VI. Clinical Case Examples by Professor Pei Zhengxue

VI. Clinical Case Examples by Professor Pei Zhengxue
Case 1: Patient Li, female, 10 years old, a primary school student in Ledu County, Qinghai Province. In November 2006, she presented with headache, vomiting, numbness in the right lower limb accompanied by unsteady gait, and was admitted to Qinghai Provincial People’s Hospital. CT and MRI examinations revealed a right-sided cerebellar glioma. The patient and her family were reluctant to undergo surgery, so they sought integrated traditional Chinese and Western medicine treatment from Professor Pei Zhengxue. Initial diagnosis included headache, dizziness, nausea, vomiting, numbness in the right limbs, weakness in the lower limbs, unsteady gait, red tongue, thin white coating, and stringy, slippery pulse.
[Western Diagnosis] Right-sided cerebellar glioma; obstructive hydrocephalus.
[TCM Diagnosis] Deficiency of righteous qi, accumulation of damp-toxin in the brain.
[Treatment] Warming yang and transforming water, activating blood circulation and removing blood stasis, softening hard masses and dispersing knots.
[Prescription] Sanjia Erdi Tang with added ingredients: Gui Zhi 10g, Fu Zi 6g, Sheng Di 12g, Shu Di 12g, Shan Yao 10g, Shan Zhu Yu 20g, Fu Ling 12g, Ze Xie 10g, Dan Pi 6g, Gui Ban 15g (decocted first), Bie Jia 15g (decocted first), Mu Li 15g (decocted first), Hong Hua 6g, Mai Dong 10g, Tian Dong 10g, Ma Huang 10g, Chuan Niu Xi 15g, Po Gu Zi 10g, Dan Shen 10g, Sha Ren 3g (added later), San Leng 10g, E Zhu 10g, Hai Zao 10g, Kun Bu 10g, Huai Hua 10g, Xia Ku Cao 15g. Decoct in water and take 600ml of the decoction, divided into four doses over two days (two doses per day, 150ml each, taken after breakfast and dinner). Additionally, Shui Zhi 6g (to be decocted separately). Professor Pei Zhengxue stated that Shui Zhi is a divine herb for removing blood stasis, and its raw use is highly effective. After one month of medication, the patient’s symptoms significantly improved, and subsequent adjustments were made based on her condition. After one year of taking traditional Chinese medicine, the patient’s gait became steady, with no discomfort, her complexion became rosy, and she resumed normal studies and daily life. A follow-up CT scan showed that the right-sided cerebellar glioma had shrunk to one-third of its original size. The patient’s confidence increased, and she continued taking the medication until 2011, after which contact was lost.

Case 2: Patient Su, male, 28 years old, a freelancer in Lanzhou City. In October 2008, he underwent craniotomy at the Second Hospital of Lanzhou University to remove a right frontal lobe glioma, followed by postoperative radiotherapy. On November 4, 2008, he presented with headache, dizziness, fatigue, swelling and discomfort in the right face and head, dark red tongue, thin yellow coating, and deep, weak pulse.
[TCM Diagnosis] Spleen-kidney deficiency, blood stasis obstruction.
[Treatment] Strengthening the spleen and kidneys while activating blood circulation and removing blood stasis.
[Prescription] Ren Shen Xu 15g, Tai Zi Shen 15g, Bei Sha Shen 15g, Dang Shen 15g, Sheng Di 12g, Shan Yao 10g, Shan Zhu Yu 30g, Gui Zhi 10g, Bai Shao 15g, Zhi Gan Cao 6g, Sheng Jiang 6g, Da Zao 4 pieces, Mai Dong 10g. A total of 30 doses, one dose per day. After one month of treatment, all symptoms alleviated. A follow-up MRI showed “changes after postoperative radiotherapy for frontal lobe tumor,” with all other laboratory results normal.
Note: Recent experimental studies have shown that traditional Chinese medicine tonifies the kidneys and spleen by improving the body’s hematopoietic system, immune system, autonomic nervous system, and endocrine system, thereby fundamentally enhancing the body’s overall responsiveness. Among them, kidney-tonifying herbs primarily improve the specific immune system, hematopoietic system, and endocrine system, while spleen-tonifying herbs mainly enhance the non-specific immune system and autonomic nervous system. Western radiotherapy and chemotherapy target the pathogenic factors directly, killing or inhibiting tumor cells. Traditional Chinese medicine, by reinforcing righteous qi, can greatly reduce the side effects of radiotherapy and chemotherapy, thus enhancing their efficacy. Combining traditional Chinese medicine’s reinforcement of righteous qi with Western radiotherapy and chemotherapy creates a complementary approach, which is an effective model for treating malignant tumors in modern internal medicine.

