In recent years, with the improvement of medical treatment level and the enhancement of national health awareness of disease prevention, more and more early stage tumors are detected and treated in a timely manner. Although Western medicine advocates a healthy lifestyle after treatment and overall regulation including endocrine therapy and targeted therapy, there are still more patients with recurrence and metastasis and low long-term survival rate, with an overall 5-year survival rate of less than 10% for lung cancer, for example [1]. Especially with the aging of the society’s population, the number of elderly tumor patients is increasing, and prolonging disease-free survival and progression-free survival with tumor is an urgent clinical problem to be overcome. During my practical study under Professor Yu Rencun, through a lot of clinical observations, I found that Yu’s clinical diagnosis and identification of Chinese medicine treatment can benefit patients with stable tumor and lesions after surgery, and the key to treatment is the theory of organismal balance, and the core ideas are The key to treatment is the theory of body balance, and the core idea is to emphasize the doctrine of spleen and stomach.
I. The role of spleen and stomach in tumor development
The human body always maintains a dynamic balance between itself and its internal and external environment, i.e. “Yin is calm and Yang is secret”, which is also the basis for maintaining normal physiological status. The development of tumor is a long-term gradual process. After birth, due to the differences in physique, character, lifestyle and living environment, there is an internal environment of internal organs deficiency, yin and yang bias, and Qi and blood imbalance; moreover, every moment produces pathological products such as phlegm, water and dampness, stagnation and blood stasis. However, with the ageing, the decline of the functions of the five organs, the loss of nourishment and the lack of congenital nutrition, these pathological products will gradually accumulate and become toxic over time, or become cancerous when the external toxic evil is felt. In this process, the function of spleen and stomach is especially important.
The spleen is the hub of the middle jiao, the source of biochemistry of qi and blood, the main transporter and disperser of water and grain essence, and the transporter of water and liquid, the main function is to raise and clear, preferring dryness to dampness, and is the basis of the latter. Su Wen? Prickly forbidden on the cloud: “…… spleen for the make, the stomach for the city.” The “make” refers to the “five viscera to make”, which means that the spleen and the stomach are the ones who transform the water and grain to provide the material basis for the five viscera. Another meaning of “make” is “turn the pivot”, which is derived from the meaning of “make” and “city” to flow unimpeded. The so-called “pivot” is to regulate the movement of the body’s qi through the role of the spleen and stomach to rotate and change in the middle. The word “pivot” also means hub. The spleen and stomach are located in the middle jiao, spleen qi has the characteristic of ascending and dispersing, and stomach qi has the characteristic of descending, one ascending and one descending, becoming the pivot of qi ascending and descending. If the spleen can not rise clear, the stomach can not descend turbid, the essence can not moisten the upper and lower, metabolic waste can not be eliminated from the body, then the body’s functions will be affected.
The beginning of human birth is based on the source of essence and blood; human birth is based on the nourishment of water and grain. Without essence and blood, there is no way to establish the foundation of the body, and without water and grain, there is no way to make the body strong [2]. If the spleen and stomach are strong, the source of qi and blood is sufficient, and the innate essence stored in the kidney is constantly nourished by the latter, the kidney energy will not be deficient; if the internal organs, meridians and limbs are sufficiently nourished by qi and blood, the righteous energy will be abundant and not easily attacked by external evil; the spleen and stomach not only irrigate the four organs with the essence of water and grain and nourish the body, but also excrete waste, promote the up and down circulation of the essence of the internal organs, circulate and transform, and can play its
Later medical practitioners have developed the doctrine of the spleen and stomach from the emphasis on the spleen and stomach in the Neijing.
Ming Jing Yue Quan Shu: “People with deficiencies and weaknesses of the spleen and kidneys, and those with disorders of the spleen and kidneys, mostly have the disease of accumulation. If the spleen is deficient, the middle jiao is not transported, the kidney is deficient, the lower jiao is not transformed, the positive qi does not work, then the evil stagnation can live in it, if these people, regardless of its visible or invisible, but when we look at its urgency are dominated by positive qi. … If hunger and satiety regardless, the diet stacked into so that the Yang Ming stomach gas a rebellion, the Yin cold gas to multiply, and the spleen is not as late as the transformation, so the remaining stagnation is not eliminated, is and the juice outside the intestine foam tumulus does not disperse, gradually become Y accumulation carry on.”
