3. Toxic Side Effects See Table 2. | | | |

Table 2 Comparison of Toxic Side Effects Between the Two Groups | Number of Cases Nausea and Vomiting | Hair Loss | Proteinuria | Cardiac Toxicity | White Blood Cell Decrease Treatment Group | 100 | 15 | 20 | 15 | 15 | 25

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Control group | 50 | 30 | 25 | 31 | 27 | 45 P<0.01

IV. Reflections

In the treatment of cancer, tonifying the body is an indispensable and important step. This is because all cancer patients have a weakened immune system. As stated in "The Orthodoxy of Surgery": "The accumulation of disease is due to deficiency of vital energy." Chemotherapy drugs are highly cytotoxic; they can inhibit cell division and proliferation from various angles or directly damage DNA synthesis in cells. However, these drugs lack selectivity: while killing tumor cells, they also harm normal human tissues, further weakening the already fragile immune system. Therefore, although chemotherapy alone can temporarily suppress tumor cells, the negative effects it has on multiple systems, including the immune system, far outweigh its therapeutic benefits. Based on the clinical case analysis in this group, there was a significant difference in short-term efficacy between the treatment group and the control group (P<0.05); and a highly significant difference in terms of toxic side effects (P<0.01). Thus, the "Lanzhou Formula" plays a crucial role in strengthening the body, reducing the toxic side effects of chemotherapy, and enhancing its effectiveness, providing a new approach and method for comprehensive cancer treatment in the future.

("National Medicine Forum," 1998, Supplement)

Chief Physician Pei Zhengxue's Treatment

Preliminary Exploration of Clinical Experience in Treating Cirrhotic Ascites

Wu Jianmin

Chief Physician Pei Zhengxue has been engaged in research on the integration of traditional Chinese and Western medicine for over 30 years. Through long-term clinical practice, he proposed the sixteen-character guideline of "Western diagnosis, TCM syndrome differentiation, primarily using Chinese herbs, supplemented by Western medicines," which has been widely applied in clinical practice to treat difficult and complex cases. During my internship from April to June this spring, I witnessed firsthand how he flexibly applied the integrated approach of TCM and Western medicine to treat numerous critically ill patients with unexpected results, greatly benefiting me. Here, I would like to briefly discuss his treatment of cirrhotic ascites.

Dr. Pei believes that cirrhotic ascites is a chronic progressive liver disease caused by multiple factors. It may develop from chronic hepatitis, or result from long-term alcohol consumption, schistosomiasis infection, metabolic disorders, and other causes. Clinically, the main manifestations include liver function impairment, splenomegaly and ascites caused by portal hypertension, as well as dilated abdominal wall veins. In TCM, this condition falls under the categories of "zhengjia," "jiju," "huangdan," and "guzhang." It arises from stagnation of liver qi, where liver wood overcomes earth, leading to damp-heat accumulation. Over time, this results in qi stagnation and blood stasis, along with deficiency of both spleen and kidney, causing internal retention of water and dampness, ultimately leading to the intermingling of qi, blood, and water, which then affects the kidneys, resulting in a pattern of deficiency at the root and excess at the surface, with mutual interference.

Dr. Pei emphasizes that treating this condition requires careful analysis of the etiology, pathogenesis, and syndrome, and applying treatment accordingly. In addition to symptomatic treatment with Western medicines, the primary approach is TCM syndrome differentiation and treatment, aiming to address the root cause. For example, for the type characterized by liver depression and spleen deficiency, use Xiaoyao San with modifications to soothe the liver and strengthen the spleen; for the type characterized by qi stagnation and blood stasis, use Gexia Zhuyu Tang with modifications to invigorate blood circulation, regulate qi flow, and relieve pain. For the type characterized by spleen-kidney yang deficiency, use Zhenwu Tang combined with Danzhi Xiaoyao San with modifications to warm the kidneys, strengthen the spleen, and promote diuresis. For severe ascites, add Wupi Yin; for obvious hepatomegaly, add Sanleng and Eshu to activate blood circulation and eliminate stasis; for severe pain in the liver region, add Shixiao San and Jinlingzi San to invigorate blood circulation and relieve pain. Moreover, Dr. Pei stresses that when treating diseases through the integration of TCM and Western medicine, one must combine TCM’s macroscopic syndrome differentiation with Western medicine’s microscopic data for better treatment outcomes. For instance, if alanine aminotransferase levels are elevated in liver function tests, it indicates an increase in serum transaminase levels, which is considered "excess." Conversely, if globulin levels are elevated, it suggests a decrease in serum protein, which is considered "deficiency." As stated in the "Inner Canon of Medicine": "Treat excess conditions by reducing them, and supplement deficiencies." Therefore, to lower alanine aminotransferase levels, one should appropriately add Qingre Jiedu herbs such as Erhua, Lianqiao, Gongying, Baijiang, Banlangen, Xiangkucao, and Sheshicao; whereas to normalize globulin levels and reduce globulin levels, one should use Huangqi, Shouwu, Dangshen, and Danggui to tonify the body and strengthen the foundation, thus achieving better therapeutic effects.

