2.1 Academic Thoughts of the Supervisor

2.1 Academic Thoughts of the Supervisor

Professor Pei Zhengxue, through in-depth study of traditional Chinese medicine, summarizing many years of clinical experience, and integrating modern medical understanding of aplastic anemia, has categorized the treatment of aplastic anemia as strengthening the spleen and kidneys, replenishing qi and nourishing blood, activating blood circulation and removing stasis, cooling the blood and stopping bleeding [14].

2.1.1 Strengthening the Spleen and Kidneys, Replenishing Qi and Nourishing Blood

"The Plain Questions · Discussion on Febrile Diseases" states: "Where evil gathers, qi must be deficient." "The Plain Questions · Discussion on Acupuncture Methods" says: "If righteous qi exists within, evil cannot invade." Righteous qi consists of kidney qi and middle qi; kidney qi is also called primordial qi, the foundation of innate qi; middle qi is also called qi of food and water, the foundation of acquired qi. The righteous qi formed by these two represents what modern medicine calls immunity, metabolism, endocrine system, autonomic nervous system, genetic factors, and so on.

Pei's Blood-Boosting Granules evolved from the "Lanzhou Formula" created by the supervisor, with four ginsengs as the main tonic for reinforcing and consolidating the body's foundation. Among qi-replenishing herbs, Taizishen is the first choice; Professor Pei says, "This herb has a mild taste but strong qi, and can enter the blood channels." Next are Jilin ginseng, Beisha shen, Dangshen, Huangqi, and others, which are also commonly used. However, Jilin ginseng is expensive, so ginseng roots can be used instead; Professor Pei says, "Roots have a sharp shape and strong qi, and can directly enter the blood channels." "Qi is the root of yang," so prolonged qi deficiency will inevitably lead to yang deficiency. Therefore, in qi-replenishing herbs, add yin-yang-enhancing herbs such as Yin Yang Huo, Po Gu Zi, and Tusi Zi, which complement each other well.

The kidneys are the foundation of innate qi and the root of primordial qi, and the important function of kidney essence is to promote the growth, development, and reproduction of the body. The kidneys govern the bones, generate marrow, and their vitality manifests in the hair. If kidney essence is insufficient, marrow cannot be produced, bones cannot be nourished, and marrow and blood share a common origin. When marrow is deficient, essence cannot regenerate blood, and Shudi, Shanyu, Shanyao, Danpi, and the Six-Flavor Rehmannia Decoction all carry the meaning of tonifying the kidneys and benefiting the blood. Moreover, large doses of Shanyu meat have been reported to improve bone marrow hematopoietic function, which proves the principle of "the kidneys govern the bones, the bones store marrow, and marrow and blood share a common origin."

The spleen is the foundation of acquired qi and the source of biochemical processes. "The Difficulty of the Yellow Emperor · Eighty-One Difficulties" says: "The middle burner receives qi, extracts the essence, and transforms it into red blood cells." "The Difficulty of the Yellow Emperor · Forty-Two Difficulties" says: "The spleen controls blood and warms the five viscera." Food entering the stomach must pass through the spleen's transformation process, extracting the essence of food and water to create qi, blood, and bodily fluids. If dietary imbalance or internal injury due to overwork occurs, it can lead to spleen deficiency, weakening its transformative function, and hindering the conversion of food and water into qi, blood, and bodily fluids. As a result, the zang-fu organs, meridians, and limbs lack sufficient nutrition and lose normal physiological functions, leading to symptoms of qi and blood deficiency such as dizziness, blurred vision, palpitations, shortness of breath, and fatigue. These discussions show that the generation and distribution of blood are closely related to the spleen. Professor Pei often uses Gui Pi, Si Jun Zi, and Baoyuan Tang as the first-choice formulas for strengthening the spleen and replenishing qi.

In addition, when the spleen is weak, it loses its ability to control blood, making bleeding very likely. In severe cases, clinical manifestations include hematemesis, hematochezia, hematuria, uterine bleeding, retinal bleeding, and intracranial hemorrhage. Weak spleen and stomach, with disrupted ascending and descending functions and weakened transformation abilities, can also lead to accumulation of pathological products such as phlegm and stasis in the body, resulting in darkened skin or bruising, persistent nosebleeds, dark purple bleeding, a dark purple tongue with stasis spots and patches, and a deep, thin, or rough pulse—signs of blood stasis. All of the above indicate that spleen deficiency is a major factor in aplastic anemia.

Research on Pei Zhengxue’s Series of Formulas and Medications

It is a crucial link. In treating blood diseases, Professor Pei has the concept of "the kidneys govern the bone marrow, while the spleen governs the extremities," because "bone marrow gradually forms in the womb, while blood in the extremities begins to develop after birth." Li Shizhen said, "Visible blood cannot rise quickly, but invisible qi must be urgently replenished." Dangshen, Maidong, and Wuweizi—the Shengmai San formula from the "Thousand Gold Prescriptions"—are famous prescriptions for replenishing qi and nourishing yin, and are often used to treat "aplastic anemia." Through long-term clinical practice, Professor Pei proposed the concept of "strengthening yang to raise white blood cells, nourishing yin to raise platelets, and replenishing qi and nourishing blood to raise red blood cells." "The Plain Questions · Great Treatise on the Correspondence of Yin and Yang" says, "Yang transforms into qi, while yin takes form," and Zhang Jingyue commented, "Yang moves and disperses, while yin remains still and condenses, thus taking form." From the functional attributes of white blood cells and platelets, white blood cells seem to belong to yang, while red blood cells and platelets seem to belong to yin. Those with prominent white blood cell deficiency often exhibit fatigue, lack of energy, and reluctance to speak; the method to boost them is to warm the kidneys and strengthen the spleen. Those with prominent red blood cell and platelet deficiency often exhibit dizziness, pale complexion, and bleeding; the method to address this is to replenish qi and nourish blood. According to this argument, the aforementioned clinical manifestations are basically consistent with this. In aplastic anemia, the former is often characterized by qi deficiency, so herbs like Huangqi, Fupian, and Rougui are used to replenish qi; the latter is often characterized by blood deficiency, so herbs like Shudi, Shouwu, and Nüzhenzi are used to nourish blood.

White Blood Cell-Raising Medications: Rougui, Fupian, Kusen, Dangshen, Po Gu Zi, Jixueteng, Huangqi, Xiyang Shen, Bajiao Huixiang

Platelet-Raising Medications: Yuzhu, Huangjing, Dazao, Shengdi, Ajiao, Lianqiao, Tudahuang, Guiban Jiao, Lujiao Jiao

Red Blood Cell-Raising Medications: Gui Pi Tang, Ren Shen Yang Rong Tang, Taizishen, Ginseng Roots, Dangshen, Huangqi, He Shou Wu, Shanyu Meat, Yuan Meat, Jixueteng, Nüzhenzi, Hanlian Cao