Discussion

Discussion

Malignant tumors are currently one of the major diseases threatening human health. In recent years, people have paid increasing attention to research on malignant tumors. In addition to many insightful findings regarding the etiology and pathogenesis of malignant tumors, numerous effective new therapeutic approaches have also been developed. Currently, common treatments for malignant tumors include surgery, radiotherapy, chemotherapy, biological therapy, physical therapy, traditional Chinese medicine, and targeted therapy. Among these, chemotherapy remains one of the most important methods for treating malignant tumors [14]. Chemotherapy has become a relatively complete discipline in the field of anti-tumor treatment and has made irreplaceable contributions to humanity in this area. Whether used alone or in combination with surgery, radiotherapy, and immunotherapy, chemotherapy plays an important role in prolonging patients’ survival and improving their quality of life. Since the primary goal of chemotherapy is to inhibit or kill as many tumor cells as possible, almost all chemotherapeutic drugs inevitably have varying degrees of toxic side effects. This is because chemotherapeutic drugs lack selectivity between tumor cells and normal cells; while killing tumor cells, they also harm normal cells [15–16]. These toxic side effects can affect various systems in the body, including the heart, liver, kidneys, hair, skin, as well as the immune system, bone marrow hematopoiesis, and metabolic functions. It must also be emphasized that among the toxic side effects of chemotherapy, bone marrow suppression and weakened immune function are the most common. These side effects often lead to the failure of chemotherapy [17]. Traditional Chinese medicine has demonstrated clear efficacy in mitigating these side effects, and this effect is referred to as “reducing toxicity and enhancing efficacy.” In recent years, research on the role of traditional Chinese medicine in reducing toxicity and enhancing efficacy during chemotherapy for malignant tumors has attracted increasing attention worldwide. The design of this experiment aims to reveal the specific role of Pei’s Shengxue Granules in this regard.

In traditional Chinese medicine, the fundamental cause of disease is considered to be “internal deficiency of vital energy.” As stated in the “Discussion on Acupuncture Techniques” section of the “Plain Questions,” “When vital energy is present within the body, pathogenic factors cannot invade.” And in the “Discussion on Febrile Diseases,” it is said, “Wherever pathogenic factors gather, the qi must be deficient.” Although weak vital energy cannot resist the growth of pathogenic factors, it leads to imbalance of yin and yang in the body, dysfunction of the zang-fu organs and meridians, and the formation of syndromes such as qi stagnation, blood stasis, phlegm accumulation, dampness accumulation, heat accumulation, and toxin accumulation. The formation of tumors should therefore be a comprehensive result of these pathological mechanisms. Consequently, treatment solely through attacking methods is unlikely to be effective. Chemotherapy, in terms of its action, falls under the category of “attacking methods” in traditional Chinese medicine. Although it can kill tumor cells, it also causes serious damage to normal cells. These damages lead to symptoms such as nausea, vomiting, poor appetite, diarrhea, hair loss, and decreased white blood cell count. From the perspective of traditional Chinese medicine, these toxic side effects are clinical manifestations of further depletion of vital energy. If vital energy is not promptly protected, it will continue to be depleted, thereby promoting the spread and progression of tumors.

The body’s “vital energy” is also known as “true qi.” As stated in the “Chapter on True Qi and Pathogenic Factors” of the “Spiritual Pivot,” “True qi is what we receive from heaven, and it combines with the qi from food to nourish the body.” True qi encompasses both innate and acquired aspects. Throughout history, medical practitioners have attributed the innate aspect to the two kidneys, calling it “original qi”; and the acquired aspect to the spleen and stomach, calling it “middle qi” (food qi). The spleen governs middle qi, while the kidneys govern original qi. Therefore, in the principle of “strengthening vital energy and consolidating the root,” “strengthening the spleen” and “tonifying the kidneys” are the two most important components. The spleen and stomach are the source of qi and blood production. As stated in the “Chapter on Deciding Qi” of the “Spiritual Pivot,” “The middle jiao receives qi and extracts juice, which transforms into red blood, thus becoming blood.” The kidneys are the source of essence and blood, where the original yin and yang reside. The kidneys govern bones, and bones contain marrow, which shares the same origin as blood. The transformation of postnatal spleen earth depends on the warming influence of innate kidney yang; while the rise of innate true yang relies on the nourishment of postnatal spleen earth. This demonstrates that the spleen and kidneys complement each other and maintain the growth and development of bodily functions [18]. Modern medical research has proven that the “spleen” and “kidneys” in traditional Chinese medicine play important roles in the immune system, endocrine system, metabolic system, autonomic nervous system, and gastrointestinal–pancreatic endocrine system. Strengthening the spleen and tonifying the kidneys can work together to promote the vitality of the body’s vital energy, so “strengthening the spleen and tonifying the kidneys” can improve the functions of these systems and embodies the essence of the principle of strengthening vital energy and consolidating the root. The concept of "fu zheng gu ben," which aims to enhance and mobilize the body's disease-resistance capabilities, shares significant similarities with modern immunology [19–27]. In traditional Chinese medicine, "zheng qi" generally refers to the body's intrinsic disease-resistance capacity, which is analogous to the physiological functions of the human immune system. The immune system comprises two main categories: non-specific immunity and specific immunity. In TCM, "zhong qi" and "wei qi" bear resemblance to non-specific immunity in modern immunology, whereas "yuan qi" corresponds to specific immunity. Specific and non-specific immunity mutually reinforce each other to achieve the body's immune response, just as "zhong qi" and "yuan qi" work together to form the body's "zheng qi." Yuan qi, or kidney qi, encompasses both kidney yin and kidney yang, serving as the decisive factor for maintaining internal yin-yang balance. Modern experimental studies in TCM have demonstrated that what are referred to as kidney yin and kidney yang are, in essence, the functions of the hypothalamus–pituitary–adrenal cortex system. According to modern immunology, this system promotes adrenal cortical secretion via ACTH, thereby reducing and inhibiting immune responses; conversely, it also stimulates immune responses through growth hormone secreted by the pituitary gland [28]. Therefore, it is evident that "fu zheng gu ben" can regulate the body's immune function.

Professor Pei Zhengxue, a renowned expert in integrated Chinese and Western medicine in China and a mentor to many, has formulated the "Lanzhou Formula" based on his more than forty years of clinical experience. After over thirty years of continuous practice, refinement, and reorganization, this formula eventually evolved into "Pei's Blood-Boosting Granules." The formula incorporates northern ginseng, Lu Dangshen, Taizi Shen, and ginseng roots, comprehensively strengthening the spleen and benefiting qi, thus serving as a powerful tonic for postnatal vitality. It further combines Shengmai San to tonify qi and nourish the lungs, enhancing the spleen-tonifying and qi-benefiting effects of the four ginsengs and replenishing the source of qi and blood production. Additionally, the formula includes key components from "Liuwei Dihuang Tang" to tonify kidney qi, with a particularly high dosage of Cornus fruit (30 g) to significantly amplify its innate tonifying effect. Furthermore, "Guizhi Tang" is traditionally believed to "harmonize the exterior with Ying and Wei while calming the internal organs," but Professor Pei argues that this effect essentially stems from the formula's regulatory influence on the autonomic nervous system, metabolic system, endocrine system, and immune system. The addition of floating wheat, licorice, and jujubes forms the Ganmai Dazao Tang, a classic prescription used by ancient practitioners to effectively treat female depressive disorders. Professor Pei believes that, in Pei's Blood-Boosting Granules, Ganmai Dazao not only regulates the autonomic nervous system but also calms the mind, stabilizes emotions, and modulates cognitive function, thereby complementing the effects of other ingredients.

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