Chest tightness and shortness of breath, coughing and wheezing.

Chest tightness and shortness of breath, coughing and wheezing. For patients who have difficulty lying flat, add Jujube Lung-Draining Decoction; for those with poor appetite and nausea with a tendency to vomit, add Hawthorn Fruit, Chicken Gizzard Stone, and Xuanfu DaiZhe Decoction to descend rebellious qi and stimulate the stomach; for severe qi deficiency, remove Dangshen and substitute with Ginseng; for yin deficiency with excessive fire and oral ulcers, add Yu Nu Jian. V. Analysis of Professor Pei Zhengxue’s Formulas for Thyroid Cancer Basic formula: Hai Zao Yu Hu Tang: 15g of kelp, 10g of Zhejiang Fritillary Bulb, 6g of dried tangerine peel, 15g of kombu, 6g of green tangerine peel, 6g of Sichuan lovage, 10g of angelica root, 10g of forsythia, 10g of pinellia, 6g of licorice, 6g of duhuo, and 15g of kelp. This formula originates from “The Authentic Surgery,” where kelp, kombu, pinellia, fritillary bulb, and forsythia transform phlegm and reduce swelling, soften hard masses and disperse nodules to eliminate goiter; green tangerine peel and dried tangerine peel regulate qi; angelica root and Sichuan lovage harmonize blood, allowing phlegm to dissipate, dampness to be removed, and qi and blood to flow smoothly, gradually reducing goiter and tumors; duhuo unblocks meridians and activates collaterals; licorice balances all the herbs. Xiao Wan: From “Clinical Handbook of Traditional Chinese Medicine Prescriptions,” xuan shen nourishes yin and reduces fire, its bitter-cold nature clears heat; fritillary bulb transforms phlegm and reduces swelling, relieving depression and dispersing nodules; oyster is salty and cold, nourishing yin and subduing yang, softening hard masses and clearing heat, together achieving the effects of clearing and moistening phlegm and softening hard masses and dispersing nodules. When these herbs are used in combination, they have effective therapeutic effects on various nodules and diseases. VI. Examples of Clinical Cases by Professor Pei Zhengxue Case 1: Patient Li, male, 65 years old. Chief complaint: A mass in the left neck for 10 years, hoarseness for 1 month. History of present illness: The patient visited a hospital in May 2011, presenting with choking cough during eating and hoarseness. Ultrasound showed an 8cm × 6cm × 5cm hard mass in the left thyroid region with slightly limited mobility. Neck MRI revealed significant enlargement of the left thyroid gland, with an irregular nodular abnormal signal measuring 55.4mm × 49.8mm × 58.0mm inside, showing heterogeneous high signal on T2WI and equal-to-low signal on T1WI, with thin low-signal margins visible on both T1WI and T2WI, compressing the trachea and causing it to deviate to the right. Subsequently, a left thyroidectomy was performed, and postoperative pathology confirmed follicular thyroid carcinoma. The patient recovered well after surgery. In July 2011, the patient visited Professor Pei Zhengxue’s outpatient clinic, complaining of hoarseness, chest tightness, frequent cough with phlegm, ecchymosis on the tongue, greasy tongue coating, and a wiry or涩 pulse. [Western medical diagnosis] Thyroid cancer. [Traditional Chinese medicine diagnosis] Goiter. [TCM syndrome differentiation] Qi stagnation and blood stasis. [Treatment principle] Regulate qi, activate blood circulation, and transform phlegm. [Prescription] Modified Hai Zao Yu Hu Wan: Hai Zao Yu Hu Wan, Xiao Wan, and Jin Ju He Ji with modifications: 15g of kelp, 15g of kelp, 15g of kombu, 6g of green tangerine peel, 10g of Qing Ban Xia, 15g of Zhejiang Fritillary Bulb, 9g of angelica root, 9g of Sichuan lovage, 6g of turmeric, 10g of tangerine leaves, 10g of Zhishi, 15g of xuan shen, 15g of Zhejiang Fritillary Bulb, 15g of oyster (decocted first), 10g of san linge, 10g of e zhu, 15g of forsythia, 6g of dried tangerine peel, 15g of tangerine seeds, 15g of lychee seeds, 15g of red peony, 15g of salvia miltiorrhiza. After taking 15 doses, the patient’s above symptoms alleviated. Second visit: Based on the original formula, added Lanzhou core ingredients: 15g of kelp, 15g of kelp, 15g of kombu, 6g of green tangerine peel, 10g of Qing Ban Xia, 15g of Zhejiang Fritillary Bulb, 9g of angelica root, 9g of Sichuan lovage, 6g of turmeric, 10g of tangerine leaves, 10g of Zhishi, 15g of xuan shen, 15g of Zhejiang Fritillary Bulb, 15g of oyster (decocted first), 10g of san linge, 10g of e zhu, 15g of forsythia, 6g of dried tangerine peel, 15g of tangerine seeds, 15g of lychee seeds, 15g of red peony, 15g of salvia miltiorrhiza, 15g of northern ginseng, 15g of prince ginseng, 15g of ginseng roots, 15g of Lu Dangshen, 12g of rehmannia, 30g of cornelian cherry. The above formula was taken long-term until 2013, with regular follow-up examinations, and no recurrence was observed. Case 2: Patient Meng, female, 68 years old. Chief complaint: 5 years after thyroid cancer surgery, choking cough for 2 months. History of present illness: In March 2006, the patient visited a hospital due to a mass in the right neck, underwent relevant examinations, considered thyroid cancer, and subsequently had a right thyroidectomy. Postoperative pathology confirmed