VII. Synthesis of Ancient and Modern Theories
“The Spirit Pivot • The Disease of Jue” states: “True headache, severe headache, pain throughout the brain, cold extremities—death if untreated.”
“The Plain Questions · The Treatise on Strange Diseases” points out: “If someone suffers from headache for several years without improvement… there must be exposure to severe cold, which penetrates to the bone marrow. Since the marrow is primarily in the brain, the brain rebels, causing headache… This condition is called ‘Jue Ni.’”
“The Essentials of Diagnosis and Treatment” says: “There is a condition called ‘headwind,’ characterized by constant ringing in the ears and chirping of birds above the head… This is caused by wind entering the head.”
“The Central Canon” states: “Long-term head and eye pain, followed by blindness, leads to death.”
“The Standard for Diagnosis and Treatment” says: “Thunder-like headache, where a lump forms in the head, or the head sounds like thunder—this is caused by wind invasion, and the wind makes noise when it moves.”
Wang Yutang believes that the occurrence of brain tumors is closely related to the liver and kidneys. For kidney essence deficiency, Liu Wei Di Huang Wan is the first choice; for liver stagnation and spleen deficiency, Xiao Yao San with modifications is recommended. The formation of brain tumors is also related to the imbalance of “the heart as the master of spirit,” emphasizing the importance of nourishing the heart and calming the spirit, using herbs like Shi Chang Pu and Yu Jin. Flexible use of wind-dispersing, phlegm-transforming, and blood-stasis-removing medicines is crucial, as only wind can reach the highest parts of the head, and wind-related medicines tend to be light and ascending. Primary brain tumors often form due to phlegm, with common remedies like Bai Fu Zi and Gua Wei to transform phlegm and disperse knots. “Brain channel deficiency” is the ultimate pathogenesis, and the formation of brain tumors is directly related to brain channel deficiency. Insect-based medicines have a pungent taste and are good at eliminating channel-related pathogenic factors, often using snakes and scorpions.
Shen Minhe believes that brain tumors form because of excessive blood stasis in the upper burner, requiring blood-stasis-eliminating and channel-unblocking treatments, using Tongqiao Huoxue Tang with modifications; in the middle burner, excessive phlegm requires spleen-tonifying and dampness-transforming treatments, along with phlegm-dispersing and wind-calming measures; in the lower burner, excessive deficiency calls for kidney-tonifying and essence-filling treatments, using Liu Wei Di Huang Wan with modifications.
Sun Guizhi divides brain tumors into four types: spleen-kidney deficiency, liver wind stirring, phlegm-dampness accumulation, and toxic blood stasis blocking each other. She uses methods such as strengthening the spleen and kidneys, calming the liver and suppressing wind, transforming phlegm and removing dampness, and clearing blood stasis and detoxifying, combining disease differentiation with syndrome differentiation, achieving remarkable results.
Zhou Zhong believes that brain tumor onset is nothing more than blood stasis, phlegm-condensation and dampness-stagnation, channel blockage, and heat-toxin accumulation, leading to righteous qi deficiency, heat-toxin-phlegm-stasis aggregation, and eventual cancer formation. Common treatments include nourishing the liver and kidneys, dispelling wind and transforming phlegm, and clearing blood stasis and detoxifying.
Pan Guoxian believes that brain tumors arise from damage to the marrow sea, phlegm-stasis aggregation, stimulation of liver wind, and injury to yin and yang, requiring treatments focused on calming wind and clearing heat, transforming phlegm and dispersing knots, and clearing blood stasis and unblocking channels, supplemented by nourishing the liver and kidneys.
Sun Guizhi believes that brain tumors are caused by spleen-kidney deficiency, insufficient marrow sea, phlegm-dampness and toxic blood stasis entering the skull to form tumors, liver yin deficiency, yang hyperactivity leading to wind, and toxic substances entering the brain to cause harm. She recommends strengthening the spleen and kidneys, calming the liver and suppressing wind, transforming phlegm and removing dampness, and clearing blood stasis and detoxifying.

