Hematopoietic stem cell transplantation (HSCT) is a treatment that removes tumor or abnormal cells from the recipient’s body through high-dose radiation and chemotherapy pretreatment, and then transplants autologous or allogeneic hematopoietic stem cells to the recipient to rebuild normal hematopoietic and immune systems. It is widely used in the treatment of malignant hematological diseases, non-malignant refractory hematological diseases, genetic diseases and certain solid tumors. Hematopoietic stem cell transplantation for hematologic diseases has made great clinical achievements, but the application of high doses of radiotherapy during the pretreatment period and immunosuppressive drugs during and after transplantation has led to various complications such as graft-versus-host disease and hepatic vein atresia syndrome, and many toxic side effects make it difficult for patients to achieve a better quality of life. The application of TCM in hematopoietic stem cell transplantation is still in the exploratory stage, and the treatment status is still in one of the adjuvant treatment methods. However, practice has shown that the use of TCM adjuvant therapy during the hematopoietic stem cell mobilization and collection period, pretreatment period and late transplantation period can enhance patients’ tolerance to pretreatment chemotherapy and have the effect of reducing toxicity and increasing effectiveness; at the same time, it has the function of accelerating hematopoietic and immune reconstruction after transplantation, reducing complications, improving body immunity, prolonging patients’ survival and preventing leukemia recurrence. The following is a breakdown of the different periods of hematopoietic stem cell transplantation. Stem cell mobilization protocol: high-dose cytarabine combined with granulocyte colony-stimulating factor (G-CSF): cytarabine 1.5g/m2, q12h×6 times; ondansetron 4-8mg/d, antiemetic by intravenous push, and hydrated alkalinization; G-CSF 300ug/d, subcutaneous injection, applied from the beginning of leukocyte drop to the lowest point to the end of collection; Chinese medicine Treatment: Astragalus injection 60ml into 0.9% sodium chloride 200ml by intravenous infusion, once daily, applied from the end of chemotherapy to the end of collection. Pre-treatment chemotherapy period] 1. Gastrointestinal reactions Clinical treatment is mostly divided into damp-heat evidence, damp-heat injury to yin evidence and qi-yin two deficiency evidence identification. If nausea and vomiting are obvious, external treatment can be applied in combination or alone. 1. Damp-heat syndrome Main symptoms: dullness, nausea, vomiting, abdominal fullness, bitterness in the mouth. Tongue and pulse: yellow, white and greasy tongue coating, smooth or moist pulse. Treatment: Clearing heat and removing dampness, eliminating food stagnation, lowering rebellion and stopping vomiting. Prescription: Huanglian Wenzhi Tang, plus or minus. Radix Scutellariae Sinensis 9g, Radix Su Zi 12g, decoction, Radix Scutellariae Sinensis 6g, Radix Scutellariae Sinensis 3g, Poria 10g, Pericarpium Citri Reticulatae 15g, Atractylodes Macrocephalae 15g, Atractylodes Macrocephalae 12g, Atractylodes Macrocephalae 10g, Sandy Nut 9g, Bamboo Roo 6g, Licorice 6g, Coix Seed 20g, Jiao Sanxian 10g, Atractylodes macrocephala and Atractylodes macrocephala strengthen the spleen and permeate dampness; Scutellaria baicalensis diarrhea bile fire; Huang Lian clear heart fire and open the stomach; Jiao Sanxian eliminate food and stomach; Licorice harmonize all the herbs. The combined use of the herbs can clear heat and remove dampness, eliminate food and stagnation, subdue rebellion and stop vomiting. 2, damp-heat injury yin syndrome Main symptoms: dullness, nausea, irritability, dry mouth without desire to drink. Tongue and pulse: light tongue, grayish yellow or yellowish brown and black thick coating, moist pulse. Treatment: Nourishing Yin and clearing heat, removing dampness and stagnation, lowering rebellion and stopping vomiting. Prescription: Combine Er Chen Tang with Sheng Wei Wei Drink. Radix Codonopsis pilosulae 10g, Radix Rehmanniae 20g, Maltodendron 15g, Zhi Mu 10g, Dampness 10g, Fructus Fructus 15g, Patchouli 10g, Poria 10g, Huang Lian 3g, Atractylodes Macrocephala 12g, Sempervisia 12g, Jiao San Xian 10g, Zeligia 10g, Pericarpium Chen 10g, Dendrobium 10g, Licorice 6g. Zhi Mu and Dan Pi clear heat and eliminate irritation; Fu Ling and Ze Di dispel dampness; Huang Lian clears heart fire and opens the stomach; Huo Xiang aromatically awakens the spleen; Jiao San Xian eliminates food and harmonizes the stomach; Licorice harmonizes the herbs. The combination of all the drugs, function to nourish Yin and clear heat, remove dampness and stagnation, subdue rebellion and stop vomiting. 