Pituitary tumor is one of the common intracranial tumors, and its incidence ranks the third after glioblastoma and meningioma. At present, the treatment of pituitary tumor has been mainly based on surgery, radiotherapy and hormone, but surgery or radiotherapy cannot completely eradicate the tumor tissue, and the recurrence rate is high; or it may injure the normal glandular tissue and affect the secretion function of pituitary gland, causing endocrine disorder and more side effects. Professor Zhang Qiujuan has been practicing medicine for more than 30 years, and has unique insights and rich clinical experience in the treatment of pituitary tumors using Chinese medicine.
According to its clinical manifestations and pathogenesis, it can be classified as “headache”, “head wind”, “pituitary tumor”, “brain tumor”, “brain tumor” and “pituitary tumor” in Chinese medicine. “According to our master, this disease is mostly due to congenital deficiency of endowment, deficiency of liver and kidney, loss of brain marrow nourishment, acquired spleen and stomach disorder, deficiency of qi and blood, internal growth of phlegm and phlegm, and intertwining of phlegm and blood stasis over time.
1, kidney essence deficiency, brain marrow loss of nourishment for the head for all the Yang will, hands and feet three Yang meridian are meeting in the head and face, is Yang; brain for the marrow sea, Qi Heng of the House, is Yin; viscera clear Yang Qi and essence of blood will be on the head and eyes. If the yin and yang are secret, evil cannot enter, the qi of the clear yang rises and the qi of the cloudy yin falls, then all diseases will not be born. As early as the Nei Jing, it is said that “if the medulla oblongata is insufficient, the brain will turn to tinnitus”; the Ling Shu? Sea theory” also cloud: “the brain is the sea of marrow, its transmission on its cover, the lower in the wind; marrow sea surplus, it is light and strong, from its degree; marrow sea deficiency, it is brain turn tinnitus, shin acid vertigo, the eyes do not see, slack and rest” records. Zhang Jie has long recognized that “strong people do not have diseases, but deficient people have them”, and the book of External Evidence Medical Compilation also points out that “the deficiency of positive energy becomes a rock”. The tumor of the brain must be blamed on the deficiency of vital energy in the brain. The brain is not full, it must be blamed on the kidneys that produce marrow. The kidney is the master of bone and produces marrow, which is connected to the brain, and the brain is the meeting place of all marrow. Due to the deficiency of kidney essence, essence and blood cannot rise to nourish the brain, the medulla is empty, the meridians are closed, fluid, phlegm and dampness accumulate in the brain and paralyze the brain, then dampness becomes phlegm, blood becomes stasis, phlegm and stasis become tumors, and headache, dizziness, blurred vision, no vision, yang atrophy, amenorrhea and other symptoms. Therefore, my master believes that the underlying pathogenesis of the disease is deficiency of kidney essence and loss of nourishment of brain marrow.
The main pathology of pituitary tumor, according to our master, is the interconnection of phlegm and blood stasis and the accumulation of evil toxins. The formation of brain tumor is closely related to phlegm and stasis. As the saying goes, “Anyone who has lumps on the body, in the middle or under the body is mostly phlegm”. Phlegm is a material that rises and falls with the qi and can be found everywhere. Phlegm and phlegm stasis are also the cause and effect of each other, and can be transformed into fire and wind, and become evil and poisonous. The pathological basis is inseparable from the liver, spleen and kidney. The kidney collects essence, produces marrow, and is connected to the brain. The spleen is the source of phlegm production. The relationship between the spleen and the kidney is inseparable, as it is said that the innate is born to the postnatal and the postnatal feeds the innate. If the spleen is not transported, water and grain are not transformed, and there is a deficiency of qi and blood, the kidney is not nourished and there is a deficiency of essence; if there is a deficiency of essence of the kidney, the spleen is not warmed and warmed, water and dampness are stopped inside, phlegm is generated inside, and pathological products are formed. Therefore, the disease is a stubborn disease with intertwined causes and effects, mixed with deficiency and reality, and the original deficiency and symptoms.
For the treatment of pituitary tumor, our master believes that the East and the West should be combined, and the disease should be identified with the evidence. Identification of disease can clarify the typology, stage, size and level of hormone secretion of pituitary tumor, evaluate the effect of treatment, monitor the change of disease, and avoid delaying the disease. The identification of evidence can be different from person to person, depending on the evidence, and the formula can be formed flexibly and added or subtracted according to the symptoms. However, my master believes that the main pathological basis of pituitary tumor is the accumulation of phlegm and blood stasis and the accumulation of evil toxins.
