Current Situation and Advantages of External Treatment of Tumor in Chinese Medicine

The application of external treatment for tumors is one of the characteristics of Chinese medicine, which has a long history of thousands of years. As early as in the Warring States period, the Yellow Emperor’s Classic of Internal Medicine recorded external treatment methods such as stabbing and bleeding; in the Eastern Han Dynasty, Hua Tuo’s “routing the abdomen and back to extract the accumulation” was the earliest recorded surgical treatment. In the Jin Dynasty, the doctor Huang Fu Qu studied the doctrine of internal organs and meridians, and formed a unique treatment method for “internal diseases and external treatment”-acupuncture. In the Ming Dynasty, Zhang Jingyue in the “Jing Yue Quanshu?” cloud: “Where the hard accumulation, must be outside the gastrointestinal, collection between the original, the original non-medicinal force can be sudden to. It is advisable to use such things as ferula cream …… to attack its outside, and then use long Sangjun needle method to attack its inside. However, this hard and stubborn product, non-fire attack is difficult to dissipate, so it is better than moxibustion.” It means that Zhang Jinyue has fully realized that for difficult and serious diseases, internal medicine is often “not medicine can suddenly reach” need to use external treatment method to directly reach the disease, internal and external use to play a therapeutic role. In the Qing Dynasty, Wu Shiji summarized the experience of his predecessors, and through a large number of clinical practice verification, formed a monograph on external treatment, “Li Bo Era”. He not only used plasters for external treatment, but also applied dozens of methods such as compressing, ironing, fumigation, dipping, rubbing, sitting, sneezing, binding, scraping, cupping, tui na, massage, etc., which can be said to be a summary of external treatment of Chinese medicine. Through the application of external treatment methods, Wu Shiji proposed that “the theory of external treatment is the theory of internal treatment. The medicine of external treatment is also the medicine of internal treatment, but the difference is the method.” In other words, Chinese medicine should grasp the causes and mechanisms of disease, emphasize the identification of evidence, and analyze the internal organs according to their yin and yang, cold and heat, deficiency and reality, and then give appropriate treatment. This is true for internal treatment, and also for external treatment. External treatment is not just a headache treatment, but also a foot treatment, and external treatment should be regarded as local medicine. External treatment should be regarded as different from internal treatment only in terms of the method and route of drug administration. With the progress of clinical technology, the methods and therapeutic scope of external treatment of TCM have made some progress, for example, the current clinical methods of external treatment of tumor are: local thin paste method, peri-compound method, corrosion method, fumigation method, filling method, enema method, Chinese medicine ion penetration method, ultrasonic drug penetration method, Chinese medicine interventional therapy, intracavitary Chinese medicine injection method, nebulized inhalation method, etc. These methods are the result of combining external treatment of TCM with modern technology. For example, in the treatment of 50 cases of medium- to advanced-stage hepatocellular carcinoma in randomized groups, Yu Shengyong et al. found that the liver function damage and bone marrow suppression were less after hepatic artery infusion of huachanoxin + iodinated oil than in the chemoembolization group alone, and that percutaneous hepatic artery infusion of Chinese herbal medicine huachanoxin + chemoembolization for hepatocellular carcinoma could be an effective method for patients not suitable for TACE or TAE. liver cancer patients. Wan Donggui et al. applied acupuncture point ion introduction of herbal compound tincture (100 g each of Yanhuosuo, Boswellia, Myrrh and Salvia, 150 g each of Xu Changqing, etc.) to treat cancer pain with a total efficiency of 84%. According to the principle of Chinese medicine, Shen Keping and others have used ultrasonic nebulization method to treat some of the concomitant symptoms of four typical malignant tumor patients: respiratory inflammation, vertigo caused by brain metastasis, pharyngitis caused by chemotherapy, and swallowing disorder caused by excessive secretion of esophageal mucus, etc. with certain clinical efficacy. Our department has also carried out the treatment of cancer pain and thoracic ascites with local external application of traditional Chinese medicine, local injection of traditional Chinese medicine injection, interventional treatment with traditional Chinese medicine injection, and enema of tonics, etc. and achieved very good clinical effects. However, due to various reasons, the external treatment of tumor is less researched and progresses slowly nationwide, especially in large Chinese hospitals, or even in a stagnant state, or limited to the application of very few diseases, and some characteristic external treatment methods of Chinese medicine have been scattered among the people, or even on the verge of being lost. As a systemic disease characterized by localized lesions, tumors are currently treated by surgery, radiotherapy, chemotherapy, biological therapy and Chinese medicine (oral), but each of these methods has its own advantages and disadvantages. Surgery has a clear goal and a good prognosis, but because the onset of malignant tumors is mostly advanced, only about 20% of patients can be suitable for surgery, coupled with the gradual aging trend of tumors, the scope of surgical treatment is greatly restricted; radiotherapy is a less invasive treatment, highly targeted, and widely used in clinical practice, but its severe irreversible side effects, dose limitation, and the expansion of the aging population all limit its application; chemotherapy is a less invasive treatment, with strong targeting, and is widely used in clinical practice. Chemotherapy is one of the most common clinical treatments nowadays, and its intravenous administration makes it convenient to use, but while it kills tumors, it also hits normal human tissues very hard. However, these drugs have a single target and narrow indications, and are expensive, so they are not much used in clinical practice; oral Chinese medicine is one of the important methods for tumor treatment, which is cheap and widely used by the public, but oral tonics are long for systemic conditioning and weak for local masses. Combined with the characteristics of malignant tumors, the drugs or methods required for clinical treatment should have the following characteristics: 1. clear target of action 2. exact clinical effect 3. repeated and continuous application 4. little or no side effects 5. inexpensive and widely applicable to the population 6. convenient application and wide indications 7. evidence-based medicine and individualized treatment. Secondly, external treatment drugs are often used for localized tumors, which have clear target points and small toxic side effects, and can be combined with some modern technologies to improve the therapeutic effect, and can be applied repeatedly without drug resistance. Thirdly, Chinese medicine has a long history of application, has a broad base of trust and is cheap and easy to apply. Therefore, the development of external treatment of tumor has a wide prospect. In order to develop tumor external treatment method, we should first strengthen theoretical literature, strengthen theoretical research, and reveal the mechanism of external treatment from the deep level, and strengthen clinical practice to standardize clinical research, and combine the development of modern multidisciplinary technology for our use, and strengthen the research of dosage form. Through the clinical efficacy, we should research and develop the effective external antitumor drugs to promote the development of external tumor treatment.