2. Prescription Composition and Adjustments

Composition: Dangshen 10 g, Huangqi 30 g, Baizhu 10 g, Gancao 6 g, Tudahuang 10 g, Huangqin 10 g, Huanglian 3 g, Zhi Rumei 3 g, Bailizi 60 g. Adjustments: For severe bleeding, add Xianhecao 10 g; for yin deficiency and internal heat, add Shengdi 12 g and Yuzhu 10 g; for fever and spontaneous sweating, add Shengshi 30 g; for lower back pain and tinnitus, add Shanyu 6 g; for palpitations and dizziness, add Yuanzhi 6 g and Xingren 15 g; for spontaneous sweating and aversion to cold, add Poguozi 10 g; for weak chi pulse, add Tusi Zi 10 g; for nosebleeds, add Quanlong Tang: Beishashen 15 g, Maidong 10 g, Yuzhu 15 g, Shihu 15 g, Danpi Tan 10 g, Chenzong Tan 10 g, Daji Tan 10 g, Bohe Tan 10 g, Huainiu Xi 20 g, Dahuang Tan 10 g, and Baimaogen Tan 10 g.

III. Treatment Effects

After taking the medication, all patients experienced varying degrees of improvement in subjective symptoms and bleeding manifestations such as purpura, with an effectiveness rate of 100%. Among them, 34 had platelet counts rising to above 50 × 10^9^/L (14 had counts above 100 × 10^9^/L). Except for two cases where platelet counts did not increase significantly (one of which saw a reduction in prednisone dosage without a corresponding drop in platelet count), the remaining effective cases all showed varying degrees of increase in platelet count. Of the 22 cases that improved after treatment, bone marrow examinations were performed, with 10 showing completely normalized bone marrow findings, 8 showing significant improvement, and 4 remaining roughly the same as before treatment. Among the 34 cases whose platelet counts rose to above 50 × 10^9^/L, 12 took fewer than 20 doses, 10 took between 20 and 40 doses, 5 took between 40 and 60 doses, and 7 took more than 60 doses.

IV. Discussion

Statistical analysis of the syndromes in this group of patients shows that, apart from purpura and bleeding symptoms, paleness, fatigue, dizziness, spontaneous sweating, pale tongue with thin coating, and fine pulse—all indicative of deficiency of middle qi—are the main manifestations of this disease. Therefore, the purpura and bleeding should be categorized under the TCM concept of “qi failing to control blood.” The “Spiritual Pivot·Decision Qi Chapter” states: “The middle jiao receives qi, extracts juice, and transforms it into red, which is called blood.” This indicates that “middle qi” is an important factor in blood production. As platelets are one of the formed elements of blood, their generation is naturally closely related to the rise and fall of “middle qi.” Therefore, the Shenqi Sanhuang Tang formula includes ingredients such as Dangshen, Baizhu, Huangqi, and Gancao, which tonify the middle qi and benefit qi. Qi is the commander of blood; if qi is deficient for a long time, blood will also become deficient. If qi is deficient for a long time, blood circulation will be impaired, leading to blood stasis. Deficient qi can cause fever, and blood stasis can also generate fire and fever, so patients often present with concurrent symptoms of excessive heat and fire, such as fatigue and spontaneous sweating with fever, palpitations and dizziness with irritability, or yellow tongue and constipation with high fever. Tang Rongchuan said: “The heart is the sovereign fire, generating blood; blood is the soul of fire, and fire is the soul of blood. When fire rises, blood rises; when fire falls, blood falls. Knowing that blood is born of fire and that fire resides in the heart, draining the heart is draining the fire, and draining the fire is stopping the bleeding.” (“Blood Evidence Theory,” Volume 7) Therefore, the formula includes Tudahuang, Huangqin, and Huanglian, embodying the principles of “draining the heart, draining the fire, and stopping the bleeding.” Baijili removes wind to control fire and harness its momentum, preventing wind and fire from escalating. Zhi Rumei dissolves stasis to cut off the source of stasis-related fire. Deficiency of middle qi often leads to yang deficiency and damp stagnation; among the patients in this group, many have greasy tongue coatings and slippery pulses. In addition to clearing fire and stopping bleeding, the Three Yellow herbs also have the effect of drying dampness. The Shenqi Sanhuang Tang treatment for idiopathic thrombocytopenic purpura achieves a 100% effectiveness rate in this group, indicating that the composition of the formula aligns with the disease mechanism. The combination of this disease and this formula forms a corresponding system of theory, method, and prescription. By examining the formula, we can further explore the TCM disease mechanisms of this condition, which include “qi failing to control blood,” “blood heat running rampant,” “blood deficiency and blood stasis,” and “yang deficiency and damp excess.” Some patients in this group still experience lower back pain and tinnitus, indicating that, in addition to middle qi deficiency as the root cause, long-term illness can also damage the kidneys. The kidneys govern bone marrow production and are also linked to platelet generation. Therefore, additions such as Shanyu, Tusi Zi, and Poguozi are often used to tonify the kidneys.

