A preliminary investigation on the treatment of myelodysplastic/myeloproliferative disease (MD/MPD) is a new category of myeloid tumors established in the 2001 WHO classification of tumors of hematopoietic and lymphoid tissues, as a clonal hematopoietic stem cell disease. The clinical and hematological features of myelodysplastic (MD) and chronic myeloproliferative disease (cMPD) are twofold, that is, myeloid lineage 1 or 2 in the bone marrow has the pathological hematopoietic phenomenon of MDS and excessive apoptosis, this developmental abnormality and ineffective hematopoiesis, resulting in a decrease of this lineage in the peripheral blood and abnormal morphology, and the overproliferation of one or more lineages of myeloid (granulocyte, monocyte, red, megakaryocyte) cells in cMPD. In addition, there is an overproliferation of one or more lineages of myeloid (granulocyte, monocyte, erythrocyte, megakaryocyte) cells with cMPD that are effective hematopoietic, resulting in an increase in peripheral blood cells of that lineage with or without abnormal development. The common symptoms include fatigue, anemia, loss of appetite, lethargy, abdominal discomfort, left upper abdominal distention, night sweats, low-grade fever, and hepatosplenomegaly. Among them, chronic granulocytic-monocytic leukemia and atypical chronic myeloid leukemia mainly occur in the elderly, with a median age of onset of 65-75 years and a median survival of mostly 20-40 months, the latter with a worse prognosis and no satisfactory therapeutic approach at present. 1. Theoretical origin There is no corresponding disease name description for MD/MPD in Chinese medicine, but by reviewing the literature, its related complaints are similar to the description of some diseases in Chinese medicine respectively. For example, anemia secondary to fatigue, dizziness and panic, loss of appetite, etc., are described in the same way as “deficiency loss” and “deficiency labor” in Chinese medicine. As early as in the “Suwen Tongjian Xue Xue Shi Lun”, it is said: “The seizure of essence is deficiency.” Its clinical manifestations as “Su Wen Yu Ji Zhen Zang Lun” recorded: “The pulse is thin, the skin is cold, the qi is small, before and after the ejaculation, and the diet does not enter, this is called the five deficiencies.” And the “difficult jing” of the creation of the “five losses” said, contained: “a loss of loss in the skin, the skin gathered and hair fall; two loss of loss in the blood, blood deficiency, can not glory in the five organs and six internal organs; three loss in the muscle, muscle wasting, diet is not for the skin; four loss in the tendons, tendons slow can not hold themselves; five loss in the bone, bone impotence Can not get up in bed ……”, to the Ming dynasty Fang Sum “medical forest rope ink” mentioned: “deficiency, qi and blood of the void; loss, the internal organs of the damage also”; “Yang deficiency more chronic cold, Yin deficiency more heat accumulation “. And the treatment is in the Suwen “three parts of the nine greetings”, “to the true to the great theory”: “deficiency, then tonic”, “labor, then warm the In the Suwen, the “Three Parts and Nine Hieroglyphs” and the “Great Treatise on the Supreme Truth”, the following principles of treatment were proposed: “for deficiency, tonify”, “for labor, warm” and “for loss, warm”. The “Five Difficulties” and the “Fourteen Difficulties” in the “Classic of Difficulties” suggest that “those who damage the lungs should benefit their qi; those who damage the heart should regulate their ying and guanxi; those who damage the spleen should regulate their food and drink and adapt to cold and warmth; those who damage the liver should slow them down; and those who damage the kidneys should benefit their essence. The disease process can also be seen in the cells. In the course of the disease, symptoms such as low fever and night sweats caused by cell proliferation and enlargement of the liver and spleen are also seen, which are the same as “blood stasis” and “Y obstruction” in traditional Chinese medicine, i.e. the symptoms of “excessive Ying Qi”. Blood stasis can be manifested as “blood stasis”, “internal steam”, “Y-accumulation” and other pathological phenomena. Blood stasis was first mentioned in Huangdi Neijing, and the “bad blood” in the “Lingshu” is the earliest record of blood stasis, and the “Lingshu Hundred Diseases Begin to Grow” chapter says: “Blood clotting is not dispersed, fluid is astringent and seeping, and the accumulation is all formed. The “Ling Shu evil qi viscera disease shape” records: “liver pulse is very urgent for the evil words, slightly urgent for fat qi, in the lower part of the wakefulness as if covering the cup.” The latter description of “fat qi” graphically indicates the characteristics of giant spleen syndrome, as mentioned in Su Wen Wu Organs Generation: “There is accumulation of qi under the heart, branching off in the month, called liver paralysis.” It is also similar to the clinical symptoms of discomfort, fullness and traction in the left upper abdomen caused by hepatosplenomegaly, as stated in the Treatise on the Origin of Diseases: “If the stasis does not subside for a long time, it becomes an accumulation of Y obstruction.” ; “Accumulation is also a dirty disease, and is born of Yin Qi.” The treatment is described in Su Wen Yin Yang Ying Xiang Da Lun: “The blood should be determined if the blood is solid. “, “Those who are knotted should be dispersed”, “Those who remain should be attacked”. The idea is to de-stasis the stasis and harmonize its ligaments, which can make the blood flow smoothly. In the “Jin Kui Yao Yao (Blood Paralysis and Void Labor Disease)”, it is stated that “blood paralysis is caused by a lack of yang qi and astringency of yin and blood, so the treatment is to “induce yang qi” and not only treat the blood component. As mentioned above, they have provided a rich literature base and treatment ideas for the understanding of MD/MPD diseases by modern medical practitioners, and some practical prescriptions have also achieved certain efficacy in clinical application. 