Acute leukemia is a common malignant tumor of the hematopoietic system, characterized by fever, anemia, bleeding and infiltration, with rapid progression, severe disease and high mortality, which seriously threatens people’s health. Due to the constraints of insufficient source of stem cell donors, high cost and high risk, combined chemotherapy is still the main treatment for acute leukemia in China, but many patients cannot tolerate chemotherapy due to the side effects of gastrointestinal reactions, cardiac, hepatic and renal toxicity, bleeding and infections that occur during chemotherapy. It can enhance the sensitivity and antitumor effect of chemotherapy drugs, regulate immunity, enhance physical fitness, promote the recovery of myelosuppression, improve patients’ quality of life, and patients’ compliance is better, which is obviously better than chemotherapy treatment alone. According to the clinical manifestations, acute leukemia belongs to the “warm disease”, “acute labor”, “hot labor”, “blood evidence” and “accumulation evidence” in Chinese medicine. “blood evidence”, “accumulation evidence”, “deficiency labor” and other categories in Chinese medicine. According to Chinese medicine [8], the pathogenesis of acute leukemia is due to the weakness of the body’s righteousness, attacked by evil toxins, the onset of internal and external factors interacting with each other, the patient’s congenital deficiency of endowment, or the seven internal injuries, poor diet, excessive labor, damage to the liver, spleen, kidney and essence, so that the yin and yang, qi and blood, internal organs dysfunction, internal deficiency of the righteousness, compounded by the six external evil spirits or plague and cause the disease, due to deficiency, due to disease, deficiency and mixed reality. As the clinical manifestation of acute leukemia is polymorphic, the symptoms vary with the development of the disease and treatment, so it is necessary to adjust the treatment rules and prescriptions according to the changes in the symptoms. According to our clinical experience, the disease is divided into three stages and treated with Chinese medicine staging sequential therapy combined with chemotherapy, with obvious clinical results, which are described below. 1. Pre-chemotherapy: Before the patient is first diagnosed with acute leukemia and has not yet undergone chemotherapy or recovered from myelosuppression after chemotherapy and is ready to undergo chemotherapy again, the patient’s evil conditions such as high fever and bleeding are more obvious during this period, and the tumor cells are proliferating vigorously (or the killing effect of chemotherapy drugs on tumor cells has basically disappeared), while the normal hematopoietic function is suppressed, and the signs of positive deficiency are also seen. The clinical symptoms include fever, sore throat, bone pain, enlargement of liver, spleen and lymph nodes, skin and mucous membrane petechiae, epistaxis, epistaxis, even blood in stool, blood in urine, dizziness, weakness, soreness and weakness of waist and knees, night sweating and low fever, five heartburn, red or dark red tongue, yellowish dry or grayish black moss, slippery and large pulse. The formula uses Huanglian Detoxification Tang, Rhizoma Dihuang Tang, Qing Ying Tang, Scrofula Soup, Tao Hong Siwu Tang, Si Jun Zi Tang, and Liu Wei Dihuang Wan with addition and reduction, and the common flavors are Prince’s Ginseng, Sheng Bai Shao, Sheng Bai Zhu, Sheng Di, Fried Dan Pi, Huang Lian, Fried Huang Bai, Gardenia, Scutellaria, White Flowered Snake Tongue Herb, Half Branch Lotus, Little Thistle, Xuan Shen, Zhe Bei Mo, Snake Berry, Mu Man Tou, San Ling, Curcuma, Long Qi, Shan Dou Gen, Xiong Huang, and Qing Dai, etc. Modern pharmacological studies have shown [9]-[14] that many heat-clearing and detoxifying, blood-stasis-activating, phlegm-dispersing herbs have anti-tumor and immune-modulating effects. Some patients with hypoproliferative leukemia show low peripheral blood triad, severe anemia, and obvious symptoms of positive deficiency at the initial stage. At this time, if we use bitter cold to attack and detoxify the blood, not only can we not solve the symptoms, but also it is very easy to injure the positive, which makes the positive more deficient, and the condition deteriorates and commits the precaution of deficiency, so it is appropriate to support the positive, and at the same time detoxify and attack the evil, and when the patient’s blood picture improves, then the main purpose is to dispel the evil, so as to lay a smooth entry of the patient into the chemotherapy period The solid foundation should be laid for the patient to enter the chemotherapy period smoothly. 2, chemotherapy period: systemic chemotherapy is still the most effective method to achieve complete remission in acute leukemia, and the sooner patients achieve complete remission, the longer their survival time. According to the patient’s systemic condition, induction of remission or consolidation of intensive, maintenance treatment programs are used to enable patients to achieve or maintain a state of complete remission and prolong disease-free survival. However, during chemotherapy, due to the toxic side effects of chemotherapeutic drugs, patients often experience gastrointestinal reactions, heart, liver, kidney and nervous system toxic reactions, clinical manifestations are mostly seen in nausea, vomiting, diarrhea, dizziness, palpitations, weakness, night sweating, pale tongue with white fur, thin and slippery pulse, Chinese medicine identifies the deficiency of both qi and yin, weakness of the spleen and stomach, loss of harmony in the middle jiao, treatment is intended to benefit qi and nourish yin, strengthen the spleen and stomach, resolve dampness and help transport, clinical use of Xiang Sha Liu Jun Zi Tang, The treatment is to benefit qi and nourish yin, strengthen the spleen and stomach, and resolve dampness and promote transportation. At the same time, a small amount of heat-clearing and detoxifying products and phlegm-dispersing products, such as Baihua snake-tongue herb, half-branch lotus, Zhebei mother and small thistle, are often added to enhance the antitumor effect in synergy