Shen Jinao, a doctor of the Qing dynasty, in “The Source of Miscellaneous Diseases? The spleen disease source flow” proposed: “cover the spleen unified four organs, the spleen has a disease, will be affected; four organs have a disease, will also be to feed the spleen, so the spleen is full, the four organs also rely on the xu yu; spleen is extinct, the four organs can not be self-generated.
Li Gao’s “Spleen and Stomach Theory”: …the sufficiency of the vital energy, all by the spleen and stomach gas without injury, and then can nourish the vital energy; if the stomach gas is weak, the diet since the times, the spleen and stomach gas is injured, and the vital energy can not be filled, and the cause of all diseases. If the stomach is deficient, the spleen is not endowed, the four organs and meridians are sick. Or because of dietary disorders, living from time to time, delusional labor, and happiness, anger and sadness, injury to the stomach’s vital energy, so that the operation of the gas is reduced, can not transfer the essence of the skin and hair meridians, so the evil to take advantage of the deficiency, the phlegm moved in the body, and become chronic diseases, so that the true energy is also internal elimination.
Therefore, the spleen and stomach healthy and healthy, the kidney is full of the organs and meridians operating smoothly, the so-called “the two organs multiplied, then a hundred diseases, two organs, then a hundred veins, and disease from rest. [3]”
The role of spleen and stomach in the treatment of tumors in Chinese medicine
Jing Yue Quan Shu: Where the deficiency is in the spleen and stomach, it should be taken as a mainstay with Wu Wei Yi Gong San or Nourishing Zhong Decoction, Warm Stomach Drink, Guei Spleen Tang, etc.; where the deficiency is in the liver and kidney, it should be taken as a discretionary measure with Li Yin Decoction, Kidney Qi Pill, Liver Warming Decoction, etc. This is called nourishing the right product since the removal, or deficiency in the stagnant people, it is worth adding less adjuvant. The most important thing is that the person who has a weakness in the spleen and stomach should be able to take care of it.
Zhang Lu “Zhang’s Medical General” that the accumulation and half, purely with sweet and warm conditioning, so that the spleen and earth health, is broken residual accumulation, not attacked since the go, must want to attack the residual, which does not leave people premature calamity is rarely carried out.
Zhang JieGu cloud: strong people do not have a product, but the deficient people are there, all by the spleen and stomach weakness, qi and blood two failure, the four gases have feelings, all can become a product. Good treatment, when the first to supplement the deficiency, so that the blood is strong, the product since the elimination of also, do not ask what organs, first adjust which, so that can eat and drink, is also its essence.
Li Shicai said: into the accumulation of also, is insufficient, and then the evil entrenchment, but attacked too quickly, the right qi turn injury, the first, middle and last of the three methods, must not be said. The beginning of the disease is still strong, the evil is still shallow, it is subject to the attack; the middle of the disease is gradually, the evil is deeper, the weakness of the righteousness, any subject and attack and supplement; the end of the root of the disease after a long time, the invasion of evil, the righteousness of the residual, it is subject to supplement. Cover the accumulation of the righteousness, day by day, month by month, not as soon as possible, so to go to the also should be gradual, too quickly is injured, is injured can not be transported, and the evil is solid.
In the treatment of successive generations of doctors focus on the regulation of the spleen and stomach, the source of capital, nourish the qi and blood, benefit the innate, adjust the normal function of the spleen and stomach, then the internal organs of qi and blood yin and yang harmonization, clear and turbid flow, “flowing water does not rot, the household pivot is not worm-eaten”, the accumulation of elimination.
III. Experiences of Yu Lao in tumor treatment
In his clinical practice for many years, Dr. Yu deeply appreciated and applied the essence of the theory of Yin and Yang in Chinese medicine, which states that “the spirit is cured when the yin and yang are secret”, and proposed that the theory of body balance is the basis for stable and long-term survival of tumors. The key to treatment is to adjust the balance between the function of internal organs, qi and blood, disease and positive qi by strengthening the spleen and stomach, so as to reduce tumor recurrence and metastasis, prolong the disease-free progression period and achieve long-term survival with tumor. Specifically as follows.