(“Research on Integrated Traditional Chinese and Western Medicine,” February 1995)

Introduction to Pei Zhengxue’s Experience in Treating Hepatitis B

Wu Bujing

Chief Physician Pei Zhengxue at Gansu Provincial Cancer Hospital has unique insights into the diagnosis and treatment of liver diseases. For hepatitis B, he has formulated a treatment principle of “soothing the liver and strengthening the spleen to address the root cause, clearing heat and draining fire to reduce enzyme levels, persevering consistently, and supporting righteous qi to treat the surface antigen.” Clinical practice has proven that the therapeutic effect is quite good.

I. Soothing the Liver and Strengthening the Spleen to Address the Root Cause

Clinically, patients with “hepatitis B” often present with symptoms such as bitter taste in the mouth and dry throat, pain in the right hypochondrium, irritability, distension and fullness in the epigastrium, poor appetite, fatigue, wiry and slippery pulse, and red tongue with thin, greasy coating—symptoms of liver-spleen disharmony. Spleen deficiency often appears early in liver disease, accompanied by bitter taste in the mouth, dry throat, irritability, and chest and flank discomfort—symptoms of liver qi stagnation—which may occur simultaneously or later. Liver qi stagnation leads to spleen deficiency, so liver qi stagnation is the root cause, while spleen deficiency is the manifestation. Treatment should combine soothing the liver and strengthening the spleen, with prescriptions such as Xiao Chaihu Tang and Xiaoyao San being commonly used. For those with severe flank pain, add Chuanlian, Yuanhu, and Zhi Rumei; for cirrhosis with ascites, add Biejia, Huangqi, Danshen, Shouwu, Huzhang, Dafupi, Cheqianzi, and Hulu Pi. For asymptomatic virus carriers, treatment focuses on strengthening the spleen and benefiting qi, aiming to achieve “strong spleen throughout the four seasons, immune to evil influences.”

[Case 1] Wang, female, 30 years old, worker. First visit on March 12, 1986. Five years ago, liver function tests revealed positive surface antigen, but due to mild symptoms, no attention was paid. In the past six months, she has felt fatigued, lost weight, had poor appetite and aversion to oil, abdominal distension, flank pain, bitter taste in the mouth and dry throat, irritability, gum bleeding, and menstrual irregularities. She has tried various Western and Chinese hepatoprotective medications, but none have worked. She came for consultation. Appearance: sallow, dull complexion, emaciation, no scleral jaundice, two spider nevi visible on the neck, abdominal distension, liver enlarged 4 cm below the xiphoid process and 2 cm below the ribs, medium hardness, mild tenderness, spleen palpable 2 cm below the ribs, mild edema in the lower limbs, dark red tongue, thin yellow and greasy coating, wiry, fine pulse. Laboratory tests: CPT 650 u, total plasma protein 7.2 g/dl, albumin 4 g/dl, globulin 3.2 g/dl, electrophoresis γ-globulin 24%, HBsAg 1:256, HBeAg (+), HBV-A-PDN (+). Western diagnosis: ① Viral hepatitis, chronic active hepatitis B, ② Early-stage cirrhosis. Syndrome: Liver wood overpowers spleen earth, liver qi stagnation and spleen deficiency, long-term illness affecting the meridians, qi stagnation and blood stasis causing flank pain. Treatment: Soothe the liver and strengthen the spleen, activate blood circulation and unblock the meridians, supplemented by nourishing yin and clearing heat. Prescription: Danzhi Xiaoyao San combined with Chaihu Shugan San with added ingredients; Danpi 10 g, Zhizi 6 g, Danggui 10 g, Baishao 15 g, Chaihu 10 g, Fuling 12 g, Baizhu 10 g, Zhishi 10 g, Chuanlian 6 g, Yuanhu 6 g, Zhi Rumei 3 g, Huangqi 30 g, Biejia 10 g, Huzhang 15 g, Banlan Gen 15 g. Decoct in water and take one dose daily. After 20 doses, flank pain significantly eased, appetite gradually improved, and gum bleeding disappeared. The original formula was adjusted by removing Danpi and Chuanlian, adding Danshen 30 g, and then taking another 20 doses. On June 28, the patient returned for follow-up, symptoms had disappeared, liver enlarged 2 cm below the xiphoid process, soft texture with no tenderness, HBsAg, HBeAg, and HBV-DNA-P all turned negative, and other symptoms were alleviated or disappeared.

