Colorectal cancer refers to malignant tumors originating from the colon and rectum, and is one of the most common gastrointestinal cancers. Among them, low-grade colorectal cancer (rectal cancer) accounts for 60% to 75% of colorectal cancer. The occurrence of this disease has obvious differences in geographical distribution, with high incidence areas such as North America, Western Europe and Oceania; low incidence areas such as Africa, Asia and South America. The incidence rate and mortality rate in high and low incidence areas differ by more than 10 to 20 times. The incidence rate of colorectal cancer occupies the 1st and 2nd place among malignant tumors in Western Europe and North America. In China, with the change of people’s living habits and diet structure, the incidence rate of colorectal cancer also has a gradually increasing trend. In 1977, the average adjusted mortality rate of colorectal cancer in China was 3.54/100,000, accounting for 5.29% of malignant tumor deaths, ranking sixth; in 1990~1992, the average adjusted mortality rate of colorectal cancer was 4.54/100,000 in the national one-tenth population sample survey, accounting for Currently, the incidence and mortality rate of colorectal cancer in large cities in China are the third highest. The age of onset of colorectal cancer is 40-60 years old, but those under 30 years old also account for 1/5, and the median age of onset is about 45 years old, and the ratio of male to female incidence is 1.2-2:1. Colorectal cancer seriously endangers people’s health and brings heavy burden to the society. Chinese medicine has its characteristics and advantages in the treatment of lung cancer, and it is playing an increasingly important role in the treatment of lung cancer. The experience of Chinese medicine treatment of lung cancer is described as follows.
1. Detailed examination of etiology and disease mechanism
Colorectal cancer belongs to the Chinese medicine “intestinal nettle”, which is the most common cause of lung cancer. Look at the (12) woods crab crab salary together with the glory to play the breams woods snail land together with change the sex cricket dad steals the wisdom to leap again! The first time I read a book, I was a member of a group of people who had been working in the field for a long time. The main reason for this is that it is a very good idea to have a good understanding of the nature of the people who are involved in this process. The actual fact that K靥逍槿酰 (5) haze dissatisfied earth sculptureУ soleξ杆鹕耸悄bragging yellow pidgeon hard spring sole sympathy gorgonzola 盎蛞巢唤谑峭庖颉3＜牟∫虿』校阂巢唤塚仁撤矢剩鹕似⑽福⑽冈嘶荆刃岸驹探岢Φ溃站枚刹. Slow rate Ы塚蚓米兀惺苄捌率蛊⑽甘苌耍凳С#怀脱觯嵊诔Φ蓝杀静. The first thing that I want to do is to make sure that I have a good understanding of the situation.
2.Keeping to the evidence-based treatment
Discriminatory treatment is the process of applying theory, method, prescription and medicine in clinical practice, which is the basic feature and essence of Chinese medicine. It is difficult to use a single type to summarize the whole course of the disease, so the treatment should adhere to the principle of discriminatory treatment and should not be confined to one corner. Clinically, the following four types of evidence are most common in colorectal cancer.
2.1 Dampness and heat accumulation type
Main symptoms: abdominal pain and distension, stagnant stool, urgency, mucus in stool, sometimes accompanied by pus and blood, burning sensation in anus, bitter and dry mouth, short and red urination. The tongue is dark red, with yellowish greasy coating and slippery pulse.
Treatment: Clearing heat and relieving dampness, detoxifying and dispersing nodules.
Main formula: Bai Tou Weng Tang with addition and subtraction.
Effects: Baitou Weng 15g, Huang Bai Bai 9g, Huang Lian 6g, Qin Pi 9g, Fructus Sulcus 30g, Di Yu 15g, Sophora 15g, Semen Nelumbo 15g, Coix Seed 30g, Bitter Ginseng 9g, Mu Xiang (later down) 6g, Bai Hua Shi Tong Cao 15g, Tu Fu 6g, Gan Cao 6g.
2.2 Internal obstruction by stasis and poison
Main symptoms: abdominal pain and distension, pain with a fixed location, abdominal mass, pus and blood mucus in the stool, or urgency, constipation or loose stool, flattening or thinning of stool. Dark red tongue with petechiae, thin yellow coating and string pulse.
Treatment: Promote blood circulation to eliminate blood stasis, detoxify and disperse nodules.
Main recipe: Add reduction to Diaphragmatic Expelling Blood Stasis Soup.