Typical Cases:

[Case 1] Zhang, female, 60 years old, worker, came to our hospital for treatment on April 20, 1992. She reported that two years earlier, after a cold that did not heal, she gradually began to feel fullness and distension in the epigastric region, abdominal bloating, loose stools, chest and flank discomfort, decreased appetite, aversion to greasy foods, fatigue, pain in the liver area, and had previously taken Ganxuebao, Ganmaotong, Weideluo granules, etc., which provided some relief. Since then, she often felt discomfort in the chest and flanks, loss of appetite, poor food intake, loose stools, but did not seek medical attention. This April, she caught a cold again, and all the above symptoms reappeared and significantly worsened, with marked abdominal distension, morning eyelid edema, reduced urine output, loose stools, and severe chills, so she sought treatment from Dr. Pei.

Physical examination: Pitting edema in both lower limbs, facial edema, abdominal distension with shifting dullness, liver palpable 2 cm below the right costal margin and 3 cm below the xiphoid process, tenderness upon percussion in the liver region, spleen palpable 2 cm below the left costal margin, abdominal circumference 87 cm, tongue red without coating, scattered petechiae, pulse string-like, fine, and rapid. Blood test: White blood cells 4.5×10^9/L, hemoglobin 98 g/L, platelets 68×10^9/L, Hepatitis B three markers: HBsAg (+) 1:64, anti-HBe (+), anti-HBc (+), liver function: ALT 40 U/mL, bilirubin index 6 U, ZnTT 20 U, TTT 5 U, TFT (+), albumin 34.5 g/L, globulin 32.2 g/L, gamma-globulin 24%, B ultrasound also showed hepatomegaly and splenomegaly. Western diagnosis: Decompensated cirrhosis, severe ascites. TCM syndrome differentiation: Accumulation of phlegm and stasis. Spleen-kidney yang deficiency type. Treatment: Western medicines—energy support for one week, fetal liver suspension once a week, daily protein supplementation once a week at 10 g each time, furosemide, spironolactone, and hydrochlorothiazide used as needed based on condition. Chinese medicine—Zhenwu Tang combined with Wuling San with modifications: processed Aconite 10 g, dried ginger 6 g, white atractylodes 15 g, licorice 6 g, magnolia bark 10 g, sandalwood 10 g, cardamom 10 g, poria 15 g, polyporus 10 g, alisma 10 g, danxiang 30 g, huangqi 30 g, raw and cooked rehmannia each 10 g, white peony 10 g, angelica 10 g, polygonatum 10 g, qinjiao 15 g, banlangen 15 g, large belly skin 15 g, gourd skin 15 g, hanfangji 15 g, plantain seeds 10 g (separately packaged), totaling more than 30 doses, basically following the original formula, with all symptoms improving. Follow-up examination after discharge: abdominal circumference 76 cm, ALT 28 U/mL, ZnTT 8 U, TTT 5 U, albumin 38 g/L, globulin 28 g/L, gamma-globulin 16%, two months later follow-up, patient in good spirits, increased appetite and food intake, abdominal circumference 76–78 cm, no more pain in the liver region.

[Case 2] Wang, female, 32 years old, farmer, reported that two years ago she experienced unexplained abdominal distension, loose stools, decreased appetite, nausea, vomiting, irregular menstruation, menstrual cramps, heavy flow, bright red color, and had taken medicine prescribed by a local elderly TCM doctor, which provided some relief. This April, due to a domestic dispute with her husband, she woke up feeling abdominal distension, loss of appetite, chest and flank pain, and the abdominal distension progressively worsened. She tried the old TCM doctor’s medicine again, but it was ineffective, so she came to seek treatment here.

