after 14 doses, abdominal distension and nausea and vomiting were reduced, the patient’s spirits and appetite improved slightly, Hb levels reached 96 g/L, WBC levels were 3.5×10^9/L, PLT levels were 120×10^9/L, and epigastrial pain was somewhat relieved. The formula was modified to remove Chaihu and red ochre, adding 10g each of chuanxiong, wuzhi, prunella vulgaris, seaweed, and Ji San Xian. Combined with Pei’s own prepared Pei’s Blood-Producing Granules [6], whose basic ingredients include northern sand ginseng, codonopsis, ginseng root, lycium barbarum, cinnamon twig, white peony, codonopsis, rehmannia root, sweet flag, licorice, fresh ginger, jujubes, floating wheat, ophiopogon japonicus, schisandra berry, and raw oyster shell, Pei’s Stomach Health Granules were given to the patient to take home. The patient continued to take the formula for over a year, without recurrence, with complete relief of epigastrial pain, increased weight, and the ability to resume daily work.

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Pei Zhengxue Clinical Collection, Volume II IV. Discussion Gastric cancer is a common and frequently occurring disease of the digestive system; most patients seek medical attention when the disease has already progressed to the middle or late stages, losing the opportunity for surgical treatment. Radiation therapy and chemotherapy have limited efficacy in such cases; therefore, combining traditional Chinese medicine with supportive therapies like strengthening righteous qi and nourishing the body has led to significant improvements in survival time and quality of life for many patients. Professor Pei Zhengxue believed that gastric cancer falls within the scope of TCM’s terms such as “hiccups,” “nausea,” and “accumulation.” Its pathogenic mechanisms primarily stem from qi stagnation, blood stasis, impaired digestion and transportation in the spleen and stomach, liver injury from anger and frustration, liver qi being blocked by the spleen, and liver qi crossing over to attack the stomach. When qi stagnates, fire rises, and when fire is excessive, it harms yin; prolonged pain that remains in the meridians is considered a concurrent symptom. In case one, the spleen and stomach are deficient, with qi stagnation and blood stasis, the formula Xiangsha Liu Junzi Tang was used in conjunction with Formula No. 1 for gastric cancer (chuanxiong, wuzhi, fried sophora flower, pentaphylla, chicken gizzard, Ji San Xian, salvia miltiorrhiza, wood fragrance, grass, prunella vulgaris, red ochre, seaweed, kelp). The treatment proved effective, and after continuing to take the Lanzhou formula with additions to Formula No. 1 for gastric cancer for over two years, the condition improved. Among the herbs, chuanxiong and wuzhi act as “Golden Bell Decoction,” promoting blood circulation and resolving blood stasis while regulating qi and relieving pain; sophora flower and pentaphylla serve as “Lost Laugh Decoction,” activating blood circulation, removing blood stasis, and dispersing nodules while relieving pain. Chicken gizzard…

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Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: ,病情得以稳定 。2010 年 12 月 ,于左颌下发现 肿物 ,诊断为鼻咽癌复发 。本次发病后出现头晕头昏 ,双耳针刺样 疼痛 ,流出黄色脓液 ,耳鸣耳聋 ,面颊部红肿灼热疼痛 , 口鼻干燥 , 五心烦热 ,形体消瘦 ,干咳少痰 ,舌质红 ,少苔脉细数 。于 2011 年 1 月来诊 。辨证属于气阴两虚 ,痰瘀互结 。以益气养阴治之 。方用养 阴清肺汤 、沙参麦冬汤 、杞菊地黄汤加减 。处方 :北沙参 15g,山萸 肉 15g,元参 10g,生地 12g,麦冬 10g,天冬 10g,玉竹 10g,枸杞子 10g,菊 花 10g,牡 丹 皮 6g,天 花 粉 30g,浙 贝 母 10g ,白 花 蛇 舌 草 15g,仙鹤草 15g,山萸肉 10g,女贞子 15g,旱莲草 15g,菟丝子 10g。 15 剂 ,每日一剂 。二诊 ,耳鼻渗液明显减少 , 口腔溃疡好转 , 口鼻干 燥、五心烦热、乏力减轻。予以海藻玉壶汤 ,升降散加减。处方 :甘草 6g,川芎 6g,海藻 10g,昆布 10g,当归 10g,姜黄 10g,连翘 15g,浙贝 母 10g,陈皮 6g,半夏 6g,大黄 6g,蝉衣 6g,僵蚕 6g 。15 剂。