Effects: Angelica sinensis 9g, peach kernel 9g, safflower 3g, red peony 12g, aromatic herb 9g, ocimum sanctum 9g, heliotrope 12g, chuanxiong 12g, yanhuosuo 12g, dampi 9g, earth turtle 6g, centipede 2, licorice 6g.
2.3 Spleen and kidney deficiency type
Symptoms: abdominal pain and falling, enlargement of abdominal mass, frequent stools, foul-smelling pus and blood in the stool, pale and tasteless mouth, little qi and dullness, cold in the extremities, soreness and weakness of the waist and knees, and physical and mental deterioration. The tongue is light and dark, with white fur and sunken pulse.
Treatment: Strengthening the spleen, tonifying the kidney, benefiting Qi and activating blood.
Main formula: Rizhong Pill combined with Sishen Pill plus and minus.
Drug: Radix Codonopsis pilosulae 15 g, Rhizoma Atractylodis Macrocephalae 15 g, Radix Ginger 6 g, Cornu Cervi Pantotrichum 6 g, Fructus Psoralea 9 g, Nutmeg 9 g, Fructus Schisandrae 9 g, Poria 15 g, Radix Astragali 30 g, Radix Glycyrrhiza Uralensis 6 g.
2.4 Qi and blood deficiency type
Main symptoms: vague pain in the abdomen, fishy mucus in the stool, pale complexion, shortness of breath, weakness, dullness, dizziness and body fatigue, loose stools. Pale tongue, thin white coating, weak and feeble pulse.
Treatment: Tonify Qi, nourish Blood, and support the root.
Direction: Add and subtract Eight Precious Soup
Effects: Astragalus membranaceus 30g, Radix Codonopsis pilosulae 15g, Atractylodes macrocephala 15g, Poria cocos 15g, Rhizoma rehmanniae 15g, Radix Paeonia lactiflora 15g, Radix Angelicae Sinensis 9g, Rhizoma Chuanxiong 15g, Agaricus blazei (melted) 9g, Glycyrrhiza glabra 6g.
3, identify the deficiency, to determine the attack and supplementation
According to the changes of the body and cancer tumor, the process of the fight between evil and positive can be roughly divided into three stages, namely, early, middle and late stages. For example, in the “Essential Reading for Medical Practitioners? It is said in the chapter of “Gathering” that: “The positive and the evil are not mutually exclusive, if they are low, a win is a loss, the evil is growing day by day, the positive is being reduced day by day, if it is not attacked, the death will come from and on! However, the attack is too fast, the righteousness of the injury, the end of the three methods of middle school must not be said. The beginning of the disease is still strong, the evil is still shallow, it is subject to attack; the middle of the disease for a long time, the evil is deeper, weaker, it is subject to attack and supplement; the end of the disease demon after a long time, the evil encroachment, the righteousness of the residual, it is subject to supplement. Cover the accumulation of the righteousness, day by day, month by month, not Yi dynasty, so to go, there should also be gradual, great urgency is wounded right qi, right qi injury can not be transported, and the evil anti-solid carry on.” From here we can find that the staging criteria of TNM in modern medicine and the staging in Chinese medicine are not exactly the same, they represent different meanings respectively. The reason for this is that the staging referred to by the former is decided according to the size of the tumor, the presence or absence of lymph node metastasis, and the presence or absence of distant metastasis, and is based on the tumor as the main object of observation; while the staging in Chinese medicine is decided according to the mutual condition of the body’s positive energy and evil energy in the process of disease development, and is based on the body as the main object of observation. From the perspective of Chinese medicine, in the initial stage, that is, the early stage, when the evil qi starts, the positive qi is strong and the evil qi is real, the treatment is based on attacking and eliminating the evil qi; in the middle stage, the tumor gradually increases, the evil qi is strong and starts to injure the qi, rob the blood and consume the essence, the evil qi is in the stage of holding each other, the organism is gradually losing its shape and spirit, the deficiency image is already revealed, the treatment is based on both attacking and supplementing; in the final stage, that is, the late stage, the cancer tumor is coiled and knotted, the evil qi is invaded and arrogant, the positive qi is deficient and unable to attack, the treatment is based on The treatment should be based on supporting and cultivating the root, with attacking and supplementing.