1. Longitudinal view, objective assessment, and phased treatment combining Chinese and Western medicine.
Before treating each cancer patient, Dr. Yu clarifies the patient’s general functional status, mental state, physical strength, diet, and the dysfunctional state of internal organs, qi and blood as the overall situation; at the same time, he grasps in detail the tumor lesion, its size, type, developmental infiltration and nature of the tumor, determines at which stage of tumor development the patient is in, establishes treatment principles for different stages, seizes the The main contradiction is to consider what means to eliminate the lesions and whether it is possible to eliminate the lesions.
Guided by the doctrine of equilibrium, according to the condition of cancer patients and the state of the waxing and waning of evil, treatment can be carried out in stages.
(1) When the diagnosis of evil and righteousness is confirmed, various means of Chinese and Western medicine should be used to combat and destroy the tumor as much as possible (attacking evil is the main focus), attention should be paid to protecting the righteousness (supplemented by supporting righteousness), and Chinese medicine should be used in combination to reduce toxicity and increase effectiveness.
②After the tumor load is greatly reduced, the focus of treatment will be shifted to supporting the righteousness and promoting the recovery of hematopoietic function and immune function to the greatest extent possible (rebuilding the righteousness).
③transferring to consolidation therapy if necessary, focusing on fighting tumors and removing potential residual cancer cells as much as possible.
④Transfer to prolonged corrective and anti-cancer treatment after stabilization (corrective treatment is the mainstay and cancer suppression is supplementary) to prevent tumor recurrence and metastasis.
⑤ When the patient’s whole body is weakened, or the tumor is already very large, or has metastasized extensively, the focus is on the maintenance of overall functions, with Chinese medicine as the mainstay, especially regulating the spleen and stomach, tonifying Qi and nourishing Blood, in order to preserve the “essence of the latter”, enhancing the patient’s own anti-cancer ability to improve the patient’s survival quality and prolonging the survival period.
Based on years of clinical experience and research results, Yu believes that the most effective and beneficial stages for patients’ survival include long-term post-operative rehabilitation with Chinese medicine, bone marrow suppression and low immune function during radiotherapy, weakness after excessive treatment with Western medicine, stable lesions and small tumor load, elderly patients with tumors or patients with advanced tumor depletion.
2. Combination of supporting the positive and eliminating the evil to establish a new balance of the organism.
In his clinical practice, Dr. Yu deeply appreciated the importance of maintaining the “essence of the patient’s nature – the spleen”, and made good use of the method of strengthening the spleen and benefiting the qi to enhance the patient’s own resistance to disease and balance the imbalance in the body, and applied the treatment of strengthening the spleen and benefiting the qi in a phased and focused manner.
According to the specific manifestations of the disease, he either focuses on helping the righteousness and supplementing the elimination of the evil, or he first attacks (eliminating the evil) and then supplements (helping the righteousness), or he first supplements and then attacks or both attacks and supplements, and receives better results according to the evidence. In other words, in the treatment of cancer patients, it is difficult to eliminate the tumor by simply supplementing the deficiency and helping the righteousness, and the one-sided emphasis on helping the righteousness will sometimes miss the opportunity to fight; it is also important to eliminate the root cause of the disease by eliminating the cancer, at this time, the method of eliminating the evil is also a kind of “tonic” for the organism in a sense, so to speak. “to get rid of evil is also to help righteousness”.
Therefore, according to Yu, “supporting the righteousness” is not simply a tonic method, which is a one-sided view. It should also include the adjustment of the physiological functions that have lost their normal activities, i.e. the adjustment of organs, qi and blood, yin and yang. Li Gao’s “The Confusion of Internal and External Injuries” says, “To warm, harmonize, regulate, and nourish are all tonic.” In the Compilation of Medical Enlightenment, it is said, “If you remove the harm, the qi and blood will be born.” Similarly, the ways and means of “dispelling evil” also vary depending on the nature of the evil. Chinese medicine advocates “attacking the evil directly” and “dismantling its toxic potential” [4]. However, for the pathological damage and disorder caused by the evil, it is advocated to regulate it, “adjusting it to make it harmonious”, so as to restore the physiological normal function state and repair the pathological damage.