3.Qi-Yin deficiency Syndrome Main symptoms: weakness, poor appetite, dry throat, heat in the hands and feet, night sweating, insomnia. Tongue and pulse: pale or red tongue, thin coating with little fluid, thin or weak pulse. Treatment: Benefit Qi and nourish Yin, strengthen the spleen and stomach. Prescription: Shengwen yin combined with Sijunzi Tang, plus or minus. Radix et Rhizoma Ginseng 30g, Mai Dong 30g, Wu Wei Zi 10g, Radix Rehmanniae 15g, Zhi Mu 12g, Radix et Rhizoma Polygonati 15g, Dried Lotus Grass 10g, Radix Paeoniae Alba 12g, Atractylodes Macrocephala 10g, Poria 10g, Jiao Sanxian 10g, Licorice 6g. The combined functions of the drugs benefit qi and nourish yin, strengthen the spleen and stomach, and help the transport and transformation of the Central State. External treatment method: half an hour before the start of chemotherapy, take 10g of powdered French Semen, 20g of fresh ginger (cut into pieces), mix the two, wrap with gauze or wound wet ointment and apply to the patient’s Shen Que point, fix with medical tape, once a day, for 12 hours each time, and continue until the end of pretreatment. 2. Organ damage Mostly use injectable salvia lyophilized powder 800mg/d to prevent hepatic vein atresia syndrome (VOD); ginseng injection 50-100ml/d to prevent chemotherapy myocardial damage; bitter ginseng injection 600mg/d to prevent chemotherapy liver damage; combined infection can be used Xiyamping injection, phlegm fever clear injection, Qingkailing injection, etc. as appropriate. The purpose of treatment is to support the righteousness, to correct the bias of yin and yang of the body, to establish a new balance of yin and yang under new conditions, so as to achieve the state of “yin and yang secret, the spirit is healing”, and to lay the foundation for normal function reconstruction after transplantation. Main symptoms: pale face, pale lips and nails, brittle nails, lack of lustrous skin, low fever and night sweats, heat in the hands and feet. Complications: epistaxis, epistaxis, thirst, dry eyes, dizziness and weakness, insomnia and dreaminess, dry stool and yellow urine. Tongue and pulse: red tongue with little coating and fine pulse. Treatment: Nourish kidney yin and fill in the marrow. Remedy: Ginseng and Astragalus Xian tonic soup with reduction. Ginseng 10g Astragalus membranaceus 10g Radix Astragali 10g Radix Phellodendron 10g Radix Pleurotus Macrocephalae 20g Fructus Ligusticum 20g Radix Araliaceae 15g Radix Rehmanniae 15g Radix Rehmanniae 10g Radix Phellodendron 10g Radix Aconite 10g Radix Aconite 30g Radix Oyster 30g Radix et Rhizoma Huangjing 10g Fructus Lycii 10g Radix Panax notoginseng 2.0g Add and subtract: If the mouth is dry, add Radix Salviae Sinensis and Radix Rehmanniae to nourish yin and generate fluid; if bleeding is severe, add Phellodendron charcoal, Phellodendron charcoal and Phellodendron charcoal to For severe bleeding, add Phellodendron charcoal, Phellodendron root charcoal and Phellodendron charcoal to stop bleeding. Explanation of the formula: Ginseng and Astragalus are the rulers together. Ginseng is a great tonic for vital energy, warms kidney yang and consolidates kidney qi, replenishes the innate and prevents further dissipation of qi and blood; Astragalus is used to replenish middle qi, warms spleen yang and benefits spleen qi to biochemistry of qi and blood. The two must be used for each other, the innate, the innate with the complement, as the saying goes, “the visible yin is difficult to quickly, the invisible yang should be urgently fixed. The herb Xianhecao has the functions of cooling, dispersing, astringent and clearing, and is a ministerial medicine. This formula focuses on cooling the blood, dispersing blood stasis, astringent, clearing heat and for the treatment of bleeding, at the same time, with ginseng and astragalus to benefit the qi and astringent blood, to prevent the qi with the blood off. Bone marrow tonic is used to warm the spleen and kidneys, tonify the bone and marrow, and directly refers to the foci of bone marrow hematopoietic failure after transplantation, and is an adjuvant to help Ginseng and Astragalus to benefit Qi and fill the essence and produce marrow. The function of chasteberry and dry lotus herb is to tonify the liver and kidney, strengthen the tendons and bones, clear deficiency heat, cool the blood and stop bleeding. This formula is used to nourish kidney yin and strengthen the main body of water. Zhi Mu is long in clearing