II. Clearing Heat and Draining Fire to Reduce Enzyme Levels

Teacher Pei believes that elevated transaminase levels indicate “excess,” and TCM says: “When there is excess qi, there is fire.” Therefore, treatment should follow the “Inner Canon’s” principle of “reducing the excess” and use heat-clearing and detoxifying methods. In fact, most hepatitis B patients with elevated transaminase levels exhibit red tongue with yellow coating, wiry and slippery pulse, dry mouth and tongue, and dry stools—manifestations of heat toxicity. Accordingly, heat-clearing and detoxifying herbs such as Yin Hua, Lian Qiao, Pu Gong Ying, Bai Jiang Cao, Xia Ku Cao, Ban Lan Gen, and Long Dan Cao often prove effective.

[Case 2] Zhang, female, 32 years old, office worker. First visit on December 20, 1985. The patient began experiencing fatigue and poor appetite a year ago. Recently, she has had pain in the liver region, distension in the epigastrium, bitter taste in the mouth and dry throat, nausea and dizziness, occasional chills and fever, dry stools and yellow urine. Appearance: sallow complexion, soft abdomen, liver palpable 3 fingers below the xiphoid process. 2 fingers below the ribs, soft texture with slight tenderness, spleen palpable 2 fingers below the ribs, no edema in the lower limbs. Pulse wiry, slippery, and rapid, tongue red with thin, yellow and greasy coating. Laboratory tests: Jaundice index 8 u, ALT 580 u, HBsAg (+), HBeAg (+), anti-HBc (+), anti-HBe (+). Western diagnosis: Viral hepatitis, chronic active hepatitis B. Syndrome: Liver qi stagnation and spleen deficiency. Damp-heat obstruction. Heat toxicity infiltrating the body causing flank pain. Treatment: Soothe the liver and strengthen the spleen, with emphasis on heat-clearing and detoxifying agents to enhance the effect of reducing enzyme levels. Prescription: Modified Xiao Chaihu Tang: Chaihu 10 g, Banxia 6 g, Dangshen 10 g, Huangqin 10 g, Gancao 6 g, Shengjiang 6 g, Dazao 5 pieces, Gui Zi 10 g, Danshen 30 g, Ban Lan Gen 10 g, Qin Jiao 10 g, Yin Hua 15 g, Lian Qiao 15 g, Yin Chen 10 g, Huzhang 15 g, Pu Gong Ying 15 g, Bai Jiang Cao 15 g, Bai Jiang Cao 15 g, and others. After taking the prescription for 30 doses, liver function tests showed: jaundice index 4 u, ALT 85 u, HBsAg (-), HBeAg (-), anti-HBsAg (-). Symptoms basically disappeared. Switched to Hepatitis B No. 1, 30 packets for post-treatment care.

III. Perseverance in Treating the Surface Antigen

Clinically, treating chronic hepatitis B to turn the surface antigen negative is not particularly difficult. As long as doctors and patients work together and persevere, the therapeutic effect is quite satisfactory. Patients must adhere to long-term medication. Build confidence and support righteous qi. The “Inner Canon” says: “Where evil gathers, qi must be deficient,” and “Righteous qi resides within; evil cannot invade.” As long as righteous qi is properly nurtured, over time the surface antigen will naturally turn negative. According to statistics from the hepatitis B team led by Teacher Pei, which has treated 2,768 cases over the past five years, the rate of turning the surface antigen negative is 39.9% in the first year, 40% in the second year, and can reach 50% in the third year—sufficient evidence that perseverance pays off. The longer the medication is taken, the higher the rate of turning the surface antigen negative. Conversely, if medication is not taken consistently or confidence in treatment is lacking, the treatment will be abandoned halfway.