Long-term Chinese medicine conditioning, supporting the righteousness, is to make the body establish a new balance by adjusting the function of the qi and blood of the internal organs. Patients with Yu Lao can often survive for a long time without disease or with tumors and obtain a good quality of life, but there are also cases where the disease deteriorates and progresses due to family reasons, external stimuli or in patients who have seen their condition stabilized and discontinued, and the established balance is broken again, thus confirming the existence and correctness of the balance theory in clinical practice. And in the treatment, strengthening the spleen is an important method to support the righteousness.
3. Summary of Yu’s clinical experience with the method of strengthening the spleen.
According to Yu, when the human body is in a pathological state, it can remove the pathological products through its own powerful function or with the help of drugs, and the strength of spleen and stomach qi plays an important role in the recovery process of human functions. First of all, all drugs must be transported by the spleen and stomach before they can be absorbed. If the spleen is weak, even though there are supplements, they cannot be absorbed and take effect. On the other hand, deficiency of the spleen is the root cause of many kinds of deficiencies, so nourishing the spleen and stomach can benefit the qi, generate blood, remove dampness and phlegm, and prevent the treatment of diseases that occur in other organs due to spleen deficiency.
Even if he applies anti-cancer detoxifying drugs, he still protects the spleen and stomach so as not to hurt the vital energy. It is common for patients to have stomach discomfort, diarrhea, loss of appetite, fatigue and lethargy after taking a lot of other detoxifying and bitter-cold drugs or nourishing Yin and nourishing fatty drugs that hinder the stomach. After taking Yu Lao’s Chinese medicine to strengthen the spleen, regulate the qi and stomach, and tonify the kidneys, the patient’s complexion and mental state improved significantly, appetite increased, physical strength improved, and quality of life improved. Especially for postoperative patients with weaknesses in qi and blood and patients during chemotherapy, the application of spleen-strengthening herbs can benefit qi, nourish blood, and help correctness to improve the immunity of the body; can reduce the toxic side effects of chemotherapy; can fight against cancer and improve the efficacy of chemotherapy, i.e., nourish the correctness and remove the product since.
Applying the method of strengthening spleen and benefiting qi in treatment can promote the recovery of spleen and stomach functions, and also enhance the cellular immunity and immune surveillance functions of patients, improve the regulation of endocrine environment, mobilize and enhance the intrinsic anti-cancer ability of the body, improve physical strength, and improve the quality of life of patients. When applying the nourishing and warming products such as cinnamon and deer horn gum to help Yang, Yu used chicken neijin, sandy nuts and jiao sanxian to protect the spleen and stomach and to supplement the vital fire without hurting the central Yang; while when combining Liu Wei Di Huang Wan, the main team of Yin nourishing products, he prevented them from being nourishing and greasy to hinder the transportation and transformation of the central state. Sometimes with raw grain buds and raw wheat sprouts to boost stomach qi.
Yu Lao’s spleen health is not just a warm tonic, but is based on regulating the spleen and stomach qi, such as Mu Xiang, Sha Ren, Hou Pao Hua, and Buddha’s Hand, i.e. spleen health is not in tonic but in transportation. Spleen yang needs to be promoted and developed, therefore, clinically, astragalus, codonopsis, ascending mushroom, pueraria, etc. are often used to promote yang and benefit qi to treat the evidence of yang not rising, so that the middle qi can be encouraged to achieve the function of promoting and developing clear yang.
4. Typical case.
Xia, female, 51 years old.
Initial diagnosis on 2008.8.7
She was operated on for colon cancer on March 29, 2008, pathology: adenocarcinoma, stage III, LNM 14/18, 8 cycles of chemotherapy with FOLFOX4 regimen after surgery. He has been using Chinese herbal medicine since then.