and moistening in the midst of diarrhea of fire, and Huang Bai functions to clear heat and dry dampness, diarrhea and detoxify fire, remove bone vapor and clear deficiency heat. Jing Yue Quan Shu – Ben Cao Zheng” contains: “Ancient books say that Zhi Mu is used with Huang Bai to nourish Yin and lower fire, with the meaning of gold and water. It is said that Phellodendron can control the fire in the bladder and the yin of the vital gate, while Zhi Mu can eliminate the lung gold and control the fire of the kidney water, which is called nourishing yin. The two must be used to nourish the yin and lower the fire, clear the deficiency heat of the kidney, to prevent the dissipation of kidney yin. Dragon bone, oyster shall be used for the astringent, in order to converge the kidney yin, solid kidney essence. Huang Jing, Fructus Lycii, Mai Dong and Radix et Rhizoma Dioscoreae nourish Yin, tonify the kidney and generate fluid, Aconite nourishes Blood, Panax notoginseng resolves blood stasis and stops bleeding, so that the blood stops without leaving stasis. The combined functions of the herbs nourish kidney yin, fill the marrow, and benefit Qi and generate blood. Prevention and treatment of recurrence after autologous hematopoietic stem cell transplantation] After transplantation, as time lengthens, the evil toxin has diminished, the positive energy gradually recovers, and the physique is close to normal, so there is no evidence to identify the disease, but at this time, we should also prevent the evil toxin from reigniting, which is also the prevention and treatment of micro residual disease in modern medicine. The formula of Beneficial Qi, Detoxifying and Invigorating Blood is often given orally in combination with Xi Huang Wan. Experimental formula: Radix Codonopsis pilosulae 10g, Radix Astragali 30g, Radix Pseudostellariae 10g, Rhizoma Polygonati 10g, Rhizoma Polygonati 10g, Rhizoma Polygonati 10g, Radix Peach kernel 6g, Poria 10g, Rhizoma Polygonati 10g, Radix Puerariae 10g, Rhizoma Polygonati 12g, Rhizoma Polygonati 15g, Rhizoma Polygonati 15g, Rhizoma Polygonati 10g, Rhizoma Chrysanthemum 10g, decoction, 1 dose daily, divided into two doses in the morning and evening, with Xiyuang Wan 3g/time. Explanation of the formula: Benefit Qi, detoxify and activate blood circulation. Xiyuang Pill is a pure Chinese medicine with high efficiency and broad-spectrum anti-cancer preparation, which is a classical formula of anti-cancer Chinese medicine and is known as the “first medicine” of Chinese medicine against cancer, with the function of supporting the root, benefiting Qi, tonifying blood, activating blood circulation, resolving blood stasis, softening hardness and dispersing nodules. Graft-versus-host disease after allogeneic transplantation】 The occurrence of graft-versus-host disease is often the most important factor affecting the survival quality of patients, and is often classified into damp-heat and blood-heat and fluid deficiency. The main symptoms are redness, swelling, numbness and pain in the hands and feet, dark red skin papules, red and swollen scrotal rash, and even epidermal ulceration. Concurrent symptoms: puffiness of the face and eyes, yellow staining of the skin and sclera, nausea, tasteless diet, diarrhea with yellowish-brown watery stools, or yellowish red urine. Tongue and pulse: light red/dark/toothed tongue, yellow and white thick/white tongue coating, slippery/moist pulse. Treatment: Clearing heat and removing dampness, softening the liver and detoxifying the toxin. Remedy: Experimental formula for anti-discharge Ⅰ. Gentiana 15g, Gardenia 10g, Scutellaria 10g, Radix Scutellariae 10g, Radix Angelicae Sinensis 15g, Rhizoma Dioscoreae 15g, Radix Tongcao 10g, Radix Bupleurum 10g, Plantago Asiatica 10g, Decoction, Radix Pseudostellariae 10g, Radix Pseudostellariae 10g, Rhizoma Atractylodes 10g, Glycyrrhiza Uralensis 6g. Explanation: In this formula, gentian grass, gardenia, scutellaria and bupleurum clear damp-heat in liver and gallbladder; zedoary, tongcao and plantain lightly percolate dampness; dioscorea, bitter ginseng and white fresh peel detoxify and kill insects to relieve itching; cananga dry dampness; angelica and raw groundnut nourish blood and soften liver; licorice harmonize all medicines. 