[Case 3] Liu, male, 27 years old, purchaser. First visit in early September 1986. The patient feels fatigued and has poor appetite. Bitter taste in the mouth and dry throat, occasional pain in the right hypochondrium, prone to catching colds. Tongue pale with thin white coating, pulse fine and wiry. Liver and spleen not palpable. Laboratory tests: HBsAg 1:256 and above, three systems: HBsAg (+), anti-HBc (+), HBeAg (-), anti-HBe (+), liver function normal. Considering the invasion of evil in Shaoyang, took Xiao Chaihu Tang with Huzhang, Yin Chen, Qin Jiao, Ban Lan Gen, etc., for over 100 days, subjective symptoms basically disappeared, only occasional fatigue. Upon checking, surface antigen ratio and three systems remained unchanged, tongue pale with thin coating and deep, fine pulse. Continued taking Hepatitis B No. 1, one packet morning and night, for three years. During this period, surface antigen ratio and three systems were checked three times, with no significant improvement. Teacher Pei ordered continued use of No. 1 for observation,

<!-- translated-chunk:47/57 -->

1990年8月检查：surface antigen (-), all indicators in the three-system examination were negative. This

case patient had taken medication for a total of 5 years starting from September 1986, and only then did the surface antigen and the three-system indicators turn

negative, which fully demonstrates the importance of perseverance in correcting the surface antigen and the three-system indicators.

(“Gansu Journal of Traditional Chinese Medicine,” 1992.1)

Analysis of Two Cases of Purpura Treated by Veteran TCM Physician Pei Zhengxue

Xue Wenhan, Li Min, Zhen Yufeng

Teacher Pei Zhengxue was recognized by the Ministry of Health in 1997 as one of the 500 renowned veteran TCM physicians nationwide. He is particularly skilled in treating difficult and complex cases. The following are two case reports of his treatment for purpura:

[Case 1] Ms. Sun, 11 years old. First visit on February 3, 1997.

After a cold, purpura appeared on both lower limbs, accompanied by pain in both knee joints, abdominal pain, and dry throat. Local hospitals administered hormone therapy without significant effect, so she came to our hospital for treatment. Examination revealed no abnormalities in the heart and lungs, no palpable liver or spleen, and clustered or scattered hemorrhagic spots visible on both lower limbs, most prominently on the medial side of the ankle joints, with bright red or dark purple color that did not blanch upon pressure. Tongue was red with thin yellow coating, pulse was floating and rapid. Laboratory tests showed platelet count at 228×10^9/L. Western medical diagnosis: allergic purpura. Teacher Pei believed this was caused by wind-heat invading the interior and blood heat running amok. Treatment should focus on clearing heat and detoxifying, cooling blood and dispelling wind. Prescription: Lonicera japonica 15g, Forsythia suspensa 15g, Rhizoma bolbostemmae 15g, Rehmannia glutinosa 12g, Fructus tribuli 10g, Tribulus terrestris 20g, Cortex dictamni 20g, Paeonia lactiflora 10g, Cicada slough 10g, Moutan cortex 10g, Saposhnikovia divaricata 12g, Smilax glabra 12g, Acorus tatarinowii 6g, Coptis chinensis 6g. Decocted in water and taken once daily, divided into multiple doses. After 10 days, purpura on both lower limbs decreased, abdominal pain disappeared, but knee joint pain persisted. Examination showed red tongue with thin yellow coating and string-like pulse. The original formula was adjusted by removing Acorus tatarinowii and Coptis chinensis, adding Aconitum carmichaelii 6g and Bupleurum chinense 10g. After another 20-odd doses, all symptoms disappeared.

Comment: “When wind and fire fan each other externally, it causes convulsions; when they fan each other internally, it forces blood to run amok.” Teacher Pei believes that allergic purpura falls under the category of wind and fire fanning internally, so treatment must emphasize both “clearing fire” and “dispelling wind” to achieve effective results. For clearing fire, use herbs that clear heat and drain fire, such as Lonicera japonica and Forsythia suspensa; for dispelling wind, use herbs that cool blood and dispel wind, such as Rehmannia glutinosa and Cicada slough.

[Case 2] Ms. Wang, 24 years old. Intermittent generalized purpura for 2 years, accompanied by epistaxis, poor appetite, fatigue, and menorrhagia. She visited in April 1995. Examination showed pale complexion and splenomegaly palpable below the ribs. Tongue was pale with thin white coating, pulse was slippery and rapid. There were dark purple hemorrhagic spots of varying sizes under the skin all over the body, especially on both lower limbs. Laboratory tests showed platelet count at 40×10^9/L. Western medical diagnosis: thrombocytopenic purpura. Teacher Pei believed this was caused by spleen failing to control the blood and deficient fire rising upward. Treatment focused on tonifying the spleen qi and clearing deficient fire. Prescription: Astragalus membranaceus 15g, Codonopsis pilosula 15g, Atractylodes macrocephala 10g, Coptis chinensis 3g, Phellodendron amurense 10g, Tribulus terrestris 20g, Rheum palmatum 15g, processed frankincense 3g, myrrh 3g, carbonized Moutan cortex 10g, carbonized blood residue 10g, Glycyrrhiza 6g. Decocted in water and taken once daily, divided into multiple doses. After more than 20 doses, purpura decreased, but fatigue and poor appetite persisted. Examination showed pale tongue with little coating and fine, rapid pulse. The original formula was adjusted by removing carbonized Moutan cortex and carbonized blood residue, adding Dioscorea opposita 12g and Dendrobium nobile 10g. After another 20-odd doses, all symptoms completely subsided, and laboratory tests showed platelet count at 80×10^9/L.