In accordance with the principles of the Nei Jing (內经), “those who are in fact, should be dispersed and drained”, “those who are firm and cut”, “those who are knotted should be dispersed”, and “those who remain should be attacked “According to the principles of the Internal Canon, the treatment principle is to dissolve phlegm and dispel stasis, and to soften and disperse the knots. Under the guidance of this treatment principle, our master consulted ancient texts and combined with modern pharmacological research to create the Brain Tumor Agreement Formula, whose drug composition is Bile Nanxing, Jiang Hanxia, Sanliao, Curcuma, Seaweed, Kunbu, Raw Oyster, Corrugated Seed, Shijiazhuang, Chuanxiong and Poria. Bile South Star, Jiang Hanxia for the ruling drug, the “Ben Jing Feng Yuan” said: “South Star, Hanxia are treating phlegm medicine. However, Nanxing specializes in the meridians, so the stroke, paralysis as a guide; half Xia specializes in the gastrointestinal, so vomiting, diarrhea as a guide. Tiannanxing bitter warm pungent, open drainage to go away, with phlegm to disperse the function of the knot, especially good at “to go to the upper jiao phlegm and dizziness” (“pearl sac”); half Xia pungent warm drainage, dry dampness and phlegm, eliminate gangrene. The two drugs combined as a force to drive away stubborn phlegm. However, the raw Nanxing and Panaxia are toxic, so Nanxing and Panaxia are concocted with ginger juice and alum to reduce their toxicity, which is safe and effective. The three prongs, Curcuma longa as the minister, to break the blood and blood stasis, the function of dispersing the knots and swelling.
The “Drug Huayi” said: “pungent and strong, specializing in attacking the blood in the gas, the main to break the accumulation and eliminate the firm, to go to the accumulation of fetish lumps …… and San Ling function quite the same”. Seaweed, kombu, raw oyster, corrugated seeds, stone see through for the adjuvant, seaweed, kombu, raw oyster, corrugated seeds to help the South Star, half of the summer phlegm to soften the firmness and disperse the knots; stone see through to help the three prongs, curcuma to move the blood, detoxification and dispersion. Chuanxiong rhizome, poria as the messenger, Chuanxiong rhizome pungent warm ascending and dispersing, for blood in the gas medicine, can go up the head, leading all the drugs up to the top of the upside down; Poria taste sweet and light, sweet can strengthen the spleen, light can benefit damp, eliminate the source of phlegm. Some studies have shown that the agreement formula has the effect of improving microcirculation, enhancing aerobic metabolism, softening lesions and shrinking tumor tissue.
2. Seeking the root of the disease and protecting the vital energy of the brain, the brain must be blamed for the deficiency of the vital energy in the brain; the brain must be blamed for the lack of filling of the kidney, which produces marrow. At the same time, products such as Nanxing, Panaxia, Sanliao, Curcuma, and Shijiazhuang, which dissolve phlegm and soften hardness, break blood and move blood stasis, and attack violently, will definitely deplete the vital energy. Therefore, in the treatment of pituitary tumors, my master must add kidney essence and protect the vital energy, which is the way to treat the disease at its root. In addition to replenishing the kidney essence with Radix Rehmanniae and Fructus Lycii, my master always adds Yang tonic products such as Xian Mao, Xian Ling Spleen and Cistanches, taking the idea that those who are good at replenishing Yin must seek Yin in Yang, so that Yin can be raised by Yang and the source of water will never end. The two organs of spleen and kidney are mutually supportive and promote each other. The spleen and stomach can transport thick and nourishing products in order to nourish the kidneys; when the spleen is nourished, the essence of water and grain can be transformed and the positive energy can be enriched in order to carry the brain and drive the evil out. My teacher specializes in the use of astragalus, more raw than hot, raw astragalus can nourish the qi and blood, support the right qi, detoxification out, the “materia medica HuiYin” called “to drive the wind and transport the poison medicine. The treatment of pituitary tumors can be summarized as a combination of disease identification and evidence identification, theoretical methods and prescriptions in conjunction with each other, the elimination of phlegm and stasis at the same time, the support of the righteous and drive away evil.