2. Blood-heat and fluid deficiency Main symptoms: redness and swelling of the hands and feet, tingling and fear of heat at the ends of the fingers, skin rash/jaundice, redness and astringency of the eyes, mouth ulcers, dry and cracked ulcers at the corners of the mouth, diarrhea. Complications: often accompanied by hematuria, frequent and painful urination, or blood in the stool. Tongue and pulse signs: red tongue, thin/brownish/cracked tongue coating, thin string pulse. Treatment: Nourish Yin and cool the blood, clear heat and detoxify. Remedy: Experimental formula for anti-rejection II. Sheng Di Huang 15g Xuan Shen 15g Mai Dong 10g Zhi Mu 10g Sheng Shi Fu 30g Yin Hua 15g posteriorly Lian Lian 15g Dan Pi 10g Red Peony 12g Artemisia 15g Scutellaria 12g Gardenia 10g Bamboo Roo 6g Bamboo Leaf 10g Licorice 6g Decoction in water, 1 dose daily, divided into 2 doses in the morning and evening. Addition and subtraction: In the case of blood in stool (gastrointestinal bleeding), remove Zhi Mu and gypsum, and add couple knot, white foxglove and Pu Huang charcoal to cool the blood and stop bleeding as well as to astringent; or take the formula Si Wei Stopping Bleeding orally. Explanation of the formula: Zhi Mu, gypsum, Yin Hua and Lian Qiao clear the heat in the lung and stomach; Dan Pi and Red Peony dispel the heat in the blood; Scutellaria, Gardenia and Bamboo Roo clear the drainage of the three jiao; Radix et Rhizoma, Radix et Rhizoma, Mai Dong and Bamboo Leaf nourish yin and generate fluid; Artemisia absinthium clears deficiency heat; Licorice harmonizes all medicines. The purpose of hematopoietic stem cell mobilization is to mobilize the hematopoietic stem cells in bone marrow and release them into the peripheral blood to facilitate the collection of sufficient number of stem cells. We obtained good results in mobilization and collection of peripheral blood stem cells by using Astragalus injection and granulocyte colony stimulating factor. Astragalus contains polysaccharides, glycosides, flavonoids and many trace elements, and has various pharmacological effects such as “supporting the righteousness and consolidating the root” and “tonifying the middle and benefiting the qi”, which is widely used in clinical practice. It is the main component of granulocyte-boosting Chinese medicine and has better proliferation and mobilization of bone marrow hematopoietic stem cells. The literature shows that Astragalus injection 20mg/kg for 3 days can significantly increase the production of granulocyte macrophage colony-forming units in mice, enhance the hematopoiesis of normal mice and promote the recovery of hematopoietic function of bone marrow granulocytes in mice damaged by 60Co irradiation. We randomly divided 21 patients with acute leukemia (AL) into Astragalus treatment group and control group for autologous hematopoietic stem cell mobilization and collection. The control group was treated with chemotherapy combined with G-CSF to mobilize peripheral blood hematopoietic stem cells; the treatment group was treated with Astragalus injection on the basis of the control group protocol, applied once daily from the end of chemotherapy until the end of collection. It showed that all 21 patients successfully collected MNC and CD34+ cells required for the target value after two blood cell separator collections, but the number of MNC and CD34+ cells obtained in the Astragalus treatment group were better than those in the control group, and the difference was statistically significant (P<0.05), and the number of cases in which the target value was reached in one collection was better than that in the control group (P<0.05). This indicates that Astragalus injection combined with granulocyte colony-stimulating factor for peripheral blood hematopoietic stem cell mobilization and collection can promote the release of stem cells, improve the collection effect, reduce the number of collections, and have definite efficacy. 2. Pretreatment chemotherapy - reduce toxicity and increase efficacy Pretreatment chemotherapy, i.e., treatment with high-dose chemotherapy or/and total body irradiation, aims to suppress the immune and hematopoietic functions of the recipient to the maximum or to a certain extent so that the hematopoietic stem cells of the donor can be implanted smoothly. During the pretreatment phase, most patients receiving radiotherapy or combination chemotherapy at extra-large doses will experience varying degrees of side effects. (1) Gastrointestinal reactions According to Chinese medicine, chemotherapy drugs are mostly "poisonous", and the purpose of chemotherapy is to attack poison with poison, which are mostly pungent, warm, dry and strong, and are very easy to hurt the body's vital energy, especially to damage the spleen and stomach's function of transportation and transformation, resulting in internal damp-heat or damp-heat injury to yin, The principle of treatment at this stage is to "treat the symptoms with urgency", to protect the gastric