1. Chronic Bronchitis

1. Chronic Bronchitis

This disease is considered closely related to autoimmunity, and its pathogenesis involves both specific and non-specific abnormal immune responses. Traditional Chinese medicine refers to this condition as prolonged cough and wheezing cough, categorizing it as internal injury cough. Improper treatment of external pathogens can lead to internal injury cough. The disease is triggered by external factors, causing repeated exacerbations. Traditional Chinese medicine has long recognized that “the manifestation lies in the lungs, but the root lies in the spleen and kidneys.” The manifestation refers to symptoms, while the root refers to the underlying cause, indicating that treating the lungs is symptomatic therapy, whereas treating the spleen and kidneys addresses the root of the disease. Treating the spleen means strengthening middle qi and bolstering wei qi, which also enhances non-specific immunity. When applying this method to treat chronic bronchitis, it is traditionally called the “nurturing earth to generate metal” method, and formulas such as Liu Jun Zi Tang, Ping Wei San, Er Chen Tang, and Buzhong Yiqi Tang can all be used interchangeably. Treating the kidneys means warming and tonifying kidney qi and regulating yin and yang, which also adjusts specific immunity. When using this method to treat chronic bronchitis, traditional Chinese medicine calls it the “warming the kidneys to gather qi” method, and formulas such as Gui Fu Ba Wei Wan, Du Qi Wan, Ji Sheng Shen Qi Wan, and Mai Wei Di Huang Wan can all be used interchangeably. Over the years, based on the above principles, traditional Chinese medicine has employed syndrome differentiation and treatment, achieving good therapeutic effects in the prevention and treatment of chronic bronchitis. For example, the Xiyuan Hospital of the Beijing University of Traditional Chinese Medicine used Gu Ben Wan to treat this disease, with an efficacy rate as high as 95.5%. The formula consisted of Liu Jun Zi Tang, Yu Ping Feng San, Bu Gu Zhi, and Zi He Che combined, aiming to strengthen the spleen and benefit qi while warming the kidneys and tonifying them. To observe the effect of this formula on the immune response in chronic bronchitis, before and after a certain course of treatment, sputum lysozyme levels were measured in some cases, and the results showed that after treatment, patients’ sputum lysozyme levels increased (P<0.001), suggesting that Gu Ben Wan enhances the body’s non-specific humoral immunity. The Shaanxi Provincial Institute of Traditional Chinese Medicine used cinnamon and processed Aconite to tonify the kidneys, Atractylodes macrocephala and dried ginger to strengthen the spleen, supplemented by white mustard seeds, radish seeds, and perilla seeds to descend qi and eliminate phlegm, forming Tan Yin Wan to treat chronic bronchitis, achieving good results. This formula was proven by animal experiments conducted by the provincial chronic bronchitis basic research collaboration group to produce significantly higher agglutination titers in rabbits treated with Tan Yin Wan compared to the control group, indicating that Tan Yin Wan can enhance the body’s specific humoral immunity. The First Medical College of Shanghai and other institutions used raw Rehmannia, cooked Rehmannia, Polygonatum, golden orange, Epimedium, Cornus officinalis, and other kidney-tonifying herbs, combined with Atractylodes macrocephala, Chinese yam, and tangerine peel to strengthen the spleen, producing Wen Yang Pian to treat this disease, with an efficacy rate exceeding 95%. Immunological tests confirmed that patients treated with Wen Yang Pian showed significant increases in serum immunoglobulin IgG and IgA compared to before treatment, and some patients’ skin sensitivity tests turned from negative to positive, demonstrating that Wen Yang Pian, which strengthens the spleen and tonifies the kidneys, improves both specific and non-specific immunity.

