Colorectal cancer is the collective name of colon cancer, rectal cancer, etc. It refers to malignant tumors occurring in the cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon, rectum and anus. This disease is equivalent to intestinal cancer in the national standard of Chinese medicine, and also belongs to the categories of intestinal mushroom, dirty poison, intestinal fetish, Y obstruction, locked anal hemorrhoid and blood in stool.
I. Diagnosis
Diagnosis is made with reference to the “New Standard for the Diagnosis and Treatment of Common Malignant Tumors” prepared by the Medical Secretary of the Ministry of Health of the People’s Republic of China in 1999. (Content omitted)
II. Chinese medicine treatment plan
(I) Treatment principles
1.Colon cancer. Surgical resection as far as possible. If the lesion is confined to the mucosa and submucosa layer and no metastasis is found in the lymph nodes, regular observation after surgery, TCM treatment is feasible. If the lesion invades beyond the muscular layer or the lymph nodes are positive, 6 cycles of adjuvant chemotherapy and TCM treatment are required after surgery.
2. Rectal cancer. Surgical resection as far as possible. If the lesion invades the pararectal tissue, choose preoperative radiotherapy as appropriate. If the lesion invades the deep muscular layer or lymph node positive after surgery, then postoperative radiotherapy, chemotherapy and Chinese medicine treatment.
3.Patients with advanced stage (or patients who are not suitable or cannot be operated) Chinese medicine treatment, chemotherapy, radiotherapy, biological therapy and symptomatic support therapy as appropriate.
(2) Discriminatory treatment: Discriminatory treatment is performed on the basis of disease identification and is suitable for all stages of colorectal cancer.
1.Spleen deficiency and blood deficiency, internal stasis and toxicity evidence (the most common clinical evidence type)
Features: abdominal pain and distension, diarrhea or constipation, or blood in the stool, abdominal masses, weakness with little food, dizziness and palpitations, pale tongue, thin white fur, weak pulse.
Treatment: Strengthening the spleen and nourishing the blood, resolving blood stasis and detoxifying the toxin.
Radix: Si Jun Zi Tang with addition and subtraction: Radix Codonopsis, Atractylodes, Poria, Astragalus, Radix Reishi, Coix Coix Coix seed, Semen Spleen, Radix Rehmanniae, Curcuma longa, Rhizoma Polygonatum, Sarsaparilla, Rhizoma Pinelliae, Glycyrrhiza glabra. Take with water.
Addition and subtraction: add maitake and pollen for dry mouth and throat; add sandy nut and bamboo rhizome for nausea and vomiting; add fried wu huo for loose stools; add white peony and yanhu zuo for abdominal pain; add heliotrope shell and thick park for abdominal distension; add fire hemp and cistanches for constipation; add angelica for blood deficiency; add wolfberry, jujube, bone fructus and bacopa monniera for decreased blood white blood cells.
2.Dampness and heat, internal stasis and toxicity
Symptoms: abdominal pain, urgency, pus and blood in the stool, purple blood, burning in the anus, red or purple tongue, yellow greasy moss, slippery pulse.
Treatment: Clearing heat and dispelling dampness, resolving blood stasis and detoxification.
The formula: Bai Tou Weng plus or minus: Bai Tou Weng, Huang Bai, Huang Lian, Qin Pi, Guang Mu Xiang, Hou Pu, Atractylodes, Di Yu, Sophora, Bai Shao, Coix Seed, Sulforaphane, White Flowering Serpent’s Tongue, for blood in the stool, add Yunnan Baiyao (rinse) licorice. Decoction with water.
Add or subtract: for hypochondriac pain, add Chai Hu and Yu Jin; for heat and constipation, add Rhubarb, Citrus aurantium and Hou Pu.
3.Spleen and stomach deficiency cold, internal stasis and poison evidence
Symptoms: abdominal distension and vague pain, prolonged diarrhea, blood in the stool, dull blood color, or abdominal masses, with a yellowish complexion, unheated extremities, pale and fat tongue, thin white fur, sunken or sluggish pulse.
Treatment: Warming Yang and strengthening the spleen, resolving blood stasis and detoxifying toxins.
Radix et Rhizoma Polygonatum (decoction to extract juice), Radix Rehmanniae Praeparata, Rhizoma Atractylodis Macrocephala, Radix Codonopsis Pilosulae, Radix Scutellariae Sinensis, Radix Aconiti (melting), Pericarpium Citri Reticulatae, Radix Pseudoginseng, Radix Pseudoginseng, Radix Scutellariae Sinensis, Radix et Rhizoma Glycyrrhizae. Take with water decoction.
