How does Chinese medicine treat chemotherapy vomiting?

       Chemotherapy for cancer has formed a perfect theoretical system and is recognized as one of the three major means of cancer treatment. Nausea and vomiting is one of the common side effects of chemotherapy, with an incidence rate of about 65%-85% and almost 100% for cisplatin.  Modern medicine recognizes the factors of vomiting mechanism, although the mechanism of chemotherapy-induced nausea and vomiting is not very clear, but on the current research results show that chemotherapy vomiting can be roughly divided into two aspects: central mechanism or gastrointestinal mechanism.  DA receptor antagonists, 5-HT receptor antagonists and NKI receptor antagonists have been developed, the former two being poorly effective against delayed vomiting and the latter effective against both acute and delayed vomiting. Protection of the gastrointestinal mucosa and reduction of the stimulation of chromophores in large numbers also have a role in anti-vomiting.  Chinese herbal medicine has made a lot of research work in the prevention and treatment of chemotherapy vomiting, but there are many shortcomings, the general formula is slow to work specificity is not strong, the mechanism is less explored, only limited to the level of a certain formula a certain effect, the research stays on the performance of vomiting, rarely systematically in-depth study of its central or peripheral intrinsic mechanism of pharmacological effect.  Therefore, in order to open up new therapeutic ideas, looking for standardized treatment methods for chemotherapy vomiting, and reveal its mechanism and propose awareness, briefly described below.  1, chemotherapy vomiting etiology understanding and symptom performance chemotherapy drugs in the long history of Chinese medicine is recently faced with emerging issues, is a dual factor in the treatment and cause disease, in the treatment of disease at the same time can cause disease. According to TCM, the etiology of vomiting includes the six external influences, the seven internal injuries, as well as the uncontrolled diet and excessive labor, etc. Chemotherapeutic drugs as the etiology seem to be related to the six external influences, the seven internal injuries, the diet and labor, plague and epidemic poison, external injuries and insect and animal injuries.  The symptoms of vomiting caused by chemotherapy are diverse, and the disease may be slow or acute, with vomiting there may be liver, kidney and even heart and lung lesions of the internal organs.  Accompanied by diarrhea or abdominal distension, facial lip and nail darkening, hair loss, light tongue, slippery moss, moist and weak pulse.  The occurrence, development and metastasis of tumor patients are fundamentally due to the deficiency of positive energy, declining function of the internal organs, imbalance of qi, blood, yin and yang, and the disease evil from superficial to deep, resulting in “evil qi overflowing” and multiple changes of evidence.  Chemotherapy drugs (toxic substances) attack the human body, and the five organs are affected by the disease, resulting in a variety of symptoms, and from vomiting, chemotherapy vomiting especially hurts the spleen, stomach and kidneys. The strength of the body’s positive energy can determine the severity of chemotherapy vomiting, strong positive energy is light, weak positive energy is heavy.  The kidney and the spleen and stomach form a dependency relationship in which the “innate” nourishes the “innate” and the “innate” feeds the “innate”. In the internal organs, vomiting disease in the spleen and stomach, but the five internal organs in the mutual root and use, especially relying on the kidney, “the kidney for the stomach off”.  The stomach is the main receiver of water and grain, the kidney is the main gasification of water, the stomach of water are gasified by the kidney and transferred to the bladder and out of the body, on the contrary, if the kidney loses gasification, can not be angry water, water will also be on the stomach, because the kidney for the peony, located in the north and the main water, and the kidney resides in the lower jiao, the real yin and real yang, for the life of the door where it lives. The stomach is the sea of water and grain. It is the master of ripening and consuming water and grain, and its Qi is descending to be smooth.  If the kidney Yang is weak, the life of the fire failure, the kidney gas can not be transformed, the lack of kidney gas can not be transformed into water, and the water gathered in the internal organs, the stomach in the middle jiao, the main gas descending, water gathered in the lower jiao, the water channel is not conducive, gastric stagnation can not be its descent, will hold the kidney of the water gathered and reverse the stomach, the hair for vomiting water.  