energy, and to regulate the spleen and stomach. Although the clinical treatment can be divided into damp-heat type, damp-heat type and qi-yin type, some patients have difficulty in taking tonics because of nausea and vomiting, so it can be combined with or applied alone to the acupuncture point of Han Xia San, which can benefit qi and nourish yin, strengthen the spleen and stomach. Alleviate the gastrointestinal reactions brought about by chemotherapy, so that the pretreatment can be carried out smoothly. (2) Organ damage Pre-treatment chemotherapy period important organs are also damaged to varying degrees, such as liver damage, the lighter ALT, AST, DBIL, TBIL elevated, appearing yellow staining, hypochondriac discomfort and other symptoms, the heavier the hepatic vein atresia syndrome (incidence of 4% to 53%) accompanied by abdominal distension, pain, etc.; myocardial damage is mainly manifested myocardial enzyme spectrum LDH, HBDH abnormally elevated, the heavier may appear acute After high-dose CTX chemotherapy, its cleavage product acrolein can damage the bladder mucosa and cause hemorrhagic cystitis (incidence 7%-52%), with dripping and painful urine and blood in urine as the main symptoms; the zero-cell stage is mostly combined with serious infection and fever. We observed 11 patients involved in Chinese medicine. During transplantation, all 11 patients had different degrees of nausea, vomiting and other gastrointestinal reactions, which disappeared after symptomatic treatment; 4 patients developed fever during the granulocyte deficiency phase, with body temperature >38.5℃ for 1 to 3 days, and the body temperature returned to normal after treatment; 7 patients had transient liver function abnormalities; 5 patients had AST and ALT elevation less than the normal value The abnormalities of myocardial enzyme profile were less than 2 times the normal value in 9 patients, mainly LDH; the heart rate increased to 90-120 beats/min in 11 patients, and the ECG showed sinus tachycardia; abdominal color Doppler showed mild to moderate liver damage, and no obvious hepatosplenomegaly; the above abnormalities disappeared after hematopoietic reconstruction. Two patients developed hemorrhagic cystitis around 30 days after transplantation, which disappeared after combined hydration and alkalinization with Chinese herbs to clear heat and cool blood to stop bleeding; no hepatic vein atresia syndrome occurred. 3. Hematopoietic reconstruction period – replenish kidney and fill essence to promote hematopoiesis When the pretreatment is over and the stem cells are transfused back, the body is in the zero-cell phase or immune vacuum phase, which is prone to complications such as serious infection, bleeding and organ function damage caused by high dose of chemotherapy drugs, restoring hematopoietic function and immune function as soon as possible and reducing complications is the key to affect stem cell transplantation The aim of treatment is to support the righteousness, to correct the bias of the body’s yin and yang, and to establish a new balance of yin and yang under new conditions, so as to achieve the state of “yin and yang secrecy, the spirit is healing”, and to lay the foundation for the reconstruction of normal functions after transplantation. Studies on the biological effects of Chinese herbal medicines on hematopoietic stem cells have also confirmed that many herbal medicines can act on hematopoietic stem cells of different cycles and affect the proliferation and differentiation of hematopoietic stem cells at the protein and molecular levels, with the aim of rebuilding and restoring the immune function. During the post-transplantation hematopoietic reconstruction period, the patient’s blood trilineage cells are severely suppressed due to the inhibitory effect of radiotherapy and chemotherapy on the bone marrow. This is often manifested as dizziness and weakness, laziness, skin petechiae, pale complexion, thin tongue with thin coating and thin pulse, and other symptoms of deficiency of kidney essence and deficiency of qi and yin. Modern pharmacological research shows that kidney tonics can promote the proliferation of hematopoietic cells and restore the immune function of the body. Therefore, we choose herbs that benefit the qi and nourish the blood, tonify the kidney and fix the essence, and form a formula to treat the disease from the kidney. 