Xie Xinling Zhejiang Chinese Medicine University Hangzhou 31005Department of oncology Zhejiang Province Traditional Chinese Medical Hospital
Xie Xinling Zhejiang Chinese Medicine University Hangzhou 31005
Department of oncology Zhejiang Province Traditional Chinese Medical Hospital director Chen Peifeng professor of Zhejiang Chinese Medicine University, doctoral tutor, physician, engaged in the combination of traditional Chinese and Western Medicine Clinical Oncology, education and research work for more than 20 years, has accumulated rich experience in the diagnosis and treatment of malignant tumor with traditional Chinese medicine and Western medicine. I have the honor to follow the teacher to learn, which will introduce the clinical experience in the treatment of colorectal cancer.
1 etiology and pathogenesis
Colorectal cancer is a traditional Chinese medicine "treatment", "accumulation", "intestinal", "Chang Qing", "anus hemorrhoids" etc.. "Q" records: "evil into the body is deep, cold and heat for a long time in the fight...... In the meantime, evil and not against, in muscle tumor...... Intestinal tumor; "pivot" Description: "Chang tan? Qi Bo said: the guest to parenteral and Wei Qi to wrestle, gas is not up, inherent in the system. But, here, is a polyp." This shows that the disease is related to the invasion of external pathogens and the imbalance of the Ying and wei. The meaning of "Chao Yuan Fang Sui" contains: "accumulation model node, the gas has accumulated in the viscera is heavy, due to improper diet, cold temperature, repetitious evil, prison is deep-rooted. Chronic disease." It is pointed out that the etiology, pathogenesis and the development of disease. Chen Shigong in the Ming Dynasty "surgical authentic" record: "toxin knot in organs, hot and dirty streamer, nodes swollen; Li Yongcui of the Qing Dynasty" treatment exchange up "pointed out:" the product of beginning students, because of living from time to time, worry, excessive, improper diet, spleen loss, evil is competing. In the abdomen, or due to injury of qi stagnation due to exogenous error fill "; Wu Qian of the Qing Dynasty in the" golden mirror of medicine "in the" by wine Atsumi, hard work, in the note in the anus, on both sides of the lump, shaped like a peach". Study by the physicians discussed and years of theory and practice, Professor Chen believes that cancer is due to Qi deficiency, and pleases food Feigan, wine, melancholy, overwork, cold and warm the disloyal, viscera Qi Yi deficiency, blood stasis and toxin long phlegm stasis and disease.
Professor Chen believes that TCM colon cancer can be divided into spleen qi deficiency, damp heat accumulation, spleen kidney yang deficiency, yin deficiency of liver and kidney, two blood loss and other syndromes, but most patients seek treatment with traditional Chinese medicine or have received western medicine treatment, including surgery, radiotherapy and chemotherapy, the development of TCM syndrome type and change the disease has a significant influence. Chen believes that from the "evil is change" point of view, with the operation or chemotherapy as a starting point, the initial evil in addition to righteousness seriously, as "evil to being false" stage. In addition to this stage of early surgical resection of lesions, often residual pathogen. The TCM syndrome type to the spleen and stomach qi, damp and hot is more. Chinese medicine treatment should be based on the centralizer, the major course can help restore healthy, clear vestiges and reduce the surgery or the side effects of radiotherapy and chemotherapy, and can maintain a longer period of efficacy. As the tumor recurrence and metastasis, gradually into the "evil is in stalemate stage. In this stage the tumor increased, plus Western medicine palliative chemotherapy, consumption of fine gas, with weak thin, is a virtual image display sheng. The TCM syndrome type showed spleen kidney yang deficiency, yin deficiency of liver and kidney, treatment of traditional Chinese medicine should be supplementation and attack. Advanced cancer has developed to the late, or more distant metastasis, tumor exposure, such as the emergence of cachexia emaciation with sallow complexion, "evil is bad" stage. At the same time, TCM syndrome type is mainly composed of two Qi and blood deficiency, which is mainly based on the strengthening of the spleen and the western medicine, in order to relieve symptoms, relieve pain and control the development of the disease. Therefore, Chen believes that Chinese medicine treatment of colon cancer should be based on the differentiation of symptoms and signs on the basis of weighing the stage of "righting" and "anti-cancer" efforts, while improving symptoms, improve quality of life.