Physical examination: Generalized edema, dullness on percussion throughout the abdomen, unsatisfactory palpation of liver and spleen. Due to financial constraints, no other laboratory tests were performed. Based on many years of experience, Dr. Pei diagnosed advanced-stage cirrhosis with severe ascites. TCM syndrome differentiation: Long-term accumulation of phlegm and stasis leading to guzhang (liver depression and spleen deficiency type). Prescription: Danzhi Xiaoyao San with modifications: danpi 10 g, shanzhi 10 g, danggui 10 g, baishao 10 g, chaibu 10 g, poria 12 g, white atractylodes 15 g, danshen 30 g, huangqi 30 g, qinjiao 10 g, banlangen 10 g, dahuang 6 g, gourd skin 15 g, large belly skin 15 g, hanfangji 15 g, plantain seeds 15 g, tongli zi 10 g, sanleng 10 g, e-shu 10 g, zhi ru mei 3 g, total of 15 doses, with significant reduction in ascites, disappearance of edema, weight dropped from 69 kg to 55 kg, improved appetite and food intake, and chest and flank pain disappeared. At discharge, Dr. Pei removed dahuang, qinjiao, and banlangen from the original formula, added sandalwood 6 g and yujin 6 g, and advised continuing medication to consolidate the effect.

[Case 3] Cai, male, 45 years old, worker, usually a heavy smoker and drinker, with a history of chronic hepatitis. In October 1991, he suffered a sudden nosebleed after drinking too much at once, losing about 500 ml of blood. Since then, he gradually began to feel abdominal distension, loose stools, chest and flank pain, and pain in the liver region. He took Gantailuo but the symptoms did not improve. On March 20, 1992, he sought treatment from Dr. Pei.

Physical examination: Dark complexion, emaciation, scattered spider angiomas on face and neck, abdomen like a drum, prominent blue veins, obvious breast enlargement, palmar erythema, red tongue, thick yellow greasy coating, pulse string-like, rapid. Three major routine tests normal, liver function: ALT 48 U/L, albumin 36.5 g/L, globulin 32.4 g/L, gamma-globulin 25%, B ultrasound shows splenomegaly. Western diagnosis: Alcohol-induced cirrhosis. TCM syndrome differentiation: Guzhang (liver depression and spleen deficiency type). Western medicines—liver-protecting and diuretic drugs. Chinese medicine—Danzhi Xiaoyao San with modifications: danpi 10 g, shanzhi 10 g, danggui 12 g, red and white peony each 10 g, chaibu 10 g, poria 15 g, white atractylodes 10 g, danshen 20 g, yujin 10 g, raw rehmannia 10 g, yuanhu 10 g, chuanlianzi 10 g, sanleng 10 g, e-shu 10 g, turtle shell 15 g, oyster shell 15 g, erhua 15 g, lianqiao 15 g, large belly skin 15 g, gourd skin 15 g, plantain seeds 10 g, after taking 7 doses, pain in the liver region significantly reduced, still eating little, abdominal distension, original formula removed yuanhu, chuanlianzi, e-shu, added jiaosanxian each 10 g, fried radish seeds 108, chicken inner gold 10 g, zhike 10 g, houpu 10 g, continued taking more than 20 doses, all symptoms markedly alleviated or disappeared. Discharged with medication.

("Journal of Gansu College of Traditional Chinese Medicine," December 1992)

Application of Pei Zhengxue's Experience

Examples of Treating Hepatitis B

Gao Weijun

Renowned expert in integrated TCM and Western medicine, Chief Physician Pei Zhengxue has extensive knowledge of both traditions and excels in treating difficult and complex cases, particularly hepatitis B. Based on his book "Diagnosis and Treatment of Hepatitis B," I have treated hepatitis B according to syndrome differentiation and consistently achieved good results. The following are some examples.

[Case 1] Huang, male, 26 years old. First visit on August 22, 1992. Complained of having hepatitis B for over a year. In May 1991, he gradually felt fatigue, nausea, aversion to greasy foods, followed by jaundice of the skin and eyes, and yellow urine. He was admitted to our mine workers’ hospital, where liver function tests revealed abnormalities and HBsAg was positive. He was hospitalized for acute hepatitis B, and after treatment, his symptoms largely subsided and liver function returned to normal, so he was discharged. However, HBsAg remained positive, and in the past two months, he again felt fatigue, nausea, aversion to greasy foods, and mild pain in the liver region, accompanied by irritability and bitter taste in the mouth. His skin and eyes were slightly yellow but not very vivid, urine was yellow, tongue coating was yellow and greasy, pulse was string-like and slippery. Liver palpable 1.5 cm below the xiphoid process, soft texture, tenderness on palpation, pain on percussion in the liver region, spleen not palpable under the ribs. Laboratory tests: ALT 330 U, TTT 10 U, HBsAg positive, HBeAg positive, anti-HBc positive, anti-HBe negative, anti-HBs negative. Diagnosis: Chronic active hepatitis B. TCM syndrome: Pathogenic factors invade Shaoyang, damp-heat traps the spleen. Treatment: Harmonize Shaoyang and clear damp-heat. Prescription: Dr. Pei’s Hepatitis B No. 2 formula with modifications: chaibu 15 g, huangling 10 g, banxia 10 g, dangshen 10 g, yinchen 15 g, danshen 20 g, qinjiao 10 g, danggui 10 g, baishao 10 g, yujin 8 g, shengyuren 30 g, wuju 4 g, quan guawei 20 g, yuanhu 10 g, chuanlianzi 10 g, gancao 6 g, ginger 3 g, dates 4 pieces, decocted in water, one dose per day. After taking 30 doses, his spirit and appetite improved, jaundice subsided, pain in the liver region almost disappeared, liver contracted, tongue coating became thinner and slightly yellow. AST 88 U, TTT less than 6 U, original formula removed yuanhu, guawei, added biejia 20 g, continued taking another 30 doses, pain in the liver region disappeared, tongue and pulse returned to normal, ALT 34 U, TTT less than 5 U, HBeAg turned negative, anti-HBe turned positive, others as before. Second visit: removed wuju, chuanlianzi, added huangmao 30 g, xianmao 10 g, fried white atractylodes 10 g, polygonatum 10 g, continued taking for 3 months, HBsAg also turned negative, anti-HBs turned positive. Follow-up for 1 year, all normal.