Radix Astragali 30g Radix Panax Ginseng 30g Radix Salviae Miltiorrhizae 30g Radix Chrysanthemum 30g
Radix et Rhizoma Ligustrum 15g, Fructus Lycii 10g, Cornu Cervi Pantotrichum 10g, Radix Bupleurum 10g
Radix et Rhizoma Chen Pi 10g Radix Panax notoginseng 10g Radix Zingiber officinale 10g Radix Aconite 10g
Curcuma longa 10g Cockscomb 10g Sarcococca spp. 10g Jiao Sanxian 30g
20 Pills
2008.11.6 Follow-up Consultation
Appetite is fine, appetite is fine, stool is formed 3-4 times/day, sleep is fine, pulse is sunken, tongue is light red with thin white fur.
Rhizoma Atractylodis Macrocephalae 10g, Poria 10g, Radix Codonopsis 12g, Radix et Rhizoma Polygonati 30g
Radix et Rhizoma Ligustrum 15g, Fructus Lycii 10g, Radix Astragali 30g, Semen Cuscutae 10g
Radix et Rhizoma Chen Pi 10g Cao He Cao 15g Serpentine 30g Bai Ying 20g
Long Qi 15g Gynostemma spp. 10g Sandy Root 10g Fu Ling 15g
30 Pills
2009.3.17 Follow-up Consultation
Appetite, normal food intake, no abdominal distension and pain, stool 2-3 times/day, formed, slight weakness, sleep, sunken pulse, light red tongue, thin white fur.
Atractylodes macrocephala 10g, Poria 10g, Radix Codonopsis 15g, Radix Astragali 30g
Radix et Rhizoma Ligustrum 15g, Fructus Lycii 10g, Radix Rehmanniae 30g, Raw Job’s Tear 15g
Radix et Rhizoma Chen Pi 10g Sheng Ma 10g Radix et Rhizoma Serpentis 30g Bai Ying 20g
Long Aegis 15g Gymnema sylvestre 10g Sandy sage 10g Fu Ling 15g
30 Pills
2010.3.11 Follow-up consultation
Two years after colon cancer surgery, he stopped using Chinese medicine in the last month. At present, he is suffering from stomach discomfort, vague pain, abdominal distension, weakness, dry mouth, nasal discharge, dry stool, sunken pulse, light and dark tongue with thin white coating.
Radix Astragali 30g, Radix Codonopsis 12g, Rhizoma Atractylodis Macrocephalae 10g, Poria 10g
Pericarpium Citri Reticulatae 10g, Fructus Mucuna Pruriens 6g, Radix et Rhizoma Polygonati 15g, Radix et Rhizoma Polygonati 15g
Radix et Rhizoma Ligustrum 15g Fructus Lycii 10g Radix Bupleurum 20g Radix et Rhizoma Longifolia 20g
Vine Root 20g Gymnema sylvestre 10g Sarcocarpus officinalis 10g Jiao Sanxian 30g
20 Pills
2010.4.1 Follow-up consultation
Gastrointestinal discomfort and abdominal distension were significantly reduced, stools were normal, and no tumor recurrence and metastasis were found in the comprehensive review. The above formula is based on removing Yuan Hu and Bai Qu Cai, adding 30g of Chicken Blood Vine and 15g of Raw Job’s Tear, and taking 30 decoctions.
This patient is a postoperative colon cancer patient with stage III, LNM 14/18, with high-risk factors and prone to recurrence and metastasis. She has been taking Chinese herbal medicine for 2 years to help eliminate evil and prevent recurrence and metastasis, and has been taking Chinese herbal medicine consistently.
After starting chemotherapy, he had no right to transport and transform the spleen, and his blood level was low, so he used Ginseng and Atractylodes macrocephala with reduction to strengthen the spleen, and Huang Qi, Radix et Rhizoma Polygonati, Fructus Lycii, and Zizhejiang to nourish the blood and supplement with detoxifying and anti-cancer products to suppress the tumor. Later on, the treatment was combined with Xiang Sha Liu Jun Zi Tang to regulate the qi of the spleen and stomach, together with Sheng Ma to promote the qi of the spleen and stomach, which has been maintained for a long time without recurrence and metastasis. Some of the Fu Zheng medicines used also have tumor suppressing and anti-cancer effects, such as Atractylodes Macrocephala, Poria, Raw Job’s Tear, Fructus Lycii and Radix et Rhizoma Polygonati, which improve the quality of life on one hand and further prevent tumor recurrence and metastasis on the other.