2. Chronic Nephritis

The onset of this disease is often associated with dysregulation of the body’s immune stability function. Due to this dysregulation, the body loses its ability to distinguish between self and non-self, mistaking its own tissues for foreign substances and producing corresponding antibodies, leading to abnormal immune responses. Specifically, the body treats the glomerular basement membrane tissue as an antigen, producing antibodies that bind to the basement membrane, forming antigen-antibody complexes. Under the promotion of complement activation, inflammatory reactions occur, resulting in tissue damage in the renal parenchyma. This is an abnormal immune response dominated by specific immunity, but still involving non-specific immunity. Traditional Chinese medicine does not have a specific term for nephritis, but based on syndrome analysis, it falls under the category of edema. Zhang Jingyue of the Ming Dynasty said: “All cases of edema are diseases related to the spleen, lungs, and kidneys. Water is the ultimate yin, so its root lies in the kidneys; water transforms into qi, so its manifestation lies in the lungs; water fears earth, so its control lies in the spleen. Now, if the lungs are weak, water cannot transform into essence but turns into water; if the spleen is weak, earth cannot control water but instead overcomes it; if the kidneys are weak, water has no master and wanders aimlessly.” This shows that the manifestation of this disease lies in the lungs, the root lies in the kidneys, and the control lies in the spleen. Edema is further divided into yin water and yang water: the former is more related to the spleen and kidneys, characterized by deficiency and cold; the latter is more related to the lungs, characterized by excess and heat. Clinically, the latter is similar to acute nephritis, while the former is similar to chronic nephritis. Thus, the key pathological signs of chronic nephritis still lie in the spleen and kidneys. In treating this disease, traditional Chinese medicine uses Buzhong Yiqi Tang with modifications to strengthen the spleen, and Ji Sheng Shen Qi Wan with added ingredients to tonify the kidneys, which happens to be an effective measure for regulating both non-specific and specific immunity. In 1965, at the National Chronic Nephritis Symposium held by the Chinese Academy of Traditional Chinese Medicine, it was proposed to focus on the spleen-kidney pathogenesis for classification, dividing it into kidney-yang deficiency type and kidney-yin deficiency type. Liaoning College of Traditional Chinese Medicine, following this classification, treated 100 cases of chronic nephritis with dual tonification of the spleen and kidneys, achieving complete remission in 33 cases, basic remission in 13 cases, partial remission in 39 cases, with an overall efficacy rate of 85%. The 281st Hospital of the People’s Liberation Army reported that in the integrated treatment of chronic nephritis involving both traditional Chinese and Western medicine, 110 cases were treated, with traditional Chinese medicine mainly focusing on tonifying the kidneys and strengthening the spleen. Clinically, 67 cases were completely cured (60.9%), 15 cases were basically cured, and 17 cases improved, resulting in an overall efficacy rate of 90%. The 51st Hospital of the People’s Liberation Army used Codonopsis pilosula, Atractylodes macrocephala, Astragalus membranaceus, Chinese yam, and Poria cocos to strengthen the spleen, and cinnamon and processed Aconite to tonify the kidneys, combining with Western medicine to treat 14 cases of nephrotic syndrome. The results were 9 cases of complete remission, 4 cases of basic remission, and 1 case of significant improvement. The above data demonstrate that treating chronic nephritis with the method of strengthening the spleen and tonifying the kidneys can indeed achieve good therapeutic effects. Understanding this issue from the perspective of the immune-regulating effect of this method seems even more accurate.

3. Tumors

Recent research on malignant tumors suggests that disruption of the body’s immune function is one of the important factors leading to the development of this disease. Under normal circumstances, the immune surveillance system dominated by T cells dependent on the thymus can prevent cellular carcinogenic mutations and inhibit the occurrence and progression of malignant tumors. Therefore, insufficient T cell function and weakened immune surveillance are major factors in tumor formation. Traditional Chinese medicine believes that the key to the occurrence of this disease is deficiency of vital energy, as stated in “Yizong Bidi”: “Tumors form when vital energy is deficient, allowing pathogenic factors to take hold.” During the Song and Yuan dynasties, Zhang Yuan, Li Dongyuan, Luo Tianyi, and others all made similar statements about “nourishing vital energy to naturally eliminate accumulation.” In recent years, the use of Fu Zheng therapy to treat tumors has achieved remarkable therapeutic effects. For example, Longhua Hospital affiliated with Shanghai University of Traditional Chinese Medicine primarily strengthened the spleen and benefited qi, supplemented by tonifying the kidneys, to treat a patient with advanced liver cancer. After two months of ineffective chemotherapy with Western medicine, traditional Chinese medicine was administered, resulting in improved appetite, renewed spirits, increased urine output, and disappearance of ascites after three months, leading to discharge. Another case involved treating a patient with advanced breast cancer, primarily using warming and tonifying the kidneys, supplemented by strengthening the spleen and benefiting qi. After various chemotherapies proved ineffective, traditional Chinese medicine was used to activate blood circulation, dissolve stasis, reduce swelling, and disperse nodules. Although there was some minor effect, the condition worsened after six months, and through syndrome differentiation, it was determined that the patient suffered from both spleen and kidney deficiency, so the treatment was changed to warming the kidneys and tonifying the spleen while strengthening qi. Four months later, the tumor disappeared. Beijing Municipal Hospital of Traditional Chinese Medicine used warming and tonifying the kidneys to treat a patient who experienced recurrence after spinal cord tumor surgery. The patient had lower limb paralysis and bowel/bladder dysfunction. After taking 24 doses of Di Huang Yin Zi and Cistanche pill with added ingredients, the patient was able to get out of bed and walk along the wall. Subsequently, the original formula was supplemented with 50 grams of Ligustrum lucidum, combined with Huo Liao Wan, which has the effect of benefiting qi and expelling evil, and after one month, the patient could walk 1 kilometer with a cane and 50 meters without it. After continuing to take the original formula for two more months, the patient independently went to the outpatient clinic for follow-up visits, without using a cane, with stable gait and controlled bowel/bladder functions. Then, the original formula was supplemented with 50 grams each of Gusuibu and Luoshiteng, taken every other day or every third day, and after four months, the patient’s physical strength recovered, walking and squatting became effortless, and the patient began working. The Chinese Academy of Traditional Chinese Medicine used the six-herb formula Liu Wei Di Huang Wan to treat 30 cases of severe hyperplasia of esophageal epithelial cells, achieving an improvement rate of 86.7% after one year of medication. Longhua Hospital affiliated with Shanghai University of Traditional Chinese Medicine, in order to explore the relationship between deficiency syndromes and the body’s immune function, conducted macrophage phagocytic activity tests, lymphocyte transformation tests, and rose flower ring tests on some lung cancer patients. The results showed that all three immune indicators in lung cancer patients were generally lower than those of healthy individuals. However, through syndrome differentiation and treatment, using Fu Zheng Pei Ben, strengthening the spleen and benefiting qi, and tonifying the kidneys and warming the yang, all indicators showed increases. Comparing pre- and post-treatment test results, all differences were statistically significant (P<0.01), indicating that Fu Zheng Pei Ben has a regulatory effect on both specific and non-specific immunity in lung cancer patients.