Note: This patient mainly presented with fatigue, nausea, aversion to greasy foods, liver tenderness, jaundice, yellow and greasy tongue coating, and string-like, rapid pulse. Combined with abnormal liver function and positive hepatitis B virus markers, it was considered that pathogenic factors still prevailed. Following Dr. Pei’s syndrome differentiation and treatment method, using Hepatitis B No. 2 formula with modifications to harmonize Shaoyang and clear damp-heat, treatment lasted 5 months and resulted in recovery.

[Case 2] Liu, male, 35 years old. First visit on March 6, 1994. Complained of having hepatitis B for 5 years, with worsening symptoms for 2 months. Five years ago, he had hepatitis B and recovered after treatment, but HBsAg remained positive. Despite multiple treatments, it never turned negative. In the past 2 months, he experienced obvious pain in the liver region, reporting pressure on both sides of the chest, especially on the right side, accompanied by fatigue, loss of appetite, nausea, aversion to greasy foods, afternoon low-grade fever, and heat in the palms and soles. Physical examination: Face dark yellow and dull, sclera slightly yellow, no spider angiomas on face or neck, no palmar erythema. Abdomen flat and soft, liver palpable 3 cm below the xiphoid process, spleen palpable 1.5 cm below the ribs, medium consistency, tenderness on palpation, pain on percussion in the liver region, spleen not palpable under the ribs. Tongue slightly purple with petechiae, coating yellow, pulse string-like, fine, and rapid. Laboratory tests: ALT 860 U, TTT 13 U, HBsAg positive, HBeAg positive, anti-HBc positive, anti-HBs negative, anti-HBe negative. Diagnosis: Chronic active hepatitis B. TCM syndrome: Qi stagnation and blood stasis, fire injuring yin, damp-heat not yet eliminated. Treatment: Regulate qi and activate blood circulation, nourish yin, clear heat, drain dampness. Prescription: Dr. Pei’s Hepatitis B No. 3 formula with modifications: chuan niuxi 10 g, danpi 10 g, danshen 20 g, maidong 10 g, shengdi 10 g, baishao 10 g, banlangen 10 g, danggui 10 g, chuanxiong 6 g, yuanhu 10 g, chuanlianzi 10 g, yujin 15 g, sheng yi ren 30 g, biejia 20 g, banxia 10 g, yinchen 20 g, ginger 2 g, decocted in water, one dose per day, continued taking 30 doses, pain in the liver region greatly reduced, spirit and appetite improved, fever subsided, heat in the palms and soles lessened, jaundice disappeared, complexion became rosy, liver contracted, liver palpable 1.5 cm below the xiphoid process, texture softened, tongue became lighter, still with petechiae, original formula removed banxia, ginger, added wuju 5 g. Continued taking 30 doses, pain in the liver region basically disappeared, liver contracted, spirit and appetite improved. ALT 62 U, TTT greater than 5 U, HBeAg turned negative. Second visit: removed yuanhu, chuanlianzi, added fried white atractylodes 12 g, 25 doses, ground into fine powder, taken twice a day, 15 g each time, mixed with warm water, added one date per dose. After nearly 5 months of continuous treatment, all symptoms disappeared, complexion rosy, tongue returned to normal, ALT 25 U, TTT less than 5 U, HBsAg also turned negative, anti-HBs and anti-HBe both turned positive. Follow-up for 1 year, all normal.