三诊 ,左锁骨上淋巴结肿大明显减小。其余症状明显好转。处

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裴正学临床荟萃第二辑 方:兰州方加减 。至今存活 ,定期门诊复诊。 四、结语

" 西医诊断 , 中医辨证 , 中药为主 ,西药为辅 "是裴正学教授提 出的十六字方针 。这十六字方针在鼻咽癌的治疗领域中的应用主 要体现在用西医诊断确立后充分发挥中医辨证 ,扶正固本的优势 。 并同时发挥西医手术、放化疗等手段杀灭癌细胞。以期达到减轻放 化疗的毒副作用 ,延缓病情发展 ,提高患者生存质量 ,延长生存期 的目的。裴教授认为鼻咽癌的发生从根本上时人体正气亏虚所致。 《医宗必读》中云:"积之成者 ,正气虚而后邪气踞之"。另一方面 ,手 术、放化疗对机体的耗气伤阴等反过来又影响脏腑气血功能 ,使正 气更虚 , 出现恶性循环。因此裴正学教授在治疗鼻咽癌时以遵从扶 正固本的根本大法 。 即所谓"正气存内 ,则邪不可干","邪之所凑 , 其气必虚"。 兰州方作为治疗本病的基础方 ,在患者发病的各个不 同阶段始终得以应用 , 同时根据患者病情辨证 ,遵循"急则治标 ,缓 则之本"的原则 ,充分发挥中西医结合治疗鼻咽癌的优势。

《新中医》2013 年 12 期

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第十六章 裴氏方药 第十六章 裴 氏 方 药 胆胰合症方 王鑫 陈光艳 赵孝鹏 裴正学 ,男 , 1938 年生 。主任医师、教授、博士生导师 。著名中 西医结合专家 ,第二、三、四、五批全国老中医药专家学术经验继承 工作指导老师 ; 中华中医药学会终身理事 ,甘肃省中西医结合学会 名誉会长 , 中国中医科学院博士生导师 ,甘肃省首批名老中医 ,甘 肃省医学科学研究院首席专家 ,甘肃省中医院首席专家 ,甘肃省文 史馆馆员。 他从事临床 、教学 、科研工作 50 余载 ,学验俱丰 ,擅长治疗肿 瘤、肝病、血液病、自身免疫病等疑难杂症 ;提出"西医诊断 , 中医辨 证 , 中药为主 ,西药为辅 "的中西医结合十六字方针已成为当前发 展中医的重要途径之一。出版《中西医结合实用内科学》《血证论评 释》《裴正学医话医案集》《裴正学医学笔记》 等 18 部医学论著 ,发 表 80 余篇医学论文。

组 成 :柴 胡 10g , 枳 实 10g , 白 芍 10g , 甘 草 6g , 川 芎 6g , 香 附 6g ,丹参 20g ,木香 10g ,草蔻 10g ,大黄 6g ,黄连 6g ,黄芩 10g ,元胡 10g ,川楝子 20g ,制乳没各 6g ,干姜 6g ,蒲公英 15g ,败酱草 15g。

