、Guaipi;

、Guaipi; Nasal Longtang (Beishashen, Maidong, Yuzhu, Shihu, Danpi Tan, Chenzong Tan, Bohe Tan, Daji Tan, Huainiu Xi, Baima Gen); for severe headache, add Baizhi; for obvious nasal congestion, add Xinyi and Cang’erzi; for asthma, add Dingchuan Tang. 2. Liver Qi Stagnation and Phlegm Condensation Symptoms: visible neck mass, thick and sticky phlegm, headache, tinnitus, nasal congestion, nosebleeds or bloody nasal discharge, bitter taste and thirst, irritability, constipation. Tongue is red, coating is yellow and greasy or thick yellow, pulse is slippery and rapid. Treatment should focus on clearing the liver, resolving phlegm, relieving stagnation, softening hard masses, and dispersing nodules. Prescription: Sini San, Longdan Xiegan Tang, Cang’erzi San, Shengjiang San with modifications: Chaihu 10 g, Zhishi 10 g, Baishao 10 g, Gancao 6 g, Longdan Cao 15 g, Huangqin 10 g, Shan Zhi 10 g, Shengdi 12 g, Shandougen 15 g, Shancigu 15 g, Baihua She Shecao 30 g, Yujin 6 g, Foshou 10 g, Chaihu 10 g, Tufuling 15 g, Xiakucao 15 g, Sheng Muli 30 g, Xinyi 10 g, Cang’erzi 10 g, Xiangfu 6 g, Zhi Banxia 10 g, Dahuang 6 g, Chan Tui 6 g, Jianghuang 10 g, Jiangcan 6 g. Decoct in water and take one dose per day. Modifications: For severe constipation, add raw Dahuang; for thick and greasy coating, remove Shengdi and add Sanren Tang; for poor appetite, add Guma Ya and Ji Neijin; For hard, immovable neck masses, add Zilong Tang (Zicao, Longdan Cao, Xiakucao, Maqianzi, Gua Wei, Taoren, Dang Shen, Xuan Shen, Shanjuyu, Shancigu, Shandougen); for excessive phlegm and cough, add Dan Nanxing and Tianzhu Huang; for poor gastric intake, add Ji Neijin and Jiaosanxian. 3. Qi Stagnation and Blood Stasis Symptoms: nasal congestion, dark blood in the nasal discharge, stabbing headache, especially worse at night, or tinnitus. Tongue is dark red, with ecchymoses on the edges, coating is thin, pulse is涩. Treatment should focus on resolving blood stasis, dispersing nodules, regulating qi, and opening up the orifices. Prescription: Pei Shi Qingzhen Tang, Kongqing Gao, Chuanxiong Cha Diaosan with modifications, Tongqiao Huoxue Tang, Taohong Siwu Tang can also be used: Cangshu 10 g, Ganheye 10 g, Shengma 3 g, Qianghuo 12 g, Fangfeng 12 g, Huangqin 10 g, Baizhi 6 g, Xixin 3 g, Lianqiao 15 g, Huoxiang 6 g, Chaihu 12 g, Danggui 12 g, Chuanxiong 9 g, Cheshao 15 g, Yiren 30 g, Yujin 6 g, Cang’erzi 15 g, Taoren 10 g, Honghua 6 g, Gancao 6 g. Decoct in water and take one dose per day. Modifications: For severe headache, add Qing Shang Teng Tang, Jiangcan, and Gaoben; Nasal Longtang (Beishashen, Maidong, Yuzhu, Shihu Danpi Tan, Chenzong Tan, Bohe Tan, Daji Tan, Huainiu Xi, Baima Gen). 4. Yin Deficiency and Excessive Fire Symptoms: dizziness, vertigo, tinnitus and deafness, nose is bright red, mouth and nose are dry, throat is dry and thirsty, five hearts are restless and hot, body is thin, dry cough with little phlegm, fatigue and weakness. Tongue is red, no coating or little coating, pulse is fine and rapid or fine. Treatment should focus on nourishing yin and clearing heat, replenishing qi and generating fluids. Prescription: Yangyin Qingfei Tang, Muji Tang, Shasha Maidong Tang, Qiju Dihuang Tang with modifications: Beishashen 15 g, Tiandong 10 g, Maidong 10 g, Tianhua Fen 30 g, Yuzhu 12 g, Zhebei 30 g, Xuan Shen 10 g, Shengdi 12 g, Shanjuyu 15 g, Jiu Zi 10 g, Ju Hua 10 g, Danpi 9 g, Hanlian Cao 15 g, Nüzheng Zi 15 g, Sizi 15 g, Baihua She Shecao 30 g, Xianhe Cao 30 g. Decoct in water and take one dose per day. Modifications: for poor appetite, add Muxiang and Caodoukou; for constipation, add Yu Li Ren and Huo Ma Ren; for obvious qi deficiency, add