4. Foster and detoxify to prevent relapse Autologous hematopoietic stem cell transplantation lacks graft-versus-tumor effect (GVL) and often fails due to tumor recurrence, so preventing relapse after autologous hematopoietic stem cell transplantation becomes a problem before us. After the transplantation, the evil toxin has been reduced, the positive energy has been restored, and the physique is close to normal, so there is no evidence to identify because there is no disease, but at this time, we should also prevent the evil toxin from reigniting, which is the prevention and control of microscopic residual disease in modern medicine. In this case, the pathogenesis of the disease is due to the deficiency of the body’s righteousness, warmth and poisonous evil into the blood and injury to the marrow caused by a faction of evil and deficiency, mixed with the evidence of deficiency and reality, and the characteristics of the struggle between righteousness and evil throughout the treatment, the formula treatment, do not need to identify and treat. Autologous transplantation combined with Chinese herbal medicine treated 19 patients with a follow-up of 10 to 55 months, with a median follow-up time of 30.89±16.95 months. One patient relapsed in the 6th month after transplantation and died after induction therapy was ineffective; one patient died of deep fungal infection in the 9th month after transplantation; the remaining 17 patients survived disease free, including one M5 patient who developed 5% primitive mononuclear cells in bone marrow image at 26 months after transplantation, with a tendency of relapse. The patient survived for 50 months without disease. After the allogeneic transplant patient was pretreated and the donor’s hematopoietic stem cells were imported, theoretically, the leukemic cells no longer existed in the patient’s body, and the cells should be mainly derived from the normal function of the cells generated by the proliferation and differentiation of the donor’s hematopoietic stem cells, but in fact, this is not the case. A certain number of leukemic cells remain in the patient’s body, and it is impossible to completely kill these leukemic cells by pretreatment alone. The killing of these leukemic cells is mainly done by the graft-versus-leukemia effect (GVL); similarly, the application of Chinese herbs that benefit the qi and nourish the yin and detoxify the spleen and kidneys, such as the experimental formula Yi Qi Detoxification and Blood Activation Formula, can not only effectively kill the remaining leukemic cells, but also induce apoptosis of leukemic cells. At the same time, Chinese medicine can activate cellular immunity, promote the reconstruction of immune system after transplantation, and enhance its own anti-tumor ability. The occurrence of various acute and chronic GVHD after allogeneic hematopoietic stem cell transplantation is one of the important factors affecting the survival quality of patients and can be life-threatening in serious cases. The prevention and treatment of this complication is still a difficult clinical problem. Although modern medicine such as Pulcoflora, cyclosporine and glucocorticoids can prevent and treat this disease to a certain extent, they often bring toxic side effects such as immune deficiency, multiple infections and severe liver and kidney damage, which are difficult for some patients to tolerate and affect the quality of survival. The treatment of TCM in this disease is still in the early stage of exploration, but it is difficult to standardize and unify the identification and typing because of the complex pathogenesis and complicated and variable symptoms. In recent years, the author has adopted Chinese medicine in the treatment of this disease and found that patients with gastrointestinal GVHD and hepatic GVHD are mainly suffering from liver and gallbladder damp-heat syndrome, while patients with cutaneous GVHD are mainly suffering from blood-heat and fluid deficiency syndrome, and the two often transform into each other and are mutually causal. The No. I formula mainly targets the liver and gallbladder damp-heat type, and the No. II formula mainly targets the blood-heat and fluid deficiency type. Those with rash or skin lesions can even use moist burn cream (the main ingredients are composed of Huang Lian, Huang Bai, Scutellaria, Di Yu, ice chips and sesame oil) externally to clear heat and detoxify, dry dampness and diarrhea fire, subdue swelling and disperse knots, and remove decay and create muscle. The clinical experience is that it is effective for mild and moderate GVHD. For severe GVHD, it is often necessary to combine western medicine treatment, which can reduce the dosage of anti-rejection drugs and reduce toxic side effects, but further summary and optimization are needed. The prognosis of patients is affected by primary disease, transplant