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裴正学临床荟萃第二辑 Function:疏肝和胃 ,清热燥湿 ,活血化瘀、行气止痛。 Indication:Chronic pancreatitis, diagnosed as liver-stomach disharmony, with damp-heat accumulation and qi stagnation and blood stasis. Usage:One dose per day, add an appropriate amount of water; first decoction for 30 minutes, second decoction for 40 minutes. Mix the two decoctions together and take in two doses, morning and evening, after meals. Formula Explanation: Chronic pancreatitis is a common clinical disease, mainly characterized by chronic dull pain in the upper left abdomen, radiating to the chest and back. Since most patients also have cholecystitis or gallstones, left flank pain is often accompanied by distension and pain in the right flank and back. Some patients may also experience abdominal distension, indigestion, pancreatic-related diarrhea, jaundice, and other symptoms. Traditional Chinese Medicine classifies this disease under categories such as “flank pain,” “abdominal pain,” and “stomach pain.” The diagnosis is often attributed to liver-stomach disharmony, damp-heat accumulation, and qi stagnation and blood stasis. Treatment should focus on soothing the liver and stomach, clearing heat and drying dampness, activating blood circulation and resolving stasis, and promoting qi flow to relieve pain. The “Bile-Pancreas Combination Formula” is a specialized treatment formula developed by Pei Zhengxue based on 50 years of clinical experience. This formula uses Chaihu Shugang San to soothe the liver, resolve depression, promote qi flow, and relieve pain. Sanhuang Xixi Tang, combined with Danshen, Muxiang, and Cao Doukou, clears heat and dries dampness, harmonizes the stomach and descends rebellious qi. For those with long-standing flank pain that does not improve, blood stasis is often present; as stated in “Clinical Guidelines for Case Studies,” “When qi has been blocked for a long time, blood will also become diseased, causing the meridians to become blocked.” Therefore, Frankincense and Myrrh are used to activate blood circulation and resolve stasis, while Yuanhu and Chuan Lianzi promote qi flow and relieve pain. In cases of prolonged illness with deficiency, intestinal rumbling and diarrhea, Ginger is used to warm the middle burner, dispel cold, strengthen the spleen, and stop diarrhea. Dandelion and Herba Patriniae clear heat and promote dampness, aiding the effects of Sanhuang in drying dampness and harmonizing the stomach. Additions and Subtractions: For jaundice, add Yin Chen 15g, Zhi Zi 15g, Da Huang 6g; for gallstones, add Jin Qian Cao 15g, Hu Zhang 15g, Ban Zhi Lian 15g; for gallbladder polyps, add 4 Ume berries, Weiling Xian 10g, and Zhuang Zi 15g; for chronic gastritis, add Xiang Sha Liu Jun Zi Tang and Ban Xia Xie Xin Tang; for chest pain, add Yue Ju Wan; for intestinal rumbling and diarrhea, add Chuan Jiao 6g, and in severe cases, add Fuzi Li Zhong Tang; for constipation, increase Da Huang to 10g and then follow up with Xia Cheng Qi Tang or Da Cheng Qi Tang; for belching and hiccups, add Xuan Fu Hua 10g, Sheng Zha Shi 15g, and for severe flank pain, add Zhi Lu Mo to 10g; for hepatitis and cirrhosis with flank pain, add Dang Gui 10g, Huang Qi 20g, Qian Tiao 10g, Ban Lan Gen 15g; for elevated transaminases, add Jin Yin Hua 15g, Lian Qiao 15g, Wu Wei Zi Powder 10g (to be taken separately), and if levels exceed 100U/L, add Bai Hua She Tiao Cao 15g, Ban Zhi Lian 15g, San Qi Powder 3g (to be taken separately); for gallbladder cancer, pancreatic cancer, or liver cancer, add Bai Hua She Tiao Cao 15g, Ban Zhi Lian 15g, Hu Zhang 15g, Xia Ke Cao 15g, Zao Xu 15g.

