II. Treatment with Traditional Chinese Medicine for Detoxification and Efficacy Enhancement

II. Treatment with Traditional Chinese Medicine for Detoxification and Efficacy Enhancement

During the postoperative radiotherapy and chemotherapy period for gastric cancer patients, combining treatment with traditional Chinese medicine can achieve the goals of detoxification and efficacy enhancement. The toxicity of radiotherapy and chemotherapy primarily affects the digestive system, with symptoms such as nausea, vomiting, abdominal distension, and poor appetite. Subsequently, suppression of hematopoietic function gradually occurs; as the three blood systems (red blood cell system, white blood cell system, and platelet system) decrease, patients may experience pallor, exhaustion, bleeding, and a series of other symptoms. Some patients may also exhibit clinical manifestations of damage to the heart, liver, kidneys, and other organs.

(1) Spleen-Stomach Qi Deficiency Type

① Symptoms: Fatigue and shortness of breath, dizziness and blurred vision, palpitations and forgetfulness, insomnia and frequent dreams, fullness and distension in the epigastric region, loss of appetite, bland taste or sour regurgitation, loose or constipated stools, greasy tongue coating, and a deep, weak pulse.

② Treatment Principle: Tonify qi and harmonize the stomach, with aromatic herbs to invigorate the spleen.

③ Prescription: Modified Baohe Wan. Ingredients include 20g of Astragalus, 15g each of Northern and Southern Ophiopogon, 10g of Citrus Peel, 10g of Pinellia, 10g of Buddha's Hand, 10g of Magnolia Bark, 10g of Amomum, 10g of Cardamom, 10g of Agastache, 10g of Eupatorium, 10g of Polygonatum, 10g of Chicken Gizzard, 30g each of Charred Shen, 6g of Licorice. Decoct twice, mix well, and take in multiple doses throughout the day, one dose per day.

(2) Heart-Spleen Deficiency Type

① Symptoms: Palpitations, shortness of breath, fatigue, dizziness, poor appetite, pale complexion, disturbed sleep, pale tongue with tooth marks, thin white coating, and a fine, weak pulse. ② Treatment Principle: Tonify the heart and spleen, nourish the blood, and calm the spirit. ③ Prescription: Modified Guipi Tang or Bazhen Tang. Ingredients include 10g of Ginseng, 30g of Astragalus, 15g of Atractylodes, 15g of Angelica, 10g of Poria, 15g of Donkey-hide Gelatin (melted), 15g of Rehmannia, 10g of Chuanxiong, 30g of Ziziphus Jujuba, 4 dates, 10g of Polygala, 10g of Agarwood, 10g of Citrus Peel, and 6g of Licorice. Decoct twice, mix well, and take in three doses daily, one dose per day.

(3) Liver-Kidney Yin Deficiency Type

① Symptoms: Dizziness, tinnitus, soreness in the lower back and knees, heat in the palms and soles, insomnia and frequent dreams, a slightly red or scanty tongue coating, and a fine, rapid pulse. ② Treatment Principle: Nourish yin and cool the blood, tonify the liver and kidneys. ③ Prescription: Modified Lanzhou Formula (Professor Pei Zhengxue’s empirical formula). Ingredients include 15g of Hangzhou White Peony, 15g of Rehmannia, 10g of Cornus Fruit, 10g of Moutan Bark, 10g of Poria, 10g of Alisma, 15g of Ginseng Root, 15g of Prince Ginseng, 15g of Northern Ophiopogon, 15g of Ophiopogon, 6g of Schisandra, 30g of Floating Wheat, 6g of Honey-fried Licorice, 4 dates, and 15g each of Raw Dragon and Oyster Shell. Decoct twice, mix well, and take in three doses daily, one dose per day.

(4) Spleen-Kidney Yang Deficiency Type

① Symptoms: Fatigue and weakness, pale complexion, aversion to cold and cold limbs, poor appetite, loose stools, soreness in the lower back and knees, a pale and swollen tongue, thin white coating, and a fine, slow pulse. ② Treatment Principle: Warm and tonify the spleen and stomach, replenish qi and fill essence. ③ Prescription: Modified Yougui Yin. Ingredients include 15g of Rehmannia, 15g of Yam, 10g of Cornus Fruit, 10g of Cinnamon, 10g of Prepared Aconite, 10g of Goji Berries, 10g of Eucommia, 10g of Psoralea, 10g of Dodder Seed, 15g of Angelica, 30g of Astragalus, and 5g of Licorice. Decoct twice, mix well, and take in three doses daily, one dose per day.

In addition to the above four syndrome differentiation types, the following patent medicines and single prescriptions can also be used in combination.