Comment: Teacher Pei believes that when qi is deficient and cannot control the blood, blood will overflow and stagnate; prolonged stagnation can generate fire, which can also force blood to run amok. This is the pathogenesis of primary thrombocytopenic purpura. Treatment must balance “strengthening the root” and “clearing fire,” while also resolving stasis and stopping bleeding. Strengthening the root involves using Codonopsis pilosula, Atractylodes macrocephala, and Astragalus membranaceus; clearing fire involves using Coptis chinensis, Scutellaria baicalensis, and Phellodendron amurense, supplemented by processed frankincense and myrrh to resolve stasis, and carbonized Moutan cortex and carbonized blood residue to stop bleeding. From these two cases, we can see that although both allergic purpura and thrombocytopenic purpura present with purpura as their clinical manifestation, their pathogenesis is entirely different: the former is a wind-heat syndrome characterized by blood heat running amok, while the latter is a qi-deficiency syndrome characterized by the spleen’s inability to control the blood. The former requires clearing, while the latter requires tonifying—treating the same disease differently can achieve effective results.

(“Journal of Traditional Chinese Medicine,” 1999.2)

Introduction to Teacher Pei Zhengxue’s Experience in Treating Liver Cirrhosis

Xue Wenhan

Teacher Pei Zhengxue is a renowned expert in integrated traditional Chinese and Western medicine, with liver diseases being one of his specialties. He has extensive experience in treating liver cirrhosis, which is summarized below.

I. Based on the fundamental pathogenesis of liver depression and spleen deficiency, establish the principle of soothing the liver and strengthening the spleen as the main therapeutic approach

Teacher Pei believes that liver cirrhosis may result from long-term invasion by pathogenic factors and stagnation of liver qi, or from dietary indiscretion and accumulation of damp-phlegm, both of which can lead to liver qi stagnation and qi-stagnation-blood-stasis syndrome. Clinical manifestations include bitter taste in the mouth, dry throat, fullness and distension in the chest and hypochondria, abdominal distension, hardening and enlargement of the liver, varicosity of abdominal wall veins, spider angiomas, palmar erythema, cyanotic tongue with ecchymoses, etc. On the other hand, liver depression can also invade the stomach horizontally, with liver wood overcoming earth, leading to symptoms such as fatigue, poor appetite, nausea, diarrhea, and a swollen tongue with tooth marks—indicating spleen-stomach deficiency. Since the spleen is responsible for transportation and transformation, if its function is impaired, qi and yang become deficient; when yang is deficient and water accumulates, ascites develops, and both lower limbs swell. As stated in “Essentials of Therapeutic Methods”: “Strong people have no accumulation, but weak people do.” Recent studies^①^ using modern statistical methods have also confirmed this point: the pathogenesis of liver cirrhosis according to TCM is predominantly liver depression and spleen deficiency. Therefore, the basic framework of the pathogenesis of liver cirrhosis consists of liver qi stagnation and spleen-stomach weakness, making the principle of soothing the liver and strengthening the spleen the main therapeutic approach. Teacher Pei has used modified Xiaoyao San to treat this condition, fully reflecting the aforementioned pathogenesis and achieving good clinical results. The composition of the formula is as follows: Moutan cortex 10g, Gardenia jasminoides 10g, Bupleurum chinense 10g, Paeonia lactiflora 10g, Angelica sinensis 10g, Atractylodes macrocephala 10g, Poria cocos 12g, Glycyrrhiza 6g, Astragalus membranaceus 30g, Salvia miltiorrhiza 30g, Rehmannia glutinosa 12g, Polygonatum odoratum 20g, Turtle shell 10g, Earthworm 10g, raw Rheum palmatum 3–6g. This formula treats both the liver and spleen, combines cold and heat, and balances attack and tonification. Through clinical adjustments and modifications, it has achieved good results in various complications of liver cirrhosis. Teacher Pei’s approach to treating liver cirrhosis originates from “If you see a disease of the liver, know that it will spread to the spleen” in “Jin Gui Yao Lue.” In this formula, Xiangsha Liu Junzi Tang is added as the basic prescription when the patient’s spleen-stomach deficiency is very prominent; if the deficiency is extremely severe, Xiangsha Liu Junzi Tang alone can be used for treatment. Regarding the prognosis of this disease, the thickness and color of the tongue coating can be used to observe the decline of stomach qi: if there is stomach qi, the prognosis is better; if there is no stomach qi, the prognosis is worse. In advanced stages of liver cirrhosis, if ascites and edema increase, it indicates that the pathogenesis has progressed from spleen-stomach qi deficiency to spleen-kidney yang deficiency, resulting in the worst prognosis.