4.Focus on supporting the righteousness and strengthening the spleen
The pathogenesis of colon cancer is a complex process. Although there are various external pathogenic factors, the key to the pathogenesis depends on the lack of positive energy caused by the dysfunction of human internal organs and meridians, i.e. “internal deficiency”. As stated in “The Essential Readings of Medicine? General Theory of Evidence and Treatment” says: “The formation of accumulation is also due to the deficiency of positive qi and the entrapment of evil qi.” Ming? Zhang Jingyue said, “People with deficiency of spleen and kidney and weakness and disorder have the disease of accumulation.” Therefore, the treatment of malignant tumors should not focus on attacking evil (anti-cancer), but must also pay attention to supporting the righteousness, maintaining the balance of yin and yang of the body, and harmonizing the internal organs. As mentioned above, spleen deficiency and dampness is the main pathogenesis of colorectal cancer, and spleen deficiency is especially important in the development of colorectal cancer. Spleen deficiency is especially important in the development of colorectal cancer because the spleen is the main transporter of water, grain, essence and water-dampness, and the spleen and stomach are the source of blood production, which is called the foundation of the latter. Poor diet or emotional disorders can lead to spleen deficiency, resulting in abnormal transportation and transformation, loss of distribution of essence and water-dampness, which will be retained in the intestine and become a tangible evil, which will lead to the development of the disease in a long time. Therefore, when treating colorectal cancer, special attention should be paid to regulating the spleen and stomach. Commonly used Chinese medicines include Radix et Rhizoma Ginseng, Atractylodes Macrocephalae, Poria, Astragalus, Semen Coix, Huai Shan, etc. Commonly used formulas include Si Jun Zi Tang and Six Jun Zi Tang, etc.
5.Internal consumption combined with enema, the six internal organs to pass for use
Ancestral medicine believes that the large intestine is one of the six internal organs, after the food and drink in the small intestine to distinguish between clear and turbid, the clear, i.e. water and grain essence is transferred to the heart and lungs through the spleen and spread around the body, the turbid, i.e. dregs, descends to the large intestine, which turns the dregs into stool through dryness and excretes them out of the body. The main physiological function of the large intestine is to transmit the dregs, so the large intestine has the name of “conduction of the internal organs” and “conduction of the official”. The Suwen Linglan Secret Code says: “The large intestine is the official of transmission, change out.” The six internal organs are used to pass and descend. Patients with colorectal cancer mostly have obstruction in the lift of intestinal qi, the clear qi drains down, the turbid yin does not descend, and the internal qi does not pass, so the clinical manifestations are dullness, abdominal distension, abdominal pain, constipation, and the urgency and heaviness. Therefore, in the treatment, we should focus on moving the qi and clearing the internal organs, cleaning the damp-heat and toxic evil, and removing the stagnation in the intestinal tract. When the clinical evidence is often used rhubarb, Chuan Park, Citrus aurantium, Lycopodium, betel nut and other drugs to move the qi and ventilate the internal organs, so that the diarrhea does not hide. In addition, Chinese medicine enema is also a common clinical treatment method, especially for patients with rectal cancer, sigmoid colon cancer and colorectal cancer combined with intestinal obstruction. Enema drugs can be used such as rhubarb, tiger scepter, dandelion, silver flower, safflower, bitter ginseng and whitehead. Chinese medicine enema has the function of opening the internal organs and lowering the qi, so that the dregs can be removed, dampness, heat, stasis and toxicity can be leaked out, and there is a way out for the evil, in addition, the drugs can directly contact with the cancer foci, and with internal Chinese medicine, it can get twice the result with half the effort and work better.
6. Combination of disease identification and evidence identification
Discriminative treatment is the basic feature of Chinese medicine and the essence of Chinese medicine in treating diseases. Like other diseases, Chinese medicine treatment of malignant tumor should also be based on the four diagnoses and eight principles and prescriptions of Chinese medicine. However, due to the special nature of colorectal cancer, on the basis of evidence-based treatment, combined with the traditional theory and experience of Chinese medicine for many years, we should select some drugs with proven anti-cancer efficacy according to the nature, taste, efficacy and clinical application characteristics of the drugs, which is called disease-specific treatment. Only with proper combination of disease identification treatment and evidence identification treatment can we obtain better clinical efficacy. Commonly used drugs that are effective against colorectal cancer include Bupleurum, Semen, Seven-leaved one flower, Bitter ginseng, Xianhecao, Shou Gong, Centipede, Coix, etc. In addition, the disease of colorectal cancer is dangerous and progresses rapidly, so it is afraid that the effect of tonics is not enough, but the in-depth research of modern Chinese medicine and the reform of dosage form can make up for these shortcomings to a large extent. Commonly used Chinese patent medicines include: Pingxiao capsule, Ankangxin capsule, compound bitter ginseng injection, Kanglaite injection, Huachansu injection, zebranate sodium injection, etc.