2.1 righting cancer, assisted Western Medicine
Western medicine surgery or radiotherapy and chemotherapy has a strong anti-cancer effect, but easy to damage the body's Qi and blood essence. This stage of TCM syndrome differentiation and treatment to health, when the major pathogenic. Surgical trauma gas consumption of blood, postoperative blood deficiency or Yin two injuries, stomach disorders, disease sees less gas lazy words, lassitude, pale or sallow complexion, poor appetite, loose stool, appropriate treatment of Qi and blood and nourishing yin. Professor Chen believes that early postoperative, the spleen and stomach should not fill up the optional, Gan light flat product formula, can be four or Maimendong decoction soup and a gentleman. Often to Atractylodes, Poria, Radix Pseudostellariae, yam, coix seed, lentils, Gorgon, ophiopogon root, Rhizoma Pinelliae, tangerine peel, licorice root, red dates, jineijin. In order to regulate the function of the spleen and stomach, strengthen the stomach, improve the immunity, accelerate the postoperative recovery, create conditions for postoperative radiotherapy and chemotherapy. Chemotherapy can cause the loss of transport of the spleen, stomach, intestinal conduction loss loss of receiving, the symptoms of nausea and vomiting, fatigue, anorexia, constipation or diarrhea, should the spleen and stomach Jiangni vomiting or diarrhea, defecation, Jiang Banxia Jiang Zhuru, commonly used antiemetic Jiangni; fried yam, fried lentils, Gorgon, psoralen, nutmeg, purslane and other antidiarrheic. The use of antiemetic medicine during chemotherapy, often cause dry stool obscure. According to the theory of traditional Chinese medicine, Fu Qi, stomach qi can be inverse, often exacerbated by vomiting, it is commonly used in semen Raphani, Trichosanthes kirilowii, citrus, Cistanche, hemp seed, rhubarb, aloe and other laxative relief organs, to alleviate the symptoms of vomiting. Chen believes that chemotherapy induced gastrointestinal reactions, can reduce the quality of life of patients, but also often make patients fear of chemotherapy. The use of the spleen and stomach, Jiangni vomiting medicine treatment can alleviate the gastrointestinal reactions during chemotherapy, improve the quality of life and treatment of confidence. Traditional Chinese medicine believes that the kidney is the main bone marrow, spleen main transport, nourishing kidney essence. The bone marrow depression after chemotherapy treatment, when the spleen and kidney, blood nourishing essence, commonly Astragalus, Radix Pseudostellariae, yam, Atractylodes, medlar, radix rehmanniae, Cornus, polygonatum, Schisandra chinensis, Ligustrum lucidum, Dendrobium etc.. Radiotherapy is toxic heat consumption, such as wound fluid, and radioactive enteritis, disease sees mucous or blood, tenesmus, wet Yun Jiao and blockage of Qi, Chen often caused by dereliction of conduction, treated by heat and cooling blood, Qi Zhixie, medicinal Scutellaria, Coptis, Ge Gen, Yu, born Sophora japonica, Agrimony etc. Qingreliangxue; purslane, Baitouweng and fraxetin, ebony and other antidiarrheic; Kou Ren, Amomum villosum, agastache andqi wet. Professor Chen believes that this is the virtual real standard of evidence, can not be used cold of the product. On this basis, Chen used tengligen, Duchesnea indica, Sargentgloryvine, Oldenlandia, Solanum nigrum, Salvia Chinensis, Scutellaria barbata, shaozuo Quxie anticancer.