Sheng Huangqi and Dang Shen. The above four classifications summarize the clinical manifestations of nasopharyngeal carcinoma at different stages of development, and the provided prescriptions—Mahuang Guizhi Heji (Mahuang 10 g, Guizhi 10 g, Xingren 10 g, Sheng Shigao 30 g, Gancao 6 g, Chuanxiong 10 g, Baizhi 6 g, Xixin 3 g, Qianghuo 12 g, Fangfeng 12 g)—Fangfeng Tongsheng San, Kang’ai Wuwei Xiaodu Yin, Sini San, Longdan Xiegan Tang, Shengjiang San, Tongqiao Huoxue Tang, Taohong Siwu Tang, Qing Shang Teng Tang, Qing Kong Gao, Chuanxiong Cha Diaosan, Pei Shi Qingzhen Tang (Cangshu 10 g, Ganheye 10 g, Shengma 3 g, Qianghuo 12 g, Fangfeng 12 g, Huangqin 10 g, Gancao 6 g)—Cang’erzi San, Zilong Tang (Zicao, Longdan Cao, Xiakucao, Maqianzi, Gua Wei, Taoren, Dang Shen, Xuan Shen, Shanjuyu, Shancigu, Shandougen), Longtang (Beishashen, Maidong, Yuzhu, Shihu, Danpi Tan, Chenzong Tan, Bohe Tan, Daji Tan, Huainiu Xi, Baima Gen)—Yangyin Qingfei Tang, Shasha Maidong Tang, Qiju Dihuang Tang—are only suitable for symptomatic treatment at each stage, but for a single patient, it's unlikely to be just one syndrome; often there are multiple overlapping syndromes, requiring individualized medication based on clinical judgment. For patients without specific symptoms, long-term use of the Lanzhou formula is recommended. V. Analysis of Professor Pei Zhengxue’s Prescriptions for Nasopharyngeal Carcinoma Basic prescription: Yangyin Qingfei Tang: Xuan Shen 15 g, Gancao 6 g, Baishao 15 g, Maidong 10 g, Shengdi 10 g, Bohe 6 g (added last), Zhebei 10 g, Danpi 6 g. This prescription comes from “Zhonglou Yu Yue”: “The treatment principle is nothing but the lungs and kidneys; the key is to nourish yin and clear the lungs, while also focusing on dispersing heat and cooling.” The prescription heavily uses Shengdi, which is cold and enters the kidneys, nourishing yin and strengthening water, clearing heat and cooling blood, serving as the chief herb; Xuan Shen nourishes yin and reduces fire, detoxifies and benefits the throat; Maidong nourishes yin and clears the lungs, acting as the assistant herb; Danpi clears heat and cools blood, disperses stasis and reduces swelling; Baishao gathers yin and releases heat, benefiting the body; Beimu clears heat and moistens the lungs, dissolving phlegm and dispersing nodules; a small amount of Bohe disperses evil and clears heat, benefiting the throat; Gancao clears heat and detoxifies, benefiting the throat; all these herbs work together to nourish yin and clear the lungs, detoxify and benefit the throat. VI. Clinical Case Examples by Professor Pei Zhengxue Case 1: Patient Zhang, female, 55 years old. Chief complaint: More than 8 months after radiotherapy for nasopharyngeal carcinoma, nasopharyngeal carcinoma recurred 1 month ago. Present illness: In March 2010, during a routine physical examination, the patient was found to have enlarged lymph nodes behind the left sternocleidomastoid muscle. After nasopharyngoscopy and cytological pathology examination, she was diagnosed with nasopharyngeal carcinoma. She received two courses of radiotherapy at a hospital in Gansu Province, and her condition was brought under control. In December 2010, a mass was discovered under the left jaw, diagnosed as a recurrence of nasopharyngeal carcinoma. After another course of radiotherapy, she developed dizziness and vertigo, sharp pain in both ears, yellow thick discharge, tinnitus and deafness, redness, hardness, and burning sensation on the cheeks, dry mouth and nose, restlessness and heat in the five hearts, emaciation, dry cough with little phlegm, red tongue, little coating, and fine rapid pulse. [Western Medical Diagnosis] Nasopharyngeal carcinoma. [Traditional Chinese Medicine Diagnosis] Nasal hemorrhoids. [TCM Syndrome Differentiation] Qi and yin deficiency, phlegm and blood stasis intertwined. [Treatment Principle] Tonify qi and nourish yin. [Prescription] Yangyin Qingfei Tang, Shasha Maidong Tang, Qiju Dihuang Tang with modifications: Beishashen 15 g,

