Treatment from fire, dryness and cold water
Esophageal cancer belongs to the category of “choking and diaphragm” in Chinese medicine, and it is advocated to classify esophageal cancer as “compartmentalized evidence”. Firstly, general esophageal lesions are not enough to cause serious symptoms, extent of lesions and poor prognosis of vomiting upon ingestion; secondly, Huang Di Nei Jing also used “septum” to describe the symptoms of vomiting upon ingestion at the earliest, and there is a classical statement in Nei Jing that “three yang knots are called septum”. In the Nei Jing, there is a classical statement that “three yang knots are called septic”.
The seventh chapter of Suwen-Yin-Yang is called: “Two yang knot is called elimination, three yang knot is called separation”. The author advocates clinical treatment from fire, dryness and cold water, and has achieved satisfactory results. The “three yang knot” is Shaoyang, Yangming, Sun three yang mutual knot, the formation of the “evidence of separation”, so from the perspective of clinical application is not difficult to understand: a Yang for Shaoyang phase fire, fire; two Yang for Yangming dry gold, dry; three Yang for the Sun cold water, cold, three Yang knot for The three yang knots are fire, dryness and cold, which obstruct the lift of qi and turn into phlegm and stasis over time, and the joint action of phlegm, fire, dryness, cold and stasis results in “compartment evidence”.
At present, western doctors use gentamicin and scopolamine injection orally to relieve esophageal cancer obstruction, which is analyzed by Chinese medicine: gentamicin dispels fire, scopolamine injection inhibits glandular secretion and has the effect of dispelling phlegm, which is partly consistent with the analysis of the etiology and pathogenesis of Chinese medicine. In addition, when analyzing the elements of the pathogenesis of esophageal cancer patients from the perspective of luck, it is found that most of the patients have the coexistence of fire, dryness and cold factors at birth, which also supports the author’s explanation of the “three yang knots” of esophageal cancer.
Gastroscopic manifestations should be identified
Discriminatory treatment is the essence of Chinese medicine, and in the application of Chinese medicine for esophageal cancer treatment, the comprehensive application of multiple discriminatory methods is emphasized. In addition to the common identification of internal organs, six meridians and qi, blood and fluids, there is also great emphasis on diagnostic methods such as ear diagnosis, hand diagnosis, facial diagnosis, pulse diagnosis, tongue diagnosis, five movements and six qi, especially the Chinese medicine identification of esophageal cancer site manifestation under gastroscopy.
Identification according to site and pathology
Tumors are also distinguished from hot and cold, and there is a certain relationship between hot and cold and tumor site and pathological type. Tumor site differentiation should be recognized from body surface – internal, head and neck – lower limbs, abdomen – back, different parts of the same organ, etc. Esophageal cancer near oral cavity is mostly squamous carcinoma, which mostly shows symptoms of fire; near cardia segment, mostly adenocarcinoma; foamy mucus is more, which mostly belongs to cold phlegm.
Identification according to gastroscopic manifestation
Early esophageal cancer can be divided into occult type, erosion type, plaque type and papillary type according to its morphology. Among them, plaque type is the most common, accounting for about 1/2 of early esophageal cancer. This type of cancer cells are better differentiated, with mildly elevated surface, rough and uneven, orange peel-like, and bleeding easily when touched. The vesicular type accounts for about 1/3 of the cases, mostly lacking in yin and belonging to Yang Ming dry gold. The most characteristic of papillary type is protruding surface with much blood on the surface, which is commonly due to Qi stagnation and blood stasis or phlegm-stasis interconnection.
The pathological morphology can be divided into medullary, myxomatous, ulcerative, constricted, intraluminal and undetermined types. Among them, medullary type has the highest malignancy, accounting for more than 1/2 of the mid- to late-stage esophageal cancer. Myxoid type accounts for 1/6 to 1/5 of middle and late stage esophageal cancer, and this type is similar to early papillary type, and the diagnosis is mostly due to Qi stagnation, blood stasis or mutual stagnation of phlegm and stasis. The ulcerated type accounts for about 1/10 of middle and late stage esophageal cancer, and the wall of this type can be obviously depressed. Constricted type accounts for about 1/10 of middle and late stage esophageal cancer. The mucosa of esophagus is contracted centripetally, so obstruction appears earlier and there are more mucous secretions, “cold is the main attraction”, so the diagnosis in TCM is mostly cold phlegm. This type is similar to the myxomatous type and ulcer type in that it has both phlegm and stagnation with insufficient qi and yin, and should be handled flexibly.
The prescription can be individualized
Warming Yang, invigorating Blood, resolving phlegm, benefiting Qi, nourishing Yin and lowering rebellion, and clearing heat to fight cancer and detoxify esophageal cancer are the basic treatment methods. The treatment is individualized according to the different evidence and individual differences.
Add and subtract according to Yin and Yang evidence
Although the clinical manifestations of esophageal cancer mainly focus on difficulty in eating, from the causes of esophageal cancer, it can be seen that most patients are heat patients, while very few can see cold signs such as cold drinks and condensation. Regardless of the pathological type of esophageal cancer, dysfunction of lung, stomach, spleen and kidney is the key to cause the disease, which is manifested as interconnection of phlegm and stagnation, and malfunction of qi flow, so the basic treatment should be to moisten lung and strengthen spleen, consolidate kidney and nourish yin, lower phlegm and eliminate stasis and stomach.
1. Add and subtract according to the metastases
Tumor metastases are mostly caused by the deficiency of positive or the obstruction of evil, therefore, we can add or subtract medicine according to the characteristics of metastases.
2. Lymph node metastasis
In case of lymph node metastasis, phlegm and dampness are flowing, the treatment should strengthen the effect of resolving phlegm and dispelling dampness by adding 30g of seaweed, 50g of sea fushi, 15g of dirong and 5g of burnt dried toad;
3. Liver metastasis
Liver metastases are mostly due to blood deficiency. Treatment should be to strengthen the effect of tonifying liver blood by adding 30g each of Radix Angelicae Sinensis, Radix Paeoniae Alba and Cornu Cervi Pantotrichum;
4. Lung metastasis
Lung is a delicate organ, the main organ of qi, and the organ for storing phlegm. In lung metastases, the lung is deficient in qi and yin, and phlegm and dampness do not dissolve, so the treatment should be strengthened by tonifying the qi and yin of the lung, resolving phlegm and dispersing nodules;
5. Multiple visceral metastases
It indicates a large deficiency of vital energy, which should be greatly tonified.
Addition and reduction according to symptoms
1. For those with swelling
Add 4 Zanthoxylum, 5g of burnt dried toad to soften the hardness and fight against cancer;
2. In case of chest pain
Add 10g of frankincense, 10g of myrrh, 10g of turmeric to activate blood circulation and relieve pain;
3. Chest tightness
Add 10g of Sandalwood, 10g of Salviae to regulate Qi and activate Blood circulation;
4. Vomiting
Add 30g of Ochre, 15g of Persimmon to subdue rebellion and stop vomiting;
5. Phlegm
Add Green Pores 30g, Fried Scutellaria 10g to remove phlegm and lower the Qi;
6. Constipation
Add 10g of rhubarb in wine, 30g of betel nut to regulate the Qi and clear the bowels;
7. Poor appetite
Add 30g of Jiao Shanzha, 30g of Jiao Shenqu, 15g of Huohuo, 15g of Su Stem to appease the stomach and relieve depression;
8. Cold
Remove Poria, Guadua, add 10g of white peppercorn, 3g of peppercorn, 10g of Sichuan pepper, 5g of Cornus officinalis, 30g of poria, 30g of zedoary to warm the Yang and dissolve the drink.