Note: This patient mainly presented with pain in the liver region, accompanied by dark yellow and dull complexion, afternoon low-grade fever, heat in the palms and soles, and purple tongue with petechiae, yellow coating, and string-like, fine, rapid pulse. Combined with abnormal liver function and positive hepatitis B virus markers, it was considered that the disease had persisted for a long time, causing qi stagnation and blood stasis, fire injuring yin, and residual pathogenic factors remaining. Following Dr. Pei’s syndrome differentiation and treatment method, using Hepatitis B No. 3 formula as the main prescription, adding biejia to soften hard masses and disperse nodules while nourishing yin, adding yi ren, yinchen, and banxia to clear heat, drain dampness, and transform turbidity into harmony. After more than half a year of treatment, the condition improved.

("Integrated TCM and Western Medicine Research," January 1996)

Teacher Pei Zhengxue’s Treatment

Report on Three Misdiagnosed Cases of Malignant Lymphoma

Wang Lijuan and Zhang Taifeng

I. Case Reports

[Case 1] Chen ××, female, 48 years old, medical record number: 6380.

Patient presented with "abdominal distension and ascites for over two years, worsening for six months" and was transferred to our department in September 1992. She reported that two years earlier she felt fatigue, night sweats, and gradual abdominal distension and swelling. She had previously been diagnosed at another hospital as "tuberculous peritonitis" and received systematic anti-tuberculosis treatment, undergoing more than ten paracenteses and draining a total of over 20,000 ml of ascitic fluid. After six months of treatment, her condition continued to worsen, with rapid increase in ascites and extremely poor overall health, so she was transferred to our department. Physical examination: T 36.2°C, P 120 beats/min, Bp 13/8 kPa, extreme emaciation, exhaustion, cachexia. Except for a bean-sized lymph node palpable in the right neck, no other superficial lymph nodes were palpable, heart and lungs (-), abdomen highly distended, abdominal circumference 90 cm, percussion revealing large amounts of ascitic fluid. Complete blood count showed: Hb 100 g/L, WBC 12.9×10^9/L, N 82%, L 18%, bPC 60×10^9/L, urine analysis showed: BIL small, KET 0.5 mmol/L, PRO 0.3 g/L, UBG 33 mmol/L, NIT POS, LEU /12 Leu/nl, ESR 55 mm/h. Ascitic fluid smear showed: clumped degenerated cells (malignant tumor cannot be ruled out), CT scan suggested possible retroperitoneal malignancy. After consultation with Chief Physician Pei Zhengxue, he instructed: "This large amount of ascites may be caused by malignant lymphoma. Recommend taking a biopsy of the cervical lymph nodes and simultaneously starting chemotherapy." To reduce chemotherapy side effects and enhance drug efficacy, we used the Chinese herbal formula "Lanzhou Formula" (a special formula formulated by Chief Physician Pei Zhengxue for use with chemotherapy, mainly composed of raw rehmannia, mountain cornelian cherry, ginseng roots, etc.), decocted in water and administered once daily. Chemotherapy regimen COPP: CTX 600 mg/w intravenous drip, VCR 2 mg/w intravenous drip, PCZ 50 mg oral, three times a day, one course every three weeks, followed by one week of rest, total of three courses. As a result, the patient’s ascites decreased day by day, and by the end of chemotherapy, the ascites completely disappeared, her physical condition recovered, and she was able to get out of bed and move around. Complete blood count showed: Hb 130 g/L, WBC 6.8×10^9/L, N 76%, L 24%, ESR 6 mm/h, other tests all normal, pathology biopsy report: malignant lymphoma (NHL).

[Case 2] Dong ××, male, 43 years old, medical record number: 6251.

Patient presented with "abdominal distension and ascites for six months" and was transferred to our department in August 1992. He reported that six months earlier, due to fatigue and exposure to cold, he developed abdominal distension, followed by ascites. He had previously been diagnosed at another hospital as "cirrhotic ascites" and received systematic liver-protecting and diuretic treatment for over five months, but it was ineffective, and his condition significantly worsened, so he was transferred to our department. Physical examination: T 36.1°C, P 87 beats/min, Bp 13/9 kPa, poor mental state, chronic wasting appearance, no superficial lymph nodes palpable, heart and lungs (-), abdomen highly distended, visible abdominal wall veins but no varicosities, liver and spleen not palpable under the ribs, large amounts of ascites, abdominal circumference 98 cm, bowel sounds not hyperactive, no edema in both lower limbs. Complete blood count showed: Hb 138 g/L, MBC 8.2×10^7/L, N 86%, L 14%, ESR:

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5mm/h, Urinalysis: SG > 1.030, NIT: P0S; liver function, protein electrophoresis, and all three systems showed no abnormalities. Isotope examination revealed: SA 777 µL/g, ß2-M: 3.08 µg/L, others (-). B-mode ultrasound indicated: suspected cirrhotic ascites, enlarged left liver. After consultation with Director Pei Zhengxue, the recommendation was: "First, collect ascitic fluid for laboratory analysis and proceed with chemotherapy using the COPP regimen, with drug administration as in the previous case." A total of five treatment courses were administered, spaced three weeks apart, combined with the traditional Chinese medicine formula 'Lanzhou Prescription.' The ascites completely disappeared, and the B-mode ultrasound showed no abnormalities. Laboratory tests were all normal, and the patient was clinically cured and discharged. Ascitic fluid analysis revealed a large number of lymphocytes, with pathological findings suggesting malignant lymphoma (NHL).

[Case 3] Huang ××, female, 59 years old, medical record number: 5815.

The patient was transferred to our department in June 1992 due to "enlarged left cervical lymph nodes for four months, accompanied by redness, swelling, heat, and pain for one month." She reported that four months prior to admission, she developed bean-sized enlarged lymph nodes in the left neck without any obvious cause, with no other symptoms. A certain hospital diagnosed her condition as "cervical lymph node tuberculosis," and after more than three months of systematic anti-tuberculosis treatment, the lymph nodes further enlarged and became red, swollen, hot, and painful, prompting her transfer to our department. Physical examination: T 36.3°C, P 74 beats/min, BP 12/8 kPa; malnutrition, chronic illness appearance, poor mental state; palpable enlarged lymph nodes in the left neck measuring 2.3 cm × 2.4 cm, lobulated, relatively smooth surface, hard consistency, limited mobility, accompanied by redness, swelling, heat, and tenderness, with spontaneous throbbing pain. Heart and lungs (-), soft abdomen, no ascites sign (-); B-mode ultrasound and chest X-ray both showed no abnormalities, normal ECG. Complete blood count: Hb 130 g/L, MBC 8.8 × 10^9/L, N 84%, L 16%, BPC 160 × 10^9/L; urine analysis: HEU; POS, microscopic examination of white blood cells: 1–7/HP, erythrocyte sedimentation rate: 75 mm/h; isotope examination: DNA-P (+), others (-). Lymph node biopsy: malignant lymphoma (HD). Chemotherapy was immediately initiated using the COPP regimen, with drug administration identical to the previous case, combined with the traditional Chinese medicine formula "Lanzhou Prescription." After four treatment courses, the patient's neck mass completely disappeared, erythrocyte sedimentation rate dropped to 5 mm/h, and all other laboratory tests showed no abnormalities. The patient was clinically cured and discharged, with no recurrence observed during follow-up to date.

II. Discussion

Malignant lymphoma is a malignant tumor originating from lymph nodes or other lymphatic tissues, which can be classified into Hodgkin's disease (HD) and non-Hodgkin's disease (NHL). For patients with typical clinical symptoms, diagnosis is not difficult; however, for those with atypical clinical presentations, misdiagnosis is common. Cases 1 and 2 above were misdiagnosed as "tuberculous peritonitis" and "cirrhotic ascites" due to prominent ascites symptoms. Case 3 was misdiagnosed as "cervical lymph node tuberculosis" because of enlarged left cervical lymph nodes but lack of obvious systemic symptoms. (Journal of Integrated Traditional and Western Medicine Research, 1993.1)

Experience of Teacher Pei Zhengxue in Treating Severe Hepatitis

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

Teacher Pei Zhengxue is a renowned expert in integrated traditional Chinese and Western medicine, skilled in treating difficult and complex diseases, particularly liver diseases. His experience in treating severe hepatitis is introduced below.

I. Early Diagnosis

Severe hepatitis is a disease characterized by extensive hepatocellular necrosis caused by various factors. The hepatitis prevention and control plan formulated at the Sixth National Hepatitis Prevention and Control Conference in 1990 states: this disease is characterized by progressively worsening jaundice accompanied by severe psychiatric symptoms and gastrointestinal symptoms, along with bleeding and a reduced liver dullness border; laboratory tests often show bilirubin-enzyme dissociation and prolonged prothrombin time. Acute severe hepatitis has an abrupt onset, quickly developing neuropsychiatric symptoms and bleeding manifestations; subacute cases are slightly slower, typically presenting these conditions after several days. Chronic severe hepatitis usually occurs on the basis of chronic active hepatitis, cirrhosis, or other liver diseases. It is worth noting that early-stage severe hepatitis is easily misdiagnosed as acute icteric hepatitis or cholestatic cirrhosis, leading to missed or incorrect treatment. Therefore, for patients with persistent jaundice and a reduced liver dullness border, the possibility of severe hepatitis should always be considered. Early diagnosis and early treatment are essential to improve therapeutic efficacy.