4. Leukemia

With the advancement of immunological research, leukemia is increasingly considered closely related to immune responses. Many experiments have shown that the immune function of leukemia patients is lower than that of healthy individuals, which is an important factor in the formation of this disease. From the perspective of traditional Chinese medicine, discussions similar to leukemia are often scattered across syndromes such as deficiency fatigue, consumption, blood disorders, and warm diseases. “Ling Shu · Hai Lun” states: “If the marrow sea is insufficient, the brain will spin, ears will ring, legs will ache, dizziness will occur, eyes will lose sight, and one will feel lazy and want to lie down.” “Jin Gui Yao Lue · Xu Lao Pian” says: “If a man’s complexion is pale, he will suffer from thirst and blood loss, sudden shortness of breath and palpitations, and his pulse will be floating, indicating internal deficiency.” “Ming Yi Za Zhu” notes: “Around the age of twenty, men who damage their essence and blood will inevitably develop symptoms of yin deficiency and fire excess. Night sweats, afternoon fever, sticky phlegm and cough, fatigue and weakness, poor appetite, and in severe cases, phlegm mixed with blood, vomiting blood, or coughing up blood, spitting blood, or nosebleeds, with a deep and rapid pulse and emaciation—this is called consumption, and it is the most difficult to treat.” From the above similar syndromes to leukemia, it can be seen that this disease is primarily a deficiency syndrome. Qin Bowei believes: “Overall, leukemia is a deficiency syndrome. Although it sometimes gets infected by external pathogens, it should not be treated as a general excess or external pathogen syndrome.” Yan Dexin believes: “This disease is a deficiency syndrome. Although it sometimes presents with symptoms of phlegm heat, warmth, or blood stasis, it changes very quickly. In fact, it is caused by deficiency, making it a syndrome of fundamental deficiency and superficial excess.” These views are consistent with the Western medical understanding that low immune function leads to disease. According to the theory that the kidneys govern bones and produce bone marrow, this disease is related to kidney deficiency. According to the theory that the middle jiao transforms qi into juice, which becomes blood, this disease is related to the spleen. In recent years, various regions have adopted the method of strengthening the spleen and tonifying the kidneys to treat this disease, with increasing success. Gu et al. used Buzhong Yiqi

V. Conclusion

The above discussion has explored the relationship between Fu Zheng Pei Ben and immunity. Based on existing data, the following conclusions can be drawn:

1. Fu Zheng Pei Ben therapy can enhance the body’s immune efficiency and improve immune responses.
2. Traditional Chinese medicine’s concepts of middle qi and wei qi bear similarities to modern immunology’s non-specific immunity, while kidney qi is analogous to specific immunity.
3. Specific immunity and non-specific immunity mutually promote each other to achieve the body’s immune function, and middle qi and kidney qi also mutually promote each other to form the body’s vital energy.
4. Existing domestic data include reports that Astragalus membranaceus can improve specific immune indicators. Further research is needed to determine whether this effect is due to direct action on the specific immune mechanism or indirect action through the non-specific immune pathway that subsequently promotes the specific immune mechanism. This remains to be further discussed.