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Chapter Sixteen: Pei’s Formulas Clinical Application: In addition to chronic pancreatitis, this formula is also used for liver-stomach disharmony, damp-heat accumulation, qi stagnation and blood stasis in cases of cholecystitis, gallstones, post-cholecystectomy syndrome, hepatitis, cirrhosis, and liver cancer. January 6, 2014, China Traditional Chinese Medicine News

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Pei Zhengxue Clinical Collection, Volume Two Lanzhou Formula Qi Qin, Qi Xueting, Zheng Fangjiang Pei Zhengxue, born in 1938, is a renowned Chinese-Western medicine expert in China, one of the first 500 nationally recognized senior traditional Chinese medicine practitioners, and one of the first group of renowned TCM doctors in Gansu Province, who received special government allowances from the State Council. He currently serves as a professor at the Gansu Provincial Academy of Medical Sciences, concurrently serving as an editorial board member of China Journal of Integrated Chinese and Western Medicine and Editor-in-Chief of China Journal of Integrated Chinese and Western Medicine Research, as well as President of the Gansu Provincial Association of Integrated Chinese and Western Medicine. Professor Pei Zhengxue has been engaged in clinical practice for over 50 years, publishing more than 50 academic papers, possessing a solid academic foundation and rich clinical experience, specializing in the treatment of various complex and difficult diseases. In 1974, he proposed a specialized treatment formula for leukemia, which was officially named “Lanzhou Formula” at the National Hematology Conference and has been widely used in hospitals across China for many years, demonstrating remarkable therapeutic efficacy. Composition: Sheng Di 12g, Shan Yao 10g, Shan Yu Rou 30g, Ren Shen Xu 15g, Tai Zi Shen 15g, Bei Sha Shen 15g, Dang Shen 15g, Mai Dong 10g, Wu Wei Zi 6g, Gui Zhi 10g, Bai Shao 10g, Sheng Jiang 6g, Da Zao 4 pieces, Zhi Gan Cao 6g, Fu Mai Xian 30g. Effects: Tonify the body and strengthen the root, nourish the kidneys and strengthen the spleen. Indications: Leukemia, aplastic anemia, and other hematological diseases. Usage: Soak in about 1500ml of water, steep for 1 hour, then simmer over low heat for 40 minutes. Repeat the second decoction (water 500ml, simmer for 30 minutes), combine both decoctions, and drink them in two doses throughout the day. Avoid eating cold, spicy, or irritating foods. Formula Explanation: Leukemia falls within the scope of TCM’s “blood deficiency” or “blood deficiency,” and Old Master Pei believed that deficiency of righteous qi is the fundamental cause of leukemia’s onset and progression. High fever and bleeding seen in the course of the disease reflect the phenomenon of “excess in deficiency.” That is, leukemia is not a condition purely characterized by excess or deficiency, but rather…

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“Take deficiency as the root, and excess as the symptom.” Accordingly, when treating leukemia, we must not rely solely on “eliminating evil,” nor can we simply “tonify the root”; instead, we must organically combine tonification of the root with the elimination of evil. Therefore, Old Master Pei believed that “tonifying the root and strengthening the base, nourishing the kidneys and strengthening the spleen” is the primary principle for treating leukemia. This formula uses Sheng Di, Shan Yao, and Shan Yu Rou to nourish kidney yin and replenish bone marrow; Ren Shen Xu, Tai Zi Shen, Bei Sha Shen, and Dang Shen—four types of ginseng—to tonify qi and nourish blood. Gui Zhi Tang harmonizes the vital energy and defensive qi, thereby stabilizing the imbalance between yin and yang in the internal organs, while Sheng Mai Yin Drink nourishes qi and nourishes yin. Gan Mai Da Zao Tang nourishes the heart and calms the spirit; when the heart and spirit are calm, the blood becomes stable. When aiming to increase white blood cells, use: Fuzi, Chuan Wu, Cao Wu, Ma Qian Zi, Guizhi, Dang Gui, Bu Gu Zhi, Tu Si Zi, Sha Yuan Zi, Ji Xue Teng, Huang Qi, Xi Yang Shen, Lu Rong, etc. To increase platelet counts, use: Zhuang Zi, Han Lian Cao, Yu Zhu, Huang Jing, Da Zao, A Jiao, Lian Qiao, Tu Da Huang, Mu Tou Hui, etc. To increase red blood cell counts, use: Gui Pi Tang with Ren Shen Xu, Tai Zi Shen, Bei Sha Shen, Yuan Shen, Xi Yang Shen, He Shou Wu, Er Zhi Wan, Shui Zhi, etc.