II. Treatment Methods

Teacher Pei believes that the fundamental pathogenesis of this disease is damp-heat pathogenic factors. Abdominal distension, nausea, and hiccups belong to Taiyin spleen-damp syndrome; fever, irritability, red tongue with yellow coating, and dry stools belong to Yangming excess-heat syndrome. In addition to involving the liver and spleen, severe hepatitis also affects the heart and kidneys. Chest and flank fullness, generalized jaundice, bitter taste in the mouth and dry throat, poor appetite and fatigue, and epigastric distension indicate disharmony between the liver and spleen; oliguria, edema, and lower back pain suggest kidney qi deficiency; irritability, insomnia, delirium, and coma reflect excessive heart fire, with heat affecting the pericardium; some patients may experience bleeding and convulsions, indicating severe heat forcing blood, causing blood movement, and wind-related symptoms. Therefore, the main therapeutic approach for this disease is clearing heat and draining dampness while soothing the liver and strengthening the spleen. Teacher Pei uses modified versions of Sanhuang Xiexin Tang combined with Xiaochaihu Tang and Yinchenhao Tang. Prescription: raw rhubarb 3–10 g, skullcap, gardenia, bupleurum, alisma, codonopsis each 10 g, artemisia 20 g, coptis, pinellia, licorice each 6 g, honeysuckle, forsythia, dandelion, houttuynia, prunella each 15 g, salvia miltiorrhiza, astragalus each 30 g, poria 12 g, decocted in water and taken once daily. The formula includes Sanhuang to clear fire and dry dampness; Xiaochaihu Tang to harmonize Shaoyang; Yinchenhao Tang is representative for treating "stagnant heat inside, resulting in jaundice"; honeysuckle, forsythia, dandelion, and houttuynia form Teacher Pei's self-created "Five-Flavor Disinfecting Drink" to enhance the heat-clearing and detoxifying effects of Sanhuang Xiexin Tang; high doses of salvia miltiorrhiza and astragalus tonify qi and invigorate blood; poria and alisma strengthen the spleen and drain dampness, allowing damp pathogens to be expelled through urination. The entire formula is rigorously structured and reasonably composed, serving as the basic prescription for treating severe hepatitis.

Adjustments: For patients with rapid onset, quick development of jaundice, and pronounced irritability and somnolence, regardless of whether bowel movements are constipated or not, increase the amount of raw rhubarb to 10–20 g and add 10 g of mirabilite (to be taken orally), ensuring regular bowel movements, preferably 2–3 times daily. For patients with slower onset, gradually deepening jaundice, and prominent fatigue and poor appetite, add 20 g each of kudzu root, polygonum multiflorum, and polygonatum sibiricum, along with 15 g each of angelica sinensis and white peony, to strengthen liver nourishment and protection. For patients with concurrent upper gastrointestinal bleeding, add 15 g each of lithospermum, cuttlefish bone, and human hair charcoal, along with 3 g of panax notoginseng (to be taken orally). For patients with ascites and edema, increase the dosage of paeonia bark, stephania tetrandra, and plantago seeds to 15 g each. For patients with prominent belching, hiccups, and abdominal distension, add 3 g each of nutmeg and cardamom, 15 g of raw ochre, and 6 g of cloves. For patients whose jaundice persists despite treatment, add 10 g of curcuma, 20 g of lycopodium, along with 15 g each of qinjiao and indigofera. For patients with severe infections such as sepsis, add 30 g of gypsum, 10 g of anemarrhena, and 15 g each of hemiphragma and hedyotis diffusa. For patients with red tongue, little coating, and dry mouth, add 15 g of northern ginseng, 10 g of ophiopogon, and 6 g each of polygonatum, dendrobium, and cymbidium.

After jaundice subsides, switch to a traditional Chinese medicine formula called "Liver-Strengthening Decoction" to further consolidate the therapeutic effect. The composition is: raw rehmannia root 12 g, astragalus, salvia miltiorrhiza, polygonatum sibiricum each 30 g, angelica sinensis, white peony, curcuma, hawthorn, yam, fermented malt, alisma, codonopsis each 10 g, indigofera, qinjiao, artemisia each 15 g, decocted in water and taken once daily.

In addition, for patients with severe hepatitis, Teacher Pei combines traditional Chinese medicine as the main treatment with symptomatic therapy and hepatoprotective medications. For patients with concurrent infections, antibiotics are administered; for those with severe ascites, furosemide is given; for patients with massive bleeding, hemostatic drugs are used along with immediate whole blood transfusion; for patients with hepatic encephalopathy, acetylglutamine and arginine are administered.