2, clinical application The disease itself is the result of the struggle between the evil and the positive, the evil is the disease evil, it is the essence, so Chinese medicine has “the evil is strong, the real, the essence take away is deficient”. MD/MPD has a dual nature due to the nature of the disease and its clinical manifestations. Therefore, the treatment should be based on the deficiency of the essence of the spleen and kidney from deficiency labor and the overabundance of blood and stasis, and the main objective is to tonify the deficiency and resolve the stasis. Slowly in the middle to supplement the deficiency, rhubarb V worm pill main.” The intention is to resolve blood stasis and open up the blockage while nourishing the blood to produce blood. Clinical symptoms include: lumps in the abdomen, dull gray face, lean body, low fever and night sweats in the afternoon, tiredness and fatigue, dizziness and tinnitus, palpitations when moving, poor appetite, general sleep at night, and still regulated bowel movements. The tongue is light and dark or purple, with thin and greasy moss, and the pulse is thin and astringent or thin. According to the four diagnoses and the reference, the disease belongs to the ancestral medicine of stasis evidence, and the evidence belongs to positive deficiency and stasis knot. The disease is caused by overwork and tiredness, liver and spleen disorders, and the accumulation of stasis is aggravated by the accumulation of stagnation over time, which can be seen as a hard mass of Y and gradually increasing in size. Blood deficiency, injury to kidney yin, and evil toxins lurking within, transpiration of blood, damage to its bone marrow, the development of internal steam; tongue and pulse from which, are deficient in qi and blood, blood stasis, internal knotted signs, the nature of the disease deficiency mixed with reality. The treatment is to resolve the stasis and disperse the knots, tonify the deficiency and eliminate the Y. The formula is optional. The medicine uses Angelica sinensis, Chuanxiong rhizome, peach kernel, red peony, wuling fat, danpi and xuanhu to activate blood circulation and resolve blood stasis, together with aromatic herbs, wu yao and heliotrope shells to regulate the liver and spleen, move qi and relieve pain; ginseng can be replaced by prunus ginseng, licorice to nourish the spleen and slow down the middle, and combined with drugs to resolve blood stasis, to benefit qi to open the channels and veins; to support the righteousness without leaving the nourishment of true yin, so there are rehmannia and asparagus; there is evil poisonous heat, which hurts its essence, so Huang Bai is used to strengthen yin and control the fire, together with sandy nuts to move qi and broaden the middle, taking the formula as meaning to get The formula is designed to obtain Yin to secret Yang, so that both water and fire can be used, and the essence returns to the kidney to produce Blood. When the disease progresses, heat signs are seen, body heat does not subside, anemia is aggravated, and liver and spleen are progressively enlarged. In case of Qi deficiency, combining Radix Astragali with Radix Angelicae Sinensis, it is important to tonify Qi to produce Blood. If the true yin is difficult to be restored and the fever is very high, add raw earth, genkoshen, turtle shell and ground bones to nourish yin and lower fire; if the lump in the abdomen is enlarged, use turtle shell decoction pills together with yellow medicinal herbs, cat’s claw herbs, mountain cichlid mushrooms and snake six grains to remove stasis and soften hardness, so as to both eliminate and tonify; if the spleen is not healthy and the appetite is poor, take Chen Pi, Shen Xiang Qu and chicken inner jin to support the spleen and harmonize the middle; if there is damp-heat and yin deficiency, add Han Xia, Bamboo Ru and Dendrobium to nourish yin and promote dampness; if the total number of leukocytes or blood plate is obvious, use the dendrobium to nourish yin and promote dampness. If the total number of leukocytes or platelets is significantly elevated and infantile cells are seen in peripheral blood, Chinese medicines such as Xihuangwan and Niuhuang Detoxification Tablets can be added. The patient, female, 51 years old, had malaise since 2004, but did not pay attention to it at that time. In 2005, the malaise was significantly aggravated, accompanied by low fever and night sweats. /On April 13, he was treated with hydroxyurea 1.0qd, Ara-c 100mg × 1 day, interferon 3 million U/qd, and WBC 2.5×10^9/L, Hb 129g/L, PLT 129×10^9/L. 129×10^9/L, since then the condition has been recurrent, WBC fluctuates