2.2 righting symptomatic, delaying recurrence
My teacher think that "evil is the stalemate in the tumor stage, treatment of traditional Chinese medicine should follow the" Fuzhengquxie, along with symptoms "principle, on the basis of supporting the healthy energy, actively play the Chinese medicine supplementation and attack utility. The prescription often consists of four parts: 1 the spleen is the foundation of "medical examination", Wu Kun said: "the spleen and stomach, and soil. The soil is the mother of all things, the bones in the spleen and stomach qi and viscera can be strong. If the body is a deficiency of spleen and stomach, not to be bullied, being weak". Jianpi Atractylodes, Poria, Radix Pseudostellariae, common yam, barley, lentils, Gorgon; spleen to help transport digestion and stomach first, is often accompanied by sprout, malt, Galli, Jiao Shanzha, etc. 2 Liushen Qu protect the stomach; the differentiation of yin and Yang Qi partial failure, Qi, nourishing and complement respectively Yin and yang. Blood deficiency, symptoms of dizzy, pale, pale tongue and lip claw veins fine, to peony, radix rehmanniae, Radix Polygoni Multiflori, mulberry, fear of feminine because of stomach with blood medicine, so often and tangerine peel, malt, equivalent to help transport the chicken. The deficiency of the symptoms, body weight loss, dizziness and tinnitus, hot flashes sweating, dry mouth and throat, red tongue, little coating, thready pulse, medicine: Radix, polygonatum, medlar, Nansha ginseng, Radix Glehniae; Yang, the symptoms of lassitude, cold, urination, pale tongue, white and thready pulse. For epimedium, dodder, eucommia, Curculigo rhizome, Radix Aconiti Lateralis Preparata Onyang products; 3 with anticancer drugs, often used is confirmed that the efficacy of anti-cancer drug, Ruto Line, sheliugu, white British, diffusa, Scutellaria barbata, Duchesnea indica and Sargentgloryvine Stem detoxicating drugs; also used Shijianchuan, zedoary Huoxue Huayu, shancigu, Prunella vulgaris ruanjiansanjie. All the medicines are cold stomach, should be timely and appropriate application. Promoting blood circulation and removing blood stasis can promote tumor metastasis, and should not be used for a long time. 4 symptomatic treatment, patients prone to abnormal stool, abdominal pain, edema, poor appetite, anal straining and other symptoms, often with the card to add and subtract.
2.3 Fuzheng conditioning, relieve symptoms
The Ming Dynasty Li Zhongzi "Yi Zong" pointed out: "the end of reading, the disease is evil, humiliation, righteousness is dispelled, either by the complement of". My teacher think that patients with advanced cancer is "evil is bad", Qi deficiency is very toxic, cancer still hyperactivity, but the body is not any attack, should be treated with Fuzheng conditioning, to alleviate the symptoms, improve the quality of life and prolong the survival period. Often in the treatment of Bazhen decoction. The commonly used white peony, licorice, such as abdominal pain, Kawa Ko Corydalis, Radix Linderae and other commonly used abdominal distension relieving pain; areca peel, orange peel, bergamot, Magnolia, green plum, etc. in August Zagreb Qi Xiaozhang; incomplete intestinal obstruction often be rhubarb, fructus cannabis, Fructus aurantii Immaturus, mirabilite purgation; abdominal water vehicles ago Polyporus, Alisma, ascites, grass, skeletons and other water Xiaozhang anal straining with Huangqi; often, Cimicifuga, Pueraria; dry mouth red tongue without fur, often with ginseng,
3 medical records
Patients, Dong Mou, male, 70. In July 2008 for "taibiandaixue February" check colonoscopy in colorectal cancer. Carry out abdominal rectal surgery (Dixon surgery), pathological examination showed moderately differentiated adenocarcinoma, mucinous adenocarcinoma. After taking 1.5g Bid Xeloda cycle, peeling blisters and other hand foot syndrome, then stop taking. In August presented to my teacher, complained of dizziness, fatigue, anorexia, loose stool, restless sleep, pale tongue with scalloped edges, white fur, thready pulse. My teacher think that the patients with loss of Qi and blood, spleen and stomach injuries combined with chemotherapy. The spleen and stomach for the day after tomorrow, the source of Qi and blood, deficiency of Qi and blood, see fatigue, dizziness, restless sleep at night; the spleen and stomach weak, endogenous dampness, therefore, anorexia, loose stool; pale tongue with scalloped edges, white fur, thready pulse, are the spleen and stomach qi deficiency and the like. Appropriate treatment of Tonifying Qi of the spleen and stomach, to restore its transport and receiving power. Prescription: 15g heterophylla, Atractylodes 15g, Polyporus 30g, barley 30g, 30g yam, Caulis 30g, Albizia 30g, Plantago 15g, sheshecao 15g, tengligen 15g, wheat 30g, hawthorn 12g, chicken 12g, licorice 6 g daily dose two times decoction. They were told not eat spicy, greasy, pickled products. Visit: take medicine after a week, appetite, stool, sleep better, there are still weak, pale tongue with scalloped edges, white fur, thready pulse. The original plus Astragalus 15g, Strengthening Qi with Pseudostellaria 30g. After every 2 weeks for 1 times, with various symptoms improved, still adhere to the outpatient treatment of traditional Chinese medicine, stable condition, nearly was basically normal indicators.