III. Case Examples

Feng, male, 36 years old, presented on January 28, 1995, complaining of "generalized jaundice for half a month accompanied by nausea." Physical examination: patient was confused and slow to respond, with severe jaundice of the skin and sclera, large bloodstains on the anterior chest, reduced liver dullness border, positive ascites sign, red complexion with greasy yellow coating, and slippery, rapid pulse. Laboratory tests: Hb 10 g/L, PC 50 × 10^9/L, WBC 11.0 × 10^9/L, NO. 78; routine urine test: BIL (+++); stool routine: OBT (+). Liver function tests showed: TBIL 170 µmol/L, SGPT 1833.7 nmol·s^-1^/L, TTT 6 u; albumin/globulin ratio 1.1:1, GT 18 seconds. Western medical diagnosis: subacute severe hepatitis. Traditional Chinese medicine diagnosis: damp-heat accumulation, blood stasis damaging the spirit. Treatment recommended: clearing heat and draining dampness. Prescription: coptis 8 g, skullcap, raw rhubarb, gardenia, mirabilite (to be taken separately), bupleurum, codonopsis each 10 g, pinellia 6 g, salvia miltiorrhiza, astragalus each 30 g, dandelion, houttuynia each 15 g, artemisia 30 g, decocted in water and taken once daily. Simultaneously, administer 500 ml of 10% glucose solution plus 10 ml of 10% potassium chloride solution, 2 g of vitamin C, 0.2 g of vitamin B6, and 10 units of insulin intravenously once daily; 200 ml of saline solution plus 2 g of cephalosporin VI intravenously twice daily; 250 ml of metronidazole intravenously twice daily; 250 ml of 10% glucose solution plus 180 ml of hepatocyte growth factor intravenously once daily. After the above treatment, the patient's jaundice significantly subsided, and ascites almost disappeared. However, in the fifth week, massive hematemesis occurred. In addition to Western blood transfusion and hemostasis treatment, the original traditional Chinese medicine formula was adjusted by adding 15 g each of lithospermum, human hair charcoal, and cuttlefish bone, and continued for four days, until the bleeding basically stopped. But the patient then experienced extreme fatigue, red tongue with little coating and no coating, and a weak, fine pulse, so the formula was changed to focus on tonifying qi and generating body fluids while clearing heat and draining dampness. Prescription: northern ginseng, dandelion, houttuynia each 15 g, ophiopogon, jade bamboo, skullcap, gardenia each 10 g, dendrobium, coptis, raw rhubarb each 6 g, artemisia 20 g, salvia miltiorrhiza, astragalus each 30 g, nutmeg, cardamom each 3 g. Decocted in water and taken once daily. After another four weeks of treatment, symptoms disappeared, mental state improved, and liver function returned to normal.

IV. Discussion

Severe hepatitis is a complex disease with rapid progression, numerous complications, and generally unsatisfactory therapeutic outcomes. Current domestic and international literature reports mortality rates ranging from 70% to 90%. Guided by the sixteen-character principle of "Western diagnosis, Chinese differentiation, Chinese medicine as the mainstay, Western medicine as auxiliary," Teacher Pei has treated hundreds of cases of severe hepatitis using traditional Chinese medicine to address the root cause and Western medicine to treat the symptoms, achieving a survival rate of over 50%. The key to successful treatment lies in grasping the fundamental pathogenesis of damp-heat. "Damp-heat combination" is the foundation of all pathogenic mechanisms in severe hepatitis, and the presence of jaundice, bleeding, and confusion indicates that heat accumulates into toxicity, heat forces blood, and heat enters the pericardium. Dampness is sticky and difficult to eliminate quickly; when damp-heat descends, it results in short, reddish urine or even anuria. Therefore, in treatment, clearing heat must not neglect draining dampness, and draining dampness must first clear heat. The use of purgative drugs is another characteristic of Teacher Pei's treatment of this disease—using raw rhubarb, coptis, skullcap, and optionally mirabilite to simultaneously purge fire, remove dampness, and stop bleeding, allowing damp-heat pathogens to be expelled through bowel movements.

(Journal of New Traditional Chinese Medicine, 1998, Supplement)

Experience of Chief Physician Pei Zhengxue in Treating Skin Diseases

Chen Ling, Xue Wenhan, Li Min

Chief Physician Pei Zhengxue is a renowned expert in integrated traditional Chinese and Western medicine, skilled in treating various difficult and complex diseases. Below is a summary of his three-year apprenticeship under Teacher Pei regarding his experience in treating skin diseases:

I. Case Examples