from 1.0 to 10×10^9/L, hemoglobin 50-90g/L, platelets 110-1200×10^9/L, intermittent application of hydroxyurea and interferon, Hb less than 60g/L is supported by blood transfusion, (06.8.30) routine blood: WBC 11.8×10^9/L, Hb 83g/L, PLT 3 million U qd. The patient was treated with arsenious acid (10mg*14 days) chemotherapy from 06.9.12, (06.9.23) blood picture WBC6.3×10^9/L, Hb70g/L, PLT935×10^9/L. Afterwards, the patient was treated with The patient was given 3 million U/qod of interferon, and on March 12, 2007, he had routine blood tests: WBC8.2×10^9/L, Hb56g/L, PLT744×10^9/L, and was given blood transfusion support. The tongue is pale purple with a thin, greasy coating. The tongue is pale purple, the moss is thin and greasy, and the pulse is thin and astringent. According to the four diagnoses and the reference, the disease belongs to the ancestral medicine of stasis evidence, and the evidence belongs to positive deficiency and stasis knot. The patient’s disease is caused by overwork and tiredness, and the evil toxin, Ying and Blood are united and accumulate inside, which can be seen as a hard and enlarged lump; the stagnant toxin is strong inside, which depletes Qi and Blood, and the Blood loses its glory, which can be seen as a dull complexion, nails and lips, fatigue and weakness, and a thin body; the heart and mind are not nourished, which can lead to palpitation and shortness of breath, dizziness and tinnitus; the spleen is not healthy, which can lead to less food and dullness; the evil toxin is inside, which can lead to deficiency of Yin and Blood, which can be seen as repeated low fever; the tongue and pulse are all signs of Qi and Blood deficiency and internal blood stasis. The treatment is to nourish Qi and Blood, resolve blood stasis and disperse the knots. The formula was used for one month, and the symptoms were greatly relieved. The prescription was increased and decreased with the symptoms, and interferon 3 million U/stem was changed to twice a week. The WBC was around 5.0×10^9/L, Hb was around 80g/L, PLT was around 400×10^9/L, the Chinese medicine was not interrupted, and the interferon dose was reduced by 1/4 (750,000 U) per week half a year ago, and still followed up in the outpatient clinic. Unlike acute leukemia, MD/MPD has a relatively long disease duration, with a phase of strife between good and evil, which provides an opportunity for TCM to give full play to its overall care and discriminatory treatment characteristics; unlike MDS, its blood solid symptoms are more obvious, and because its bleeding symptoms are relatively few, the advantages of TCM in activating blood circulation and removing blood stasis, as well as attacking and supplementing can also be given full play. Of course, this disease can be identified as positive deficiency, which also includes the meaning of Qi deficiency, Blood deficiency and Yin deficiency, each of which has its own strengths at different stages of the disease, and which can be transformed into each other, sometimes as a manifestation of disease progression. Stasis mainly reflects another special manifestation of the disease, the accumulation of stagnant blood and evil toxins in the body, which in turn depletes the qi, blood and yin essence, as suggested in the Treatise on Blood Evidence: “This blood in the body cannot be added to the good blood, but instead blocks the transformation mechanism of the new blood.” This means that stagnant blood does not go away and new blood does not arise, so it should be the main direction of diagnosis and treatment. Modern pharmacological studies have confirmed that drugs that benefit qi and nourish yin can improve the body’s autoimmune function, and drugs that activate blood circulation and resolve blood stasis have the effect of regulating immune function, improving the state of immune dysfunction, increasing the sensitivity of red lineage progenitor cells to erythropoietin, causing red blood cells to proliferate and differentiate, and treating the disease with evidence to support the root, enhance the body’s own anti-tumor vitality, kill tumor cells, and improve anemia so that the disease can be relieved [4], [5]. In the normal situation, Qi and Blood work together to maintain the vitality of the body, kill tumor cells, and improve anemia so that the disease can be relieved [5]. Under normal conditions, qi and blood work together to maintain the vital activities of the human body. If qi and blood are out of balance, qi stagnation is not relieved, and blood flow is not smooth, it may lead to qi stagnation and blood stasis. The use of blood-stasis activating drugs in hematological diseases is limited to the characteristics of the disease itself and the risk of bleeding, considering that although blood-stasis evidence exists in different stages of disease development, different stages have different degrees of blood-stasis evidence, and blood-stasis activating drugs are divided into different types such as harmonizing blood, activating blood, and breaking blood [6], the clinical use of drugs should be based on the needs and rational use of evidence. The clinical formula is composed of multiple drugs, and many single drugs contain multiple chemical components, how these components function, which components take the primary position and perform corresponding effects, is also a direction for clinicians to explore.