64 Integrated Western and Traditional Chinese Medicine Treatment for Epigastric Pain

① Liuwei Dihuang Oral Liquid. Take 10ml each time, three times a day, orally. It has a good protective effect on the hematopoietic system. ② Shengbai Tablets. Made from 30g of Psoralea, 15g each of Epimedium and Placenta Powder, 60g of Ligustrum, 75g of Cornus Fruit, 60g of Millettia, 9g of Notoginseng Powder, and 30g of Polygonum cuspidatum. Formulated into tablets, each containing 1.85g of crude drug, take 5 tablets each time, three times a day. ③ Shengxue Soup. Use 30g each of Astragalus, Prince Ginseng, and Millettia, 10g each of Atractylodes and Poria, 15g each of Goji Berries, Ligustrum, and Dodder Seed, take one dose daily, morning and evening, for a 6-week course. When combined with chemotherapy, blood cell counts do not decline, and platelet counts even increase. ④ Zhenqi Fuzheng Capsules (powder form). Take 4 capsules each time, three times a day, orally, for a 6-week course.

Clinically, when treating bone marrow suppression, the following drugs are often chosen: Astragalus, Codonopsis, Polygonatum, Rehmannia, Angelica, White Peony, Longan Meat, Donkey-hide Gelatin, Deer Antler Gelatin, Turtle Shell Gelatin, Millettia, Goji Berries, Purple River Carriage, Ligustrum, He Shou Wu, and others.

Section 4: Traditional Chinese Medicine Treatment

In the literature of traditional Chinese medicine, there are terms such as "epigastric pain," "dysphagia," "regurgitation," and "stomach and abdominal fullness." From the perspective of modern medicine, all these are related to gastric cancer, especially the descriptions of "dysphagia" and "regurgitation," which are very similar to the symptoms of cardia cancer and pyloric obstruction. For example, in "Suwen·Zhi Zhen Yao Da Lun," it is recorded: "The epigastric region hurts right in the center, radiating to both sides of the ribs; in severe cases, there is vomiting and difficulty swallowing." In "Jingyue Quanshu," it is stated: "The symptom of dysphagia must be caused by excessive worry, overwork, or excessive indulgence in alcohol and sex, leading to damage. Excessive worry causes qi stagnation, which prevents proper digestion; excessive indulgence in alcohol and sex damages yin, leading to depletion of essence and blood; when qi cannot flow properly, dysphagia occurs in the upper part, and when essence and blood are depleted, dryness and blockage occur in the lower part." In "Waitai Mi Yao," it is said: "When both nutritive and defensive qi are deficient, and there is insufficient qi and blood, water accumulates in the stomach, causing coldness in the stomach. With coldness, the spleen does not function properly, and undigested food remains stagnant, leading to reverse flow of qi and stomach problems. Thus, one eats in the morning and vomits in the evening, or eats in the evening and vomits in the morning, with a heavy feeling in the stomach like a cup, alternating chills and fever, and in severe cases, vomiting after eating." After nearly half a century of continuous exploration by clinical practitioners of traditional Chinese medicine, current understanding of the etiology, pathogenesis, and syndrome differentiation of gastric cancer has basically reached consensus. It is believed that gastric cancer is a local manifestation of a systemic disease affecting the whole body. It is caused by long-term dietary indiscretion, emotional imbalance, internal injury from overwork, or exposure to external pathogenic factors, leading to an imbalance of yin and yang in the body.

Chapter 5 Gastric Cancer 65

This imbalance leads to dysfunction of the zang-fu organs and meridians, resulting in a series of pathological changes such as food stagnation, qi stagnation, blood stasis, phlegm accumulation, and internal accumulation of pathogenic factors. Ultimately, this leads to the formation of masses and tumors. Professor Qian Bowen, a renowned expert in traditional Chinese oncology in China, pointed out that qi stagnation is an important factor in inducing gastric cancer. Many patients before onset have long-term depression and sorrow, or have suffered setbacks without relief, leading to liver qi stagnation. Therefore, the progression of gastric cancer can roughly be divided into three stages: initially, it is often caused by emotional frustration, liver qi stagnation, or dietary indiscretion, damaging the spleen and stomach, leading to disharmony between the liver and stomach and qi stagnation in the spleen and stomach. At this stage, the condition is relatively mild. As it progresses, it becomes liver qi stagnation, with qi unable to disperse and blocked in the blood vessels, leading to blood stasis, phlegm and blood stasis intertwining, gradually forming masses. This is the second stage. If treatment is not timely or incorrect at this stage, the condition drags on, eventually depleting yang qi, causing qi and blood to become intertwined, disrupting the balance between the spleen and stomach, and leaving no source for qi and blood production, resulting in qi and blood deficiency. On the other hand, since new blood is not produced and old blood is not eliminated, masses form, worsening the condition, and patients often seek medical treatment at this stage. Patients suffer from severe qi and blood deficiency, weak spleen and stomach, and also have real pathogenic factors such as phlegm and blood stasis, creating a situation where deficiency coexists with pathogenic factors, making treatment difficult. Treating pathogenic factors risks harming righteous qi, while strengthening righteous qi may block the path for pathogenic factors. Therefore, it is crucial to carefully balance the benefits and drawbacks of strengthening righteous qi and eliminating pathogenic factors.

I. Syndrome Differentiation Treatment