It can be seen that the deficiency of kidney qi, the loss of the transformation of water, the loss of guard, water gathered and attacked on the stomach, resulting in the loss of gastric Qi, rushing against the upper, vomiting can be issued, spleen qi depletion is issued for tiredness and weakness, cachexia, dizziness and palpitations, limbs are sore and soft face light white light, kidney qi damage, then hair loss, lumbar weakness.  Therefore, it is believed that chemotherapy drugs into the human body, is the poison attack to make the right qi depletion, health and transportation loss, qi stagnation, gastric qi upward rebellion, “into the pulse into the marrow”, many organs damage, while not being able to regulate the protection also has a relationship.  Chemotherapy drugs as evil, is the process of poisonous attack, that these cytotoxic drugs damage the righteousness, the righteousness exists within, evil can not dry. The spleen is strengthened so that the spleen can reach the healthy movement, and the stomach and stomach qi and descend, and the kidney is strengthened so that the kidney can move water with luck, then the lift is orderly, and the qi is regulated, and the spleen and kidney are strengthened so that the positive qi is stored inside (some scholars modern pharmacological research on strengthening the spleen and benefiting qi drugs can improve the tolerance of animals to chemotherapy drugs, and there is a significant overall detoxification effect on a variety of chemotherapy drugs. Therefore, it is believed that strengthening the spleen, stomach and kidney is the basic rule for treating chemotherapy vomiting.  The formula consists of Xiang Sha Liu Jun Zi Tang and Liu Wei Di Huang Wan, which is composed of Mu Xiang, Fa Xia, Sha Ren, Ginseng, Shu Di Huang, Shan Yao, Chen Pi and Yu Zhu. Xiang Sha Liu Jun Zi Tang originally treats spleen and stomach Qi deficiency, stagnation of cold and dampness in the middle jiao, and functions to strengthen the spleen and stomach, regulate Qi and relieve pain. Liu Wei Di Huang Wan is used to nourish the liver and kidney. Ginseng in this formula is sweet, slightly bitter and slightly warm. It belongs to the spleen and lung meridians.  It is good for treating Qi deficiency, Spleen Qi deficiency, Lung Qi deficiency and Blood deficiency and Yang atrophy. The materia medica Jing Vegetables: “ginseng can return Yang Qi in the dying, …… benefit true Qi, then the five organs are tonic carry on”. Poria taste sweet, light, flat. It belongs to the heart, spleen and kidney. Efficacy: diuresis and percolation of dampness, strengthen the spleen, calm the mind.  Used for spleen deficiency evidence, palpitations, insomnia and edema. The “World Complementary Medical Book”: “Poria can move water”, “Poria can also move damp”. Cornus officinalis is sour and slightly warm, and belongs to the liver and kidney. Effects tonic liver and kidney, astringent and kidney.  It is a good source of energy for the liver and kidneys. Lei Gong Gong Gong Moxibustion: “Strengthening the vital energy and secreting the essence”. Radix Rehmanniae Praeparata is sweet and slightly warm, and is classified as a member of the Liver and Kidney meridians. It is effective in nourishing the blood and nourishing the yin, and tonifying the marrow.  It fills the bone marrow and grows muscles, generates essence and blood, nourishes the deficiencies of the five internal organs, opens the blood vessels, benefits the ears and eyes, and darkens the hair. Fuxia is warm in nature and belongs to the spleen, stomach and lung meridians. It is warm and belongs to the spleen and lung meridians.  Many medicines in this formula have the effect of strengthening the spleen, tonifying the kidneys and filling the essence, so that the positive qi can be consolidated and protected, while Mu Xiang, Chen Pi and Fuxia have the function of harmonizing the stomach and lowering the rebellion.  The time requirement of medication is generally 2-3 days before chemotherapy, the sweet and moist taste is heavy, sour and astringent taste should be light (the patient feels, sour taste is difficult to swallow) chemotherapy with DA receptor antagonist, 5-HT receptor antagonist, etc.  Before and after chemotherapy with spleen and stomach drugs, chemotherapy interval to consolidate the kidney medicine is the main, after the end of chemotherapy, can be taken continuously, add or subtract with the disease, to the end of the chemotherapy course, can significantly reduce, or even control nausea and vomiting, reduce the occurrence of delayed vomiting, and at the same time can protect the body’s righteousness.  The rule and medication is the summary of clinical practice and is a proven method. We should actively carry out the mechanism and clinical exploration of chemotherapy vomiting, especially delayed vomiting, and give play to the strengths of Chinese medicine to be in the forefront of the times as soon as possible.  Prescription treatment can also prevent and control bone marrow suppression and raise white blood cells.