Add and subtract: for those with urgency and posterior heaviness, add Magnolia officinalis and Boneset; for those with dark red blood in stool, add fried mugwort leaves and ground elm charcoal; for those with uncontrolled diarrhea in stool, add Horehound and Wu Bei Zi.
4.Spleen deficiency and internal stagnation of toxins
Features: abdominal swelling, weakness, shortness of breath, lazy speech, loose stools, or even prolapse, or abdominal masses, pale face, pale tongue, thin white fur, sunken and weak pulse.
Treatment: Benefit Qi and strengthen the spleen, resolve blood stasis and detoxify.
Remedy: Tonifying Zhong Yi Qi Tang with addition and subtraction: roasted Astragalus, Radix Codonopsis, Rhizoma Atractylodis Macrocephala, roasted Chai Hu, Radix Angelicae Sinensis, roasted licorice, Curcuma longa, Citrus aurantium, Pueraria lobata, Fleabane. Take with water decoction.
Add and subtract: for short breath and sweating, add red ginseng (steamed and blended), maidenhair and schisandra; for blood in the stool and palpitation and insomnia, add sour date palm, mugwort charcoal and fulong liver.
(C) Identification of medicine for disease
1.Commonly used Chinese patent medicines (in-hospital preparation)
(1) Ping cancer tablets: 8 to 10 tablets, taken orally, 3 times/day.
(2) Cancer Fucang: 8-10 tablets, orally, 3 times/day.
(3) Fuxiangbangcai capsule: Benefit Qi, nourish Yin, resolve blood stasis and detoxify; usage: 2 tablets each time, orally, 3 times a day.
(4) Crow’s bile oil soft capsule: softens and disperses hard knots, anti-cancer; usage: 4 capsules per time, orally, 3 times a day.
(5) Crow’s bile oil oral milk: softens and disperses knots, anti-cancer; usage: 20ml per time, orally, 3 times a day.
(6) West Yellow Capsules: detoxify and disperse nodules, relieve swelling and pain; usage: 4-8 capsules per time, orally, 2 times a day.
(7) Ubenimex: support and anti-cancer; usage: 1 tablet or 1 capsule per time, orally, 3 times a day.
2. Commonly used herbal injections.
(1) Compound bitter ginseng injection: 10-20ml added to 200ml saline for intravenous injection, 1 time/day. The total amount of 200ml is a course of treatment and can be used continuously for 2 to 4 courses. Depends on the specific situation.
(2) Kangai injection: 20～40ml, 1 time/day, diluted with 5% glucose injection or saline 250ml~500ml and then injected intravenously, 30 days as a course of treatment.
(3) Sodium zebranate vitamin B6 injection: 10-50ml, 1 time/day, diluted with 5%-10% glucose injection or 0.9% sodium chloride and then injected intravenously, 30 days as a course.
(4) Crowberry oil cream injection: 20-30ml once, diluted with 5% glucose injection or saline 250ml-500ml and then injected intravenously, once a day, 14-21 days as a course of treatment.
(5) Addi Injection: It is effective for clearing heat and detoxifying, eliminating stasis and dispersing nodules; it is suitable for internal heat of Yin deficiency and internal stasis and nodules; usage: 50-100ml once, diluted with 5% glucose injection or physiological saline 250ml-500ml and then injected intravenously once a day, 14-21 days as a course of treatment.
(6) Anti-cancer injection: it is effective in clearing heat and detoxifying, resolving phlegm and softening firmness; it is suitable for phlegm-heat and poisonous knots; dilute with 5% or 10% glucose injection and then drip, 20-100ml once a day, 14 days as a course of treatment.
(7) Eleuthero injection: anti-cancer; usage: 400-600mg (4-6) once, diluted with 5% glucose injection 400-500ml, intravenous, once a day, 14-21 days as a course of treatment.
(D) Interventional treatment of colorectal cancer liver metastasis with Chinese medicine
(1) Indications: Applicable to colorectal cancer liver metastasis; not suitable for those with serious cardiac, hepatic and renal impairment or coagulation dysfunction.
(2) Commonly used perfusion drugs: opium bile oil emulsion injection, elecampane emulsion injection, etc. can be used as single drug or combined with two drugs for perfusion through the intrinsic hepatic artery or tumor blood supply artery or left in the drug box for perfusion treatment; they can be combined with small doses of chemotherapeutic drugs for perfusion, such as fluorouracil, oxaliplatin, piroplatin, etc.