Additions and Subtractions: If the total white blood cell count is low, add Bu Gu Zhi or Ji Xue Teng; if the red blood cell count is low, add Zhuang Zi or Han Lian Cao; if the platelet count is low, add Yu Zhu or Huang Jing; for those with poor appetite and abdominal distension, add Muxiang or Cao Doukou; for those with fever, add Ban Zhi Lian, Bai Hua She Tiao Cao, Sheng Shi Shu, Han Shui Shi; for those with bleeding, add Dan Pi, Chi Shao, San Qi, A Jiao.

May 2014, China Traditional Chinese Medicine News

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Pei Zhengxue Clinical Collection, Volume Two Three-Flavor Eliminating Stagnation Soup Wang Xin, Qi Qin, Zheng Fangjiang Pei Zhengxue, born in 1938, is a chief physician, professor, and doctoral supervisor. He is a renowned expert in integrated Chinese and Western medicine, serving as a guiding teacher for the second, third, fourth, and fifth groups of national senior TCM experts, a lifelong council member of the Chinese Society of Traditional Chinese Medicine, an honorary president of the Gansu Provincial Association of Integrated Chinese and Western Medicine, a doctoral supervisor at the China Academy of Traditional Chinese Medicine, one of the first group of renowned senior TCM doctors in Gansu Province, a chief expert at the Gansu Provincial Academy of Medical Sciences, a chief expert at the Gansu Provincial Hospital of Traditional Chinese Medicine, and a curator at the Gansu Provincial Museum of History and Culture. He has spent over 50 years engaged in clinical practice, teaching, and research, possessing extensive clinical experience and knowledge, specializing in the treatment of tumors, liver diseases, hematological disorders, autoimmune diseases, and other complex and difficult conditions. He proposed the “Western Diagnosis, Chinese Syndrome, Chinese Medicine as the Mainstay, Western Medicine as a Supplement” sixteen-character principle for integrated Chinese and Western medicine, which has become one of the key approaches to developing TCM today. He has published 18 medical works, including “Practical Internal Medicine of Integrated Chinese and Western Medicine,” “Clinical Commentary on Blood Disorders,” “Medical Talks and Case Studies of Pei Zhengxue,” and “Pei Zhengxue’s Medical Notes,” and has published more than 80 medical papers. Composition: Jin Yin Hua 15g, Lian Qiao 15g, Pu Gong Ying 15g, Bao Jiang 15g, Tu Fu Ling 15g, Bai Lian Pi 20g, Sheng Di 12g, Di Fu Zi 10g, Fang Feng 10g, Lei Feng 10g, Bi Fei 10g, Chi Shao 10g, Dan Pi 6g, Xian He Cao 15g, Zi Cao 15g, Qian Cao 15g, Han Lian Cao 15g, Yi Mu Cao 20g, Deng Xin Cao 6g, Chan Tui 6g, Gan Cao 6g. Function: Disperse wind and clear heat, detoxify and promote dampness, cool the blood and stop bleeding. Indication: Allergic purpura, diagnosed as wind-heat combined with dampness, affecting the blood vessels. Usage: One dose per day, add an appropriate amount of water; first decoction for 30 minutes, second decoction for 40 minutes. Mix the two decoctions together and drink them in two doses, morning and evening, after meals.

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Formula Explanation: Allergic purpura, also known as hemorrhagic capillary poisoning, is a microvascular allergic hemorrhagic disease. Clinically, it primarily manifests as skin purpura and mucosal bleeding, often accompanied by abdominal pain, joint swelling and pain, or kidney damage. Pei Zhengxue believes that this disease falls under the category of “fā bān” and “blood disorders” in TCM, often arising from wind-heat combined with dampness, entering the blood and damaging the blood vessels. Treatment should focus on dispersing wind-heat, detoxifying and promoting dampness, cooling the blood and stopping bleeding.