II. Utilizing findings from modern medical research, emphasize promoting blood circulation and resolving stasis

While inheriting the experiences of predecessors, Teacher Pei actively incorporates new findings from modern medical research. Patients with liver cirrhosis不同程度地 exhibit hepatocyte degeneration and necrosis, proliferation of fibrous tissue, formation of pseudo-lobules, and deformation and hardening of the liver. From a TCM perspective, this is what is known as blood stasis syndrome. Treatment should therefore focus on this aspect and employ methods to promote blood circulation and resolve stasis. Teacher Pei’s basic formula for treating liver cirrhosis includes herbs such as Salvia miltiorrhiza, earthworm, and raw Rheum palmatum, which promote blood circulation and resolve stasis. Additionally, based on clinical manifestations such as splenomegaly and cyanotic tongue, he adds herbs like Curcuma wenyujin, Curcuma zedoaria, leech, Corydalis yanhusuo, Melia azedarach, and Prunus persica, among others. Modern research has confirmed that herbs like Salvia miltiorrhiza indeed promote hepatocyte regeneration^②^, as they can improve and even eliminate blood stasis in the liver by dilating blood vessels and increasing hepatic blood flow. Especially when the patient’s general condition is good, it is crucial to apply blood-circulation-promoting and stasis-resolving drugs without delay. It should be noted that long-term use of these drugs can irritate the gastrointestinal tract to some extent, and some patients do experience discomfort in the epigastric region, nausea, and poor appetite after taking them. In such cases, it is important to strike a balance between long-term and short-term effects, alternating with herbs that strengthen the spleen and stomach; however, blood-circulation-promoting and stasis-resolving treatments should never be abandoned, because only by promoting blood circulation and resolving stasis can the underlying blood stasis in the liver be fundamentally corrected, thus achieving long-term benefits. Clinically, we have indeed observed that most patients experience shrinking of the spleen, increased platelet counts, and improved blood stasis conditions through blood-circulation-promoting and stasis-resolving therapies.

III. Syndrome differentiation and individualized treatment, with adjustments made according to symptoms

Due to the complex and diverse clinical manifestations of this disease, treatment is not limited to a single formula or drug. Teacher Pei believes that if, after improvement in liver cirrhosis, ascites disappears and the patient’s nutritional status improves, yet right hypochondriac pain still occurs, it is often due to concurrent liver-gallbladder disease. In such cases, herbs that clear heat and detoxify, such as Artemisia capillaris, Gentiana scabra, Isatis tinctoria, Hedyotis diffusa, and Houttuynia cordata, can be added to the above formula as appropriate; for severe pain, Corydalis yanhusuo and Melia azedarach can be added. For liver cirrhosis complicated by massive ascites, add Plantago psyllium, Pericarpium citri reticulatae, Calabash peel, Stephania tetrandra, and Semen coptidis to the basic formula, or combine with Wuling San to enhance diuretic effects; alternatively, increase the dose of raw Rheum palmatum, and for patients with constipation, consider adding Glauber’s salt to induce bowel movements and increase fluid excretion through the intestines. For liver cirrhosis complicated by upper gastrointestinal bleeding, following the TCM understanding that “bleeding is mostly caused by fire—when fire is excessive, it forces blood to run amok; damage is mostly caused by qi—when qi is injured, blood has no way to be retained”—adopt methods to stop bleeding and clear fire, while also tonifying qi and reversing reverse flow. Commonly used remedies include Huangtu Tang combined with Rheum palmatum, Coptis chinensis, Pinellia ternata, Hematite, Codonopsis pilosula, and Atractylodes macrocephala, along with Western medicines for hemostasis, blood transfusion, and anti-infection treatment. For patients who develop hepatic coma, use Fuzi Lizhong Tang in combination; for those with persistent high fever, add Glauber’s salt, raw gypsum, and cold water stone to the basic formula; for those with bone-steaming and tidal heat, add turtle shell, tortoise plastron, and silver bupleurum; for anemia, heavily use Rheum palmatum; for thick and greasy tongue coating, add Coptis chinensis, Scutellaria baicalensis, and Phellodendron amurense, while removing Rehmannia glutinosa and turtle shell to avoid greasiness; for insomnia, add Longdan xie, fried jujube seeds, and night-blooming jasmine. For liver cirrhosis causing immune dysfunction and increased susceptibility to external infections, with symptoms such as generalized soreness, excessive sweating, or peripheral nerve damage that are difficult to cure after infection, use Xiao Chaihu Tang in combination, with optional additions of purslane and large green leaves as antiviral agents.