(V) Treatment after surgery, during chemotherapy and radiotherapy
1.Post-surgery treatment (one month)
Treatment: Strengthening the spleen and stomach, tonifying Qi and blood.
Prescription: Bajhen Tang plus or minus: Baishen (steamed and blended), Astragalus, Atractylodes, Poria, Radix Angelicae Sinensis, Paeonia lactiflora, Citrus aurantium, Sandy, Chicken Neijin, Chicken Blood Vine, Licorice. Take with water decoction.
Prepared Chinese medicine: Cancer Fucang tablets: 8-10 tablets per time, taken orally, 3 times a day.
2.Treatment during chemotherapy
Treatment: Strengthen the spleen and benefit the kidney.
Formula: Spleen and kidney formula with reduction: Astragalus, Radix Codonopsis, Atractylodes, Poria, Fagus, Ganoderma lucidum, Radix et Rhizoma Polygonati, Fructus Lycii, Semen Cuscutae, Glycyrrhiza glabra. Take with water decoction. Cancer Fucang: 8 to 10 tablets per time, orally, 3 times a day.
3.Treatment during radiotherapy
Treatment: Benefit Qi and nourish Yin.
Formula: Si Jun Zi Tang combined with Sha Shen Mai Dong Tang plus or minus: Astragalus, Tai Zi Shen, Fu Ling, Huai Shan, Glycyrrhiza, Mai Dong, Sha Shen, Danshen, Fructus Saposhnikovia, White Flowering Snake Tongue Herb. Take with water decoction.
4.Characteristic herbal treatment for hand-foot syndrome caused by chemotherapeutic drug Siroda
The incidence of hand-foot syndrome caused by chemotherapeutic drug Siroda is about 50% to 70%. Patients have swelling, pain and numbness at the end of the limbs, or blisters, desquamation, peeling, cracking and oozing, which increase patients’ pain and often interrupt chemotherapy. The above symptoms are classified as “blood paralysis” in Chinese medicine, and the basic treatment is to “benefit qi and open meridians, harmonize blood and open paralysis”. jujube.
(6) Chinese medicine enema therapy
Enema therapy with the special Chinese medicine “intestinal safety decoction
The treatment of colorectal cancer is based on the treatment of clearing heat and relieving dampness, resolving blood stasis and detoxification, and promoting the flow of qi and internal organs, which is manifested as abdominal distension, abdominal pain, diarrhea, blood in stool, purple tongue and thick and greasy coating. Intestinal Security Decoction: Composed of Comfrey
The decoction is made up of more than 10 herbs, including Ziziphi, Diyu, Huang Lian, Scutellariae, Phellodendron, Shi Jian Jian, Coix Seed, Bitter Ginseng, Atractylodes, Hou Pu, Citrus aurantium, Rhubarb, and Ice.
Method: Decoct 200ml/bag of enema solution, the temperature of the solution is 39±0.5℃, deep enema, kept for 2 hours after the operation, once a day, 7 days for a course of treatment; 2-4 courses of treatment in a row.
(vii) Acupuncture treatment
Commonly used points: foot San Li, large intestine Yu, Nei Guan; alternate points: upper Ju Xu, lower Ju Xu, Tian Shu. Acupuncture treatment, 1~2 times a day, 5~7 days for 1 course of treatment. It is suitable for patients with colorectal cancer with abdominal distension and constipation.
(H) External treatment
1.3～5 g of raw rhubarb powder, mixed with honey into burnt, applied to Shen Que point, fixed with dressing tape (bandage for allergic person), and warmed with 50～60 degree white wine about 5mI 1～2 times a day locally. 2 days to change medicine once, 5 times for a course of treatment, applicable to patients with colorectal cancer constipation.
2. 300 g of rhubarb, 200 g of mannitol, grind into powder, mix the two thoroughly, mix with vinegar into a burnt form, put into a cloth bag, the patient lies down, put the bag on the abdomen, and heat the hot water bag externally, the temperature is not to burn the skin. It is applied 1~2 times daily for 5 days as a course of treatment. It is suitable for patients with actual evidence of colorectal cancer internal organs.
(ix) Chinese medicine emotional and spiritual de-stressing therapy
For bowel cancer patients with emotional and mental disorders, a variety of Chinese medicine emotional and mental guidance therapies are applied, including “talking therapy” for individual patients, “quieting the mind”, “happy and cheerful method”, and “explaining doubts with doubts”. “The method of relieving doubts with doubts, the method of shifting attention, the method of guiding qi, and the method of overcoming emotions with emotions, etc. Similar to the individual psychotherapy, group mutual help emotional and spiritual diversion therapy, and the five elements of music diversion therapy.