The Three-Flavor Eliminating Stagnation Soup uses Bai Lian Pi, Di Fu Zi, Fang Feng, and Chan Tui to disperse wind and eliminate pathogenic factors; Jin Yin Hua and Lian Qiao to disperse wind and clear heat; Pu Gong Ying, Bao Jiang, Tu Fu Ling, and Lei Feng to detoxify and promote dampness, unblock the meridians and relieve pain. When heat enters the blood, forcing blood to flow abnormally, and the blood needs to be cooled and dispersed, yet still need to be stopped and stabilized, therefore Sheng Di, Chi Shao, and Dan Pi are used to clear heat and cool the blood; Zi Cao and Han Lian Cao cool the blood and stop bleeding; Yi Mu Cao and Qian Cao break up blood stasis and stop bleeding; Xian He Cao constricts and stops bleeding; Deng Xin Cao calms the heart and stabilizes the blood. Gan Cao alone is used to clear heat and detoxify, harmonizing all the herbs. The entire formula disperses wind and clears heat, detoxifies and cools the blood; when wind and heat are dispersed, blood heat is cleared, and the purpura will naturally subside. Additions and Subtractions: For those with deep heat toxicity and dense purpura, add Ce Bai Ye 10g or Wild Chrysanthemum 15g; for those with a clear history of allergies, add Chai Hu 10g, Dang Gui 10g, and 4 Ume berries; for those with abdominal pain, add Xiao Hui Xiang 10g, Fula Ba 10g, Wu Zhu Yu 6g, Yan Hu Suo 10g, Chuan Lian Zi 20g; for purpura primarily affecting the lower limbs, or accompanied by joint pain in the lower limbs, add Si Miao San; for severe joint pain, add Zhi Chuan Cao Wu each 15g (soaked for 1 hour), Xi Xin 15g (soaked for 1 hour), Ma Qian Zi 1 piece (fried in oil), Lei Gong Teng 20g (peeled, soaked for 1 hour); for those with purpura accompanied by kidney problems and positive urine protein, add Su Bing 20g, Chan Tui 6g. For those with positive occult blood, add Bai Mao Gen 30g, Ce Bai Ye 10g, Da Xiao Ji each 10g, San Qi Powder 3g (to be taken separately), Zhuang Zi 15g, etc. Clinical Application: Allergic purpura is often closely related to external infections, dietary factors, and other causes. Therefore, patients should avoid consuming meat, eggs, milk, and other protein-rich foods, and actively prevent colds. When a cold occurs, switch to Majui Heji (Ma Huang Tang with Sheng Shi Shu, Chuan Qiu, Bai Zhi, Xi Xin, Qiang Du Huo, Fang Feng), and administer antibiotics intravenously when necessary. If allergic purpura leads to nephritis, and the purpura has subsided, with positive urine protein and occult blood, switch to Fufang Yishen Tang (Taohong Sisi Tang with reduced Sheng Di, adding Yi Mu Cao, Dan Shen, Jin Yin Hua, Lian Qiao, Pu Gong Ying, Bao Jiang, and Ban Lan Gen). Combining the aforementioned additions and subtractions for treatment, if ineffective, use Yueli Zhong Qian Shi Heji for urine protein, and use “Yi Xue Xin” A Jiao Powder for occult blood. April 9, 2014, China Traditional Chinese Medicine News 443