type, donor-recipient compatibility, age, post-transplant graft-versus-host disease, etc. Generally, benign diseases such as aplastic anemia have better prognosis than malignant blood diseases; malignant diseases such as chronic granulocytic leukemia have better prognosis than acute leukemia; acute myeloid leukemia has better prognosis than acute lymphoblastic leukemia; allogeneic transplantation with allogeneic compatibility has better prognosis than allogeneic transplantation with allogeneic compatibility. Graft-versus-host disease is relatively mild after transplantation in young donors and recipients. The application of TCM has been widely appreciated by the medical community, especially in promoting hematopoietic and immune reconstitution, organ damage prevention, and mild to moderate graft-versus-host disease. However, there is still a lack of multicenter and multisample controlled studies, especially in stem cell mobilization and prevention of hemorrhagic cystitis. How to achieve the organic combination of Chinese and Western medicine and fully exploit the potential of Chinese medicine in hematopoietic stem cell transplantation for hematologic diseases needs further research and summary. Due to the presence of nausea and vomiting caused by pretreatment chemotherapy drugs, the daily calorie requirement cannot be met, so it is necessary to supply a high-calorie, high-protein, nutrient-rich diet, and try to give sugar foods that are easy to digest and absorb and easy to oxidize and decompose to replenish the consumed calories and prevent excessive decomposition of proteins. 1. Dietary management of myelosuppression period Pretreatment chemotherapy can cause poor bone marrow regeneration, especially the most obvious decline in white blood cells. During chemotherapy patients should supplement a high protein diet, such as milk, soybeans, lean meat, pig’s feet, sea cucumber, fish, animal liver and red dates, peanuts, walnuts, black fungus, carrots, adzuki beans, etc. River crab, black fish, beef, animal jelly such as gum, pig skin jelly, etc. can also help to raise white blood cells. Animal bone marrow, such as bone marrow stew from cows, sheep and pigs, or diet made from chicken, duck, goose and pig blood can also be added in moderation during chemotherapy. You can also eat more five black foods, such as black sesame, black rice, black beans and black dates, which can nourish the kidney and fill the marrow and help the recovery of blood production. 2. Oral mucous membrane damage care Pretreatment chemotherapy can cause oral mucositis, manifested as mucosal congestion, edema, ulcers, pain and so on. At this time, we should keep the oral cavity clean, rinse the mouth with ice tin combination after eating, and eat a liquid or semi-liquid diet, such as lotus seed soup, snow ear soup, milk, soybean milk, carp soup, etc. Avoid overheating, acidity and stimulation. Avoid too hot, too acidic and stimulating diet. 3. Dietary management and prevention of liver and kidney injury Pretreatment chemotherapy drugs can cause liver and kidney injury, with elevated transaminases, abnormal creatinine and urea nitrogen, etc. At this time, we should eat more bitter melon, mung beans, shiitake mushrooms, wood ear, monkey mushrooms and other mushroom foods, more vitamin-rich fruits, such as kiwi, peach, apple, grapes, etc., and limit protein intake, combined with edema to low-salt diet, eat more animal kidney, oyster fish, The combination of edema should be low-salt diet, eat more animal kidney, black fish, spinach and amaranth. The patient is a 48-year-old farmer from Tangshan, Hebei. He was seen on January 5, 2007, mainly because he had relapsed 19 months after autologous hematopoietic stem cell transplantation for acute granulocytic leukemia. The patient was admitted to the hospital for the 1st time on January 14, 2005 for intermittent fever for 20 days, aggravated with epistaxis and epistaxis for 1 week. After relevant investigations, the diagnosis was made: acute granulocytic leukemia partially differentiated type (M2a). On June 18, 2005, a repeat bone aspiration showed that the bone marrow proliferation was obviously active, with 33% of primitive granulocytes, suggesting a relapse of leukemia. After consolidation with MAE and HD-Ara-C, autologous peripheral hematopoietic stem cells were collected and autologous hematopoietic stem cell transplantation was performed on August 19, 2005. Recombinant human interleukin-II (IL-2) was given on the 30th day after transplantation as 500,000 units/dose by subcutaneous injection every other day for 2 months to prevent recurrence. On January