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Section 9: Theory and Practice of Activating Blood Circulation and Dissolving Stasis

Activating blood circulation and dissolving stasis is an extremely important component of the traditional Chinese medicine treatment system. The clinical application of this therapeutic method is not only effective for common ailments but also often achieves remarkable results in treating difficult and complex conditions that remain unresolved by modern medicine. Therefore, research and discussion on this issue have attracted widespread attention from the modern medical community. Pei Zhengxue begins by discussing the traditional understanding of “activating blood circulation and dissolving stasis” in traditional Chinese medicine, and then, combining it with modern experimental research findings, provides a concise overview of this topic.

I. Overview

“The Plain Questions · Discussion on Bi” states: “When a disease persists for a long time and penetrates deeply, the flow of Ying and Wei qi becomes sluggish, the meridians become blocked, and thus, blockage occurs.” It also says: “Bi refers to stagnation of blood in the vessels, preventing its normal flow.” The “Plain Questions” also mentions treatment methods such as “draining blood stasis when it is solid” and “dispersing clots when they form.” Medical bamboo slips unearthed from the Han tomb in Wuwei also reveal prescriptions for activating blood circulation and dissolving stasis. This may be the earliest record in traditional Chinese medicine regarding blood stasis syndrome. Later, in the 3rd century, the renowned internal medicine physician Zhang Zhongjing introduced the concepts of “accumulated blood,” “blood stasis,” and “dry blood” in his works “Shanghan Lun” and “Jin Gui Yao Lue.” Generally, accumulated blood refers to blood heat accumulating in the bladder, as described in “Shanghan Lun”: “When heat accumulates in the bladder, the person becomes狂-like, blood flows out on its own, and those who experience this are cured. Those whose external symptoms are not resolved yet should first address the external issues. Once the external symptoms are resolved, but the lower abdomen remains tightly contracted, then it is appropriate to attack the internal problem, using Tao Ren Cheng Qi Tang.” As for blood stasis, it refers to blood pooling in the organs, meridians, muscles, and skin, as stated in “Jin Gui Yao Lue”: “Patients with abdominal distension, drooping lips, bluish tongue, dry mouth, but wanting to rinse their mouths rather than swallow, no fever or chills, with a weak and slow pulse; those without abdominal distension, but claiming to feel full, likely have blood stasis.” Dry blood, as described in “Jin Gui Yao Lue,” refers to “darkened eyes, rough and cracked skin, with dry blood inside.” All these conditions were treated by Zhang Zhongjing using the principle of activating blood circulation and dissolving stasis, employing formulas such as Xia Yu Xue Tang, Bie Jia Jian Wan, Gui Zhi Fu Ling Wan, and Tao He Cheng Qi Tang. Due to their reliable efficacy and rigorous formulation, these formulas remain representative prescriptions for activating blood circulation and dissolving stasis even today. These discussions laid a solid foundation for the formation of the traditional Chinese medicine principle of activating blood circulation and dissolving stasis. Subsequently, generations of scholars such as Chao Yuanfang, Sun Simiao, Wang Kentang, Wang Tao, and Li Shizhen all made certain contributions to the development of this principle. Li Shizhen dedicated a special chapter on blood-stasis medicines in “Ben Cao Gang Mu,” listing 150 types of blood-dispersing and blood-breaking herbs, making the application of blood-activating and stasis-dissolving medicines more comprehensive. During the Qing dynasty, with the development of the theory of blood stasis, the application of this principle became even more widespread. Wang Qingren’s “Medical Forest Correction” summarized more than 50 types of blood-stasis syndromes and formulated 33 prescriptions for activating blood circulation and dissolving stasis, unifying the theory, methods, formulas, and medicines for this purpose. The new prescriptions formulated by Wang were mostly reliable, sparking public interest in researching the principle of activating blood circulation and dissolving stasis. Later, Tang Zonghai from Peng County, Sichuan, wrote “Discussion on Blood Disorders,” which, although focused on blood disorders, contained insightful discussions on blood stasis and the principle of activating blood circulation and dissolving stasis, such as “Therefore, in all cases of blood disorders, removing stasis is paramount” and “If old blood is not removed, new blood cannot develop normally.” These arguments provided excellent guidance for clinical practice. In recent years, with the vigorous development of integrated Chinese-Western medicine research, experimental studies on activating blood circulation and dissolving stasis have been widely carried out across the country. Cities such as Beijing, Shanghai, Chengdu, and Xi’an have all established specialized research institutions for this field, while Guangzhou and Shanghai have also hosted specialized training courses on activating blood circulation and dissolving stasis. The General Logistics Department of the Chinese People’s Liberation Army even organized two three-month specialized training courses on activating blood circulation and dissolving stasis in Guangzhou in 1978–1979, cultivating a group of core personnel for research in this area. Currently, research on activating blood circulation and dissolving stasis is advancing to new depths and widths, representing an important aspect of current integrated Chinese-Western medicine research.

II. Clinical Research on Activating Blood Circulation and Dissolving Stasis