IV. Case examples

[Case 1] Patient Ms. Su, female, 52 years old, employee of Qilian Mountain Pharmaceutical Factory, hospitalization number: 8265. The patient came to our hospital seeking treatment for six months of abdominal distension accompanied by poor appetite, weight loss, fatigue, and sleep disturbances. Upon admission, the patient appeared listless and had a dark complexion; ultrasound showed: obvious shrinkage of the liver, spleen thickness of 5.5 cm, small amount of ascites; upper gastrointestinal barium meal showed esophageal varices; laboratory tests showed platelet count at 48×10^9/L, protein electrophoresis showed total protein at 62.3 g/L, albumin-to-globulin ratio at 1.4:1, gamma globulin at 24.5%, diagnosed as liver cirrhosis with ascites. Teacher Pei treated her by soothing the liver and strengthening the spleen, tonifying qi, and promoting blood circulation. The prescription was: Moutan cortex 10g, Gardenia jasminoides 10g, Bupleurum chinense 10g, Paeonia lactiflora 10g, Angelica sinensis 10g, Atractylodes macrocephala 10g, Poria cocos 12g, Astragalus membranaceus 30g, Polygonatum odoratum 20g, Salvia miltiorrhiza 30g, Curcuma wenyujin 10g, Curcuma zedoaria 6g, earthworm 6g, Alisma plantago-aquatica 10g, Houttuynia cordata 15g, Hedyotis diffusa 15g, Rehmannia glutinosa 10g, fried jujube seeds 15g, leech 6g (taken orally). After taking the above medicine for more than 40 doses, abdominal distension and other symptoms significantly alleviated, and appetite improved. However, after catching a cold, facial nerve paralysis, excessive sweating, and head-and-body pain occurred, so Teacher Pei switched to a method of harmonizing Shaoyang. The prescription was: Bupleurum chinense 10g, Scutellaria baicalensis 10g, Pinellia ternata 10g, Codonopsis pilosula 10g, Glycyrrhiza 6g, fresh ginger 4g, four jujubes, Astragalus membranaceus 30g, Salvia miltiorrhiza 30g, white Aconitum 10g, silkworm pupa 10g, whole scorpion 10g, Angelica sinensis 12g, Paeonia lactiflora 10g, Isatis tinctoria 15g, purslane 60g, snake-tongue grass 15g, Hedyotis diffusa 15g, Paeonia lactiflora 15g, and took the medicine for more than 10 days, completely eliminating the cold symptoms, basically correcting the facial asymmetry, and then continued with the original formula with adjustments for another 30-odd days, until all symptoms disappeared. Follow-up ultrasound showed normal liver size, spleen thickness of 4.9 cm, and laboratory tests showed platelet count at 124×10^9/L, protein electrophoresis showed total protein at 61.4 g/L, albumin-to-globulin ratio at 2.4:1, internal globulin at 19.8%, all returning to normal.

[Case 2] Patient Mr. Lei, male, 38 years old, farmer from Wushan County. The patient has a history of hepatitis B for more than 10 years and now presents with abdominal distension, bilateral lower limb edema accompanied by fatigue and dizziness, and has previously experienced black stools. Local hospitals provided liver-protective and diuretic treatments with no obvious effect, so he sought treatment from Teacher Pei. At the first visit, the patient exhibited jaundice throughout the body, deep red lips, emaciation, splenomegaly palpable at the midclavicular line 4 cm below the ribs, and positive ascites sign (+). Laboratory tests showed mild liver function impairment, HBsAg level at 128, platelet count at 34×10^9/L, total protein at 57.7%. Diagnosed as liver cirrhosis with ascites, treatment focused on soothing the liver and strengthening the spleen, promoting water metabolism, and supplementing with blood-circulation-promoting and stasis-resolving measures. The prescription was: Moutan cortex 10g, Gardenia jasminoides 10g, Bupleurum chinense 10g, Paeonia lactiflora 10g, Angelica sinensis 10g, Atractylodes macrocephala 10g, Poria cocos 12g, Astragalus membranaceus 30g, Salvia miltiorrhiza 30g, Rehmannia glutinosa 12g, earthworm 10g, turtle shell 10g, Stephania tetrandra 15g, Plantago psyllium 15g, Pericarpium citri reticulatae 15g, Calabash peel 15g, Stephania tetrandra 15g, Curcuma wenyujin 10g, Hedyotis diffusa 15g, Houttuynia cordata 15g, Paeonia lactiflora 15g, and raw Rheum palmatum 3g. After taking the above formula for more than 30 days, bilateral lower limb edema and ascites disappeared, but jaundice persisted, and right hypochondriac pain appeared, so the original formula was adjusted by adding Gentiana scabra and Isatis tinctoria, each 15g, and after another 20-odd days, jaundice and right hypochondriac pain lessened. Further adjustments were made for another 30-odd days, until clinical symptoms and ascites disappeared, and the spleen shrank back to normal. Laboratory tests showed platelet count at 63×10^9/L, albumin-to-globulin ratio at 1.5:1, gamma globulin at 24.9%, demonstrating significant efficacy.