Pei Zhengxue Clinical Collection, Volume Two “Shen Qi San Huang Tang” – Treatment for Thrombocytopenic Purpura Wang Xin, Feng Yongxiao, Bai Lijun Key Reminder: Pei Zhengxue, born in 1938, is a chief physician, professor, and doctoral supervisor. He is a renowned expert in integrated Chinese and Western medicine, serving as a guiding teacher for the second, third, fourth, and fifth groups of national senior TCM experts; a lifelong council member of the Chinese Society of Traditional Chinese Medicine, an honorary president of the Gansu Provincial Association of Integrated Chinese and Western Medicine, a doctoral supervisor at the China Academy of Traditional Chinese Medicine, one of the first group of renowned senior TCM doctors in Gansu Province, a chief expert at the Gansu Provincial Academy of Medical Sciences, a chief expert at the Gansu Provincial Hospital of Traditional Chinese Medicine, and a curator at the Gansu Provincial Museum of History and Culture. Pei Zhengxue, born in 1938, is a chief physician, professor, and doctoral supervisor. He is a renowned expert in integrated Chinese and Western medicine, serving as a guiding teacher for the second, third, fourth, and fifth groups of national senior TCM experts; a lifelong council member of the Chinese Society of Traditional Chinese Medicine, an honorary president of the Gansu Provincial Association of Integrated Chinese and Western Medicine, a doctoral supervisor at the China Academy of Traditional Chinese Medicine, one of the first group of renowned senior TCM doctors in Gansu Province, a chief expert at the Gansu Provincial Academy of Medical Sciences, a chief expert at the Gansu Provincial Hospital of Traditional Chinese Medicine, and a curator at the Gansu Provincial Museum of History and Culture. He has spent over 50 years engaged in clinical practice, teaching, and research, possessing extensive clinical experience and knowledge, specializing in the treatment of tumors, liver diseases, hematological disorders, autoimmune diseases, and other complex and difficult conditions; he proposed the “Western Diagnosis, Chinese Syndrome, Chinese Medicine as the Mainstay, Western Medicine as a Supplement” sixteen-character principle for integrated Chinese and Western medicine, which has become one of the key approaches to developing TCM today. He has published 18 medical works, including “Practical Internal Medicine of Integrated Chinese and Western Medicine,” “Clinical Commentary on Blood Disorders,” “Medical Talks and Case Studies of Pei Zhengxue,” and “Pei Zhengxue’s Medical Notes,” and has published more than 80 medical papers.

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Chapter Sixteen: Pei’s Formulas [Shen Qi San Huang Tang] Composition: Dang Shen 15g, Huang Qi 20g, Da Huang 6g, Huang Lian 6g, Huang Cui 10g, Bai Zhu.

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Pei Zhengxue Clinical Collection, Volume Two This formula is a combination of Dang Shen, Huang Qi, Da Huang, Huang Lian, Huang Cui, and Bai Zhu, designed to treat thrombocytopenic purpura by tonifying qi and nourishing blood, clearing heat and drying dampness, activating blood circulation and relieving pain. It is particularly effective for patients with mild to moderate thrombocytopenia, especially those experiencing symptoms such as bruising, bleeding, and joint pain due to the disease. The formula helps to restore normal blood cell counts and alleviate symptoms associated with thrombocytopenia, such as fatigue, weakness, and discomfort. By balancing qi and blood, this formula supports the body’s natural healing processes and promotes overall health and well-being.

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Professor Pei Zhengxue’s Clinical Experience in Integrating Traditional Chinese Medicine and Western Medicine for Nasopharyngeal Cancer

Bai Lijun, Chen Guangyan, Liang Yi
[Keywords] Nasopharyngeal cancer; Integrated TCM and Western Medicine therapy; Professor Pei Zhengxue

Professor Pei Zhengxue is the Chief Physician at Gansu Provincial Cancer Hospital and a doctoral supervisor. He is a renowned expert in the integration of traditional Chinese medicine and Western medicine in China, a national-level mentor for advanced students, and a lifetime director of the Chinese Society of Traditional Chinese Medicine. He specializes in treating various complex and difficult cases. I had the privilege of studying under Professor Pei, and now I would like to share Professor Pei’s clinical experience in treating nasopharyngeal cancer as follows.

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