with chemotherapeutic drugs. Experimental studies have shown [14]-[16] that zhebei mu and chuanxiong have the effect of reversing drug resistance of leukemia cells and enhancing the sensitivity of chemotherapeutic drugs. Thus, the combination of Chinese herbal medicine during chemotherapy can achieve a potentiation and toxicity reduction effect and improve the remission rate of acute leukemia patients. It is worth noting that since some leukemia patients have heavy gastrointestinal reactions during chemotherapy, there are certain difficulties in taking Chinese medicine tonics. In addition to taking small amounts frequently, on the basis of not affecting the efficacy of the medicine, the Chinese medicine dosage form can be improved and Chinese medicine tablets and injectable drugs can be developed to increase the effective utilization and improve the clinical efficacy. This period is characterized by dysfunction of the internal organs, deficiency of qi and blood, and bone marrow damage, and is characterized by clinical fatigue, dizziness and tinnitus, dullness and little food, soreness and weakness of the waist and knees, lack of color, pale tongue with white fur, and sinking pulse. The treatment is to strengthen the spleen, benefit the kidney, benefit the qi and nourish the blood, at the same time to clear the evil toxins and support the righteousness, with the help of dispelling the evil. It should be noted that the late stage of chemotherapy for leukemia is often the evil is weak, the vital energy, gastric energy, fluids, essence and blood are damaged, treatment should be to support the righteousness and cultivate the root, but not suddenly into the warm tonic agent, one is deficient in tonic, the other is easy to close the door to stay invasive, help the fire to generate heat, so that the heat and toxicity of the evil has been controlled “rekindled”, and committed the real real disadvantage, the clinical evidence is often The main objective is to strengthen the spleen and kidneys, and to remove the residual evil toxins by using detoxifying and anti-tumor products, so as to make up without stagnation, and to clear but not over. Patients in this stage often have fever, bleeding and anemia due to bone marrow suppression and obvious decline in peripheral blood trigeminal system. Numerous experiments in recent years have shown [17]-[19] that many Chinese herbal medicines that benefit the qi and nourish the yin and tonify the kidney have the effect of regulating immunity, eliminating the tiny residual lesions of leukemia, and enhancing the function of the body’s immune surveillance system, thus effectively preventing the relapse of acute leukemia and prolonging the survival period. 4, the urgent is to treat its symptoms: the urgent is to treat its symptoms is in the heat toxicity, blood heat delusion, internal closure and external release and manifestation of obvious bleeding, fever, dizziness, because the condition is more urgent, rapid progress, should be quickly cast clear heat detoxification, cool blood to stop bleeding, wake up the brain to open the orifice of the agent to treat the symptoms first. If there is also blockage of internal qi, the diarrhea of heart soup from the Treatise on Typhoid can be added as appropriate, taking the meaning of “diarrhea of heart means diarrhea of fire, and diarrhea of fire means stopping bleeding”, so as to remove heat and stop bleeding. It can be combined with comprehensive measures such as blood transfusion, anti-infection, dehydration and lowering cranial pressure to quickly control the disease, and after the heat toxicity is removed, the fever subsides and the bleeding is controlled, then try to treat it later. 5, time to time to protect the stomach gas: the former sage cloud: “with stomach gas is alive, no stomach gas is dead.” The stomach is the sea of water and grain, the main intake of decomposition, to descend for and, like to moisten but not dry; the spleen is the main transport, clear, like to dry but not wet. The spleen and stomach are the pivot of the qi flow, all food and drugs are taken in and cooked by the stomach, and the maintenance of the body’s vital activities depends on the transformation of the water and grain essence into qi, blood and yin essence, and the transformation of the water and grain essence is inseparable from the normal transport function of the spleen and stomach. Therefore, when treating acute leukemia patients with chemotherapy and a large number of drugs, it is very easy to damage the spleen and stomach, and once the spleen and stomach are injured, there is no source of Qi and blood biochemistry, and the kidney essence is not filled with water and grain essence, so it is difficult for therapeutic drugs to work and the blood production function cannot be restored.
Therefore, during the treatment of leukemia with Chinese medicine in stages, we always add products that regulate qi to help transport and harmonize the stomach to resolve dampness, so as to attack the evil without hurting the middle, and to supplement the deficiency without congestion, often taking Xiang Sha Liu Jun Zi Tang with an addition and subtraction, such as Han Xia, Chen Pi, Cardamom Seed, Fried Citrus Aurantium and Pelargonium. At present, except for acute promyelocytic leukemia, the improvement rate of pure Chinese medicine for leukemia is still low and cannot achieve the same effect as chemotherapy drugs, while the combination of Chinese medicine staged sequential therapy with chemotherapy can improve the remission rate of acute leukemia, reduce the toxic side effects of chemotherapy, reverse leukemia cell resistance, eliminate micro residual leukemia foci, enhance the body’s immune surveillance function and improve physical fitness, but not all patients can However, not all patients can achieve these results, so we need to further carry out clinical research on TCM for acute leukemia, as well as in-depth experimental research on the targets of TCM for regulating body immunity, reversing drug resistance, inducing differentiation, and promoting apoptosis, so that the experimental research can be closely integrated with clinical practice to further optimize the TCM treatment protocol for acute leukemia.