Note: ① Zhao Yuqiu et al. Application of epidemiology in the study of clinical diagnostic criteria for liver diseases in TCM. Journal of Traditional Chinese Medicine, 1991, (3): 49

② Qin Wanzhang et al. Progress in research on blood stasis and blood-circulation-promoting and stasis-resolving methods. Journal of Traditional Chinese Medicine, 1980, (10): 75

(“Integrated Research on Traditional Chinese and Western Medicine,” 1995.1)

Pei’s “Lanzhou Formula” Combined with Chemotherapy Treatment

Observation of Efficacy in 100 Cancer Cases

Li Min, Xue Wenhan, Li Wei, Chen Ling, Zhang Taifeng, Wan Qiang

The “Lanzhou Formula” is a prescription formulated by Professor Pei Zhengxue, which was named the “Lanzhou Formula” at the 1973 Suzhou National Conference on Hematology due to its successful cure of one case of acute leukemia. Its composition includes: Rehmannia glutinosa, Dioscorea opposita, Cornus officinalis, Moutan cortex, Alisma plantago-aquatica, Poria cocos, Glehnia littoralis, Panax quinquefolius, Codonopsis pilosula, Sophora flavescens, Ginseng roots, Astragalus membranaceus, Atractylodes macrocephala, Angelica sinensis, Poria cocos, Floating wheat, Jujube, Ophiopogon japonicus, Schisandra chinensis, Glycyrrhiza, Fried jujube seeds, Polygala tenuifolia. Since 1993, we have applied Professor Pei’s “Lanzhou Formula” in combination with chemotherapy to treat 100 cancer patients, achieving significantly better efficacy compared to the chemotherapy-only control group, while also markedly reducing toxic side effects. The following is a report:

I. Clinical Data

A total of 150 hospitalized patients were divided into treatment and control groups, all of whom had been pathologically confirmed to have cancer. Among them were patients who had lost surgical opportunities for various reasons, those who refused surgery, or postoperative patients. They were randomly sampled and assigned to treatment and control groups. In the treatment group of 100 patients, there were 69 males and 31 females; ages ranged from 7 to 77, with a median age of 52; including 20 cases of lung cancer, 20 cases of gastric cancer, 12 cases of colon cancer, 12 cases of liver cancer, 10 cases of malignant lymphoma, 6 cases of esophageal cancer, 2 cases of acute lymphoblastic leukemia, 3 cases of chronic myelogenous leukemia, 5 cases of breast cancer, 4 cases of nasopharyngeal cancer, 3 cases of bladder cancer, 2 cases of pleural mesothelioma, and 1 case of left submandibular gland cancer. In the control group of 50 patients, there were 28 males and 22 females; ages ranged from 8 to 76, with a median age of 48; including 6 cases of lung cancer, 6 cases of gastric cancer, 5 cases of colon cancer, 4 cases of liver cancer, 4 cases of esophageal cancer, 4 cases of breast cancer, 3 cases of nasopharyngeal cancer, 3 cases of bladder cancer, 3 cases of malignant melanoma, 3 cases of pleural mesothelioma, 3 cases of gallbladder cancer, 3 cases of cervical cancer, and 3 cases of ovarian cancer.

II. Treatment Methods

Patients in the treatment group began receiving the “Lanzhou Formula” one week before chemotherapy, taking one dose daily, divided into two oral administrations, until the end of chemotherapy; the control group started chemotherapy directly. Treatment plans should be determined according to each patient’s specific diagnosis and pathological classification.

III. Treatment Results