VIII. Anatomy, Physiology, and Pathology
The nose consists of three parts: the external nose, nasal cavity, and paranasal sinuses. It serves as a respiratory passage and has functions such as olfaction, resonance, and reflexes. The pharynx is the intersection of the respiratory and digestive tracts, extending from the base of the skull down to the lower edge of the cricoid cartilage, divided into nasopharynx, oropharynx, and hypopharynx. It performs respiratory functions, defensive protection, resonance, and regulation of middle ear pressure.
Biopsy of tumor tissue is the only way to confirm nasopharyngeal carcinoma. Nasopharyngeal carcinoma often occurs at the posterior wall of the nasopharyngeal roof, followed by the lateral walls, while occurrences on the anterior and inferior walls are extremely rare.

1. Morphological classification of nasopharyngeal carcinoma
   Nodular type, cauliflower type, submucosal type, infiltrative type, and ulcerative type. Nodular or cauliflower-type tumors may protrude into the nasopharyngeal cavity, while infiltrative, submucosal, and ulcerative types mostly grow beneath the mucosa.
2. Histological classification
   (1) Carcinoma in situ: Cancer cells proliferate in a bud-like or spike-like manner, projecting into the subepithelial layer. There is still a clear basement membrane separating the cancer cells from the underlying mucosal lamina propria. Compared with normal epithelial cells, carcinoma in situ cells have a larger nucleus-to-cytoplasm ratio, meaning their nuclear area is significantly enlarged.
   (2) Infiltrative carcinoma
   ① Micro-infiltrative carcinoma: The basement membrane is destroyed by cancer cells, but the infiltration does not exceed 400 times the magnification of the microscope. The cell morphology is markedly different from carcinoma in situ, with invasive growth through the basement membrane.
   ② Squamous cell carcinoma: Most nasopharyngeal carcinomas originate from columnar epithelium, but the majority are actually squamous cell carcinomas. Under microscopic examination, squamous differentiation is characterized by keratin pearls, intracellular and extracellular keratinization, intercellular bridges, and a layered arrangement of cells within the tumor nest similar to squamous epithelium. The cells do not appear as syncytial cells. Depending on the degree of squamous differentiation, nasopharyngeal squamous cell carcinomas can be classified into high-, medium-, and low-grade differentiation.
   ③ High-grade differentiated squamous cell carcinoma: When most of the tumor tissue shows intercellular bridges or keratinization, it is considered well-differentiated squamous cell carcinoma or keratinized squamous cell carcinoma. Generally, there is no lymphocyte infiltration within the tumor nest, though occasional scattered lymphocytes may be seen. The boundaries of the tumor nest are usually quite clear, sometimes even completely enclosed by a membrane. The stroma of this type of cancer is mostly fibrous tissue. There may be infiltration of neutrophils, lymphocytes, plasma cells, etc., but plasma cells are usually not numerous.
   ④ Medium-grade differentiated squamous cell carcinoma: When clear intercellular bridges and/or keratinization are observed in the tumor tissue, it is not isolated but appears in a certain number of nasopharyngeal cancers.

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