papillary thyroid carcinoma. The patient recovered well after surgery. In June 2011, the patient visited Professor Pei Zhengxue’s outpatient clinic, complaining of choking cough during eating, hoarseness, chest tightness and shortness of breath, palpitations and dyspnea, limb fatigue and weakness, loss of appetite and reduced food intake, bowel and bladder dysfunction, and emaciation. The tongue was dark or pale and plump, with little coating, and the pulse was deep, fine, and weak. [Western medical diagnosis] Thyroid cancer. [Traditional Chinese medicine diagnosis] Goiter. [TCM syndrome differentiation] Deficiency of vital energy with excess pathogenic factors. [Treatment principle] Tonify qi and nourish blood, detoxify and eliminate goiter. [Prescription] Modified Tuoli Tou Nong San and Baoyuan Tang: 6g of agarwood, 6g of sandalwood (added later), 15g of Dangshen, 12g of Poria, 30g of Astragalus, 15g of Ophiopogon, 10g of angelica root, 6g of Sichuan lovage, 15g of red peony, 15g of white peony, 15g of Atractylodes, 15g of kelp, 15g of kombu, 9g of green tangerine peel, 10g of pinellia, 6g of schisandra, 15g of Prunella, 30g of raw oyster (decocted first), 6g of fried licorice. After taking 15 doses, the patient’s above symptoms alleviated. Second visit: Adjusted to San Shu Qing Cao Zeng Ye Tang with Lanzhou core ingredients: 10g of san linge, 10g of e zhu, 6g of green tangerine peel, 15g of Prunella, 12g of rehmannia, 15g of xuan shen, 10g of Dan Nanxing, 12g of duhuo, 15g of white peony, 6g of Sichuan lovage, 10g of angelica root, 12g of rehmannia, 10g of mountain yam, 30g of cornelian cherry, 6g of danpi, 10g of ze xie, 15g of calcined wa leng, 15g of oyster, 15g of Zhejiang Fritillary Bulb, 15g of northern ginseng, 15g of prince ginseng, 15g of ginseng roots, 12g of rehmannia, 30g of cornelian cherry. The above formula was taken long-term until 2013, with regular follow-up examinations, and no recurrence was observed. VII. A Collection of Ancient and Modern Theories “San Yin Fang” provides specific descriptions of the clinical manifestations of the five types of goiter: those that are hard and immovable are called stone goiter; those whose skin color remains unchanged are called flesh goiter; those with exposed veins and knots are called tendon goiter; those with intertwined red veins are called blood goiter; and those that wax and wane with sorrow are called qi goiter. “Sheng Ji Zong Lu” states, “Stone (goiter) and mud (goiter) both arise from water, mountains, and diet.” “The Treatise on the Origins and Symptoms of Various Diseases” discusses “goiter symptoms”: “Goiter arises from emotional distress and qi stagnation…” “Wai Tai Mi Yao” once recorded, “Stone goiter is untreatable,” indicating that the prognosis for this disease is generally poor. Qin Bowei: “The shape of goiter is not uniform—some shrink or grow, some are soft and not firm, with normal skin color; some are as soft as cotton, others as hard as steamed buns, neither tight nor loose, shaped like an overturned bowl; some are firm and purple, with blue veins winding around, shaped like locusts or earthworms; some are purplish-red, with visible veins, as hard as stone, impossible to move, tightly adhering to the bone; and some have pale red skin, soft but not hard.” It can thus be seen that “goiter” is very complex, encompassing many types of thyroid diseases. Some manifestations of thyroid cancer are similar to stone goiter—those that are hard and immovable.” Guo Zhixiong believes that thyroid cancer can be divided into four types: phlegm-stasis obstruction, liver-qi stagnation with phlegm accumulation, blood-stasis with cold accumulation, and yin-deficiency with fire-excess. For the phlegm-stasis obstruction type, one should transform phlegm, soften hard masses, and disperse goiter, optionally using Hai Zao Yu Hu Tang with modifications; for the liver-qi stagnation with phlegm accumulation type, one should regulate qi, dispel goiter, transform phlegm, and disperse nodules, optionally using Chai Hu Shu Gan San with modifications; for the blood-stasis with cold accumulation type, one should activate blood circulation, dispel cold, and soften hard masses and disperse nodules, optionally using Xiao Huo Luo Dan with modifications; for the yin-deficiency with fire-excess type, one should clear the heart and nourish yin, transform phlegm, and soften hard masses, optionally using a self-formulated Qing Xin Ruan Jian Tang with modifications. Park Byung-gyu believes that this disease arises from the obstruction of phlegm and qi, and clinically one should distinguish between real fire, virtual fire, and deficiency of vital energy. In the early stages of thyroid cancer, one can divide it into three types: phlegm and qi condensation, internal accumulation of heat toxin, and mutual entanglement of phlegm and stasis; in the middle and late stages, one can divide it into three types: dual deficiency of qi and blood, obstruction of phlegm and stasis, deficiency of qi and yin with residual toxins remaining, and deficiency of heart and kidney yin; after surgery, it is mostly due to deficiency of qi and blood. Anatomy, physiology, and pathology (---) Anatomy and physiology