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Input: Tian Dong 10g, Mai Dong 10g, Tian Hua Fen 30g, Yu Zhu 12g, Zhe Bei Mu 30g, Xuan Shen 10g, Sheng Di 12g, Shan Zhu Yu 15g, Gou Qi Zi 10g, Ju Hua 10g, Dan Pi 9g, Han Lian Cao 15g, Nv Zhen Zi 15g, Tu Si Zi 15g, Bai Hua She She Cao 30g, Xian He Cao 30g. Take 1 dose daily, for a total of 15 doses. Ear and nasal discharge significantly reduced, oral ulcers controlled, dry mouth and nose, five-heart vexation, and fatigue markedly alleviated, but submandibular mass still present. Second consultation prescription: Hai Zao Yu Hu Tang and Sheng Jiang San with modifications: Dang Gui 10g, Chuan Xiong 10g, Ban Xia 6g, Chen Pi 6g, Fu Ling 12g, Gan Cao 6g, Hai Dai 10g, Kun Bu 10g, Hai Zao 15g, Du Huo 10g, Lian Qiao 15g, Zhe Bei Mu 10g, Da Huang 6g , Chan Tui 6g, Jiang Huang 10g, Jiang Can 6g. Take for 15 doses, patient's posterior cervical lymph nodes significantly reduced, other symptoms all markedly improved. Third consultation prescription: Lan Zhou Fang with modifications: Bei Sha Shen 15g, Tai Zi Shen 15g, Ren Shen Xu 15g, Lu Dang Shen 15g, Sheng Di 12g, Shan Yao 10g, Shan Zhu Yu 30g, Gui Zhi 10g, Bai Shao 10g, Sheng Jiang 6g, Gan Cao 6g, Da Zao 4 pieces , Mai Dong 10g, Wu Wei Zi 3g, Fu Xiao Mai 30g, San Leng 10g, E Zhu 10g, Hai Zao 10g, Kun Bu 10g. Take for 30 doses. Survived until 2013, attended regular outpatient follow-ups, then lost contact. Example 2: Patient Liu, male, 31 years old, chief complaint: nasopharyngeal carcinoma radiotherapy for 1 week. Present illness: In April 2011, patient developed nocturnal nasal congestion, visited a hospital in Gansu Province, nasopharyngoscopy revealed an occupying lesion, pathological biopsy confirmed nasopharyngeal carcinoma. Underwent radiotherapy for 1 week, patient experienced significant nasal dryness, nasal congestion, occasional purulent nasal discharge with blood, oral ulcers, constipation, hot breath from the nose, headache, cough, numbness in the right neck accompanied by a mass. White blood cell count 2.2 x 10^9/L. Pale complexion, slippery and rapid pulse, red tongue body and yellow tongue coating. [Western medical diagnosis] Nasopharyngeal carcinoma. [Chinese medicine diagnosis] Nasal hemorrhoids. [Chinese medicine syndrome differentiation] Pathogenic heat in the lungs. [Treatment principle] Disperse lung qi and clear heat, resolve phlegm and disperse nodules. [Prescription] Based on Ma Huang Gui Zhi He Ji, Anti-Cancer Five-Flavor Disinfecting Drink, and Anti-Cancer Four-Ingredient Formula with modifications: Ma Huang 10g, Gui Zhi 10g, Xing Ren 10g, Sheng Shi Gao 30g (decocted first), Gan Cao 6g, Chuan Xiong 10g, Bai Zhi 6g, Xi Xin 3g, Qiang Du Huo each 10g, Fang Feng 12, Xiu 15g, Bai Hua She She Cao 15g, Ban Zhi Lian 15g, Hu Zhang 15g, Xia Ku Cao 15g, Hai Zao 10g, Kun Bu 10g, San Leng 10g, E Zhu 10g. Take for 15 doses. Second consultation: In May 2011, patient's headache, nasal congestion, and cough all significantly alleviated, purulent nasal discharge gone, oral ulcers still present but pain lessened, bowel movements no longer dry, right neck still numb, eating improved, pulse thin, tongue body somewhat red, tongue coating not dry. Second consultation added Chai Hu Si Ni San based on the above: Ma Huang 10g, Gui Zhi 10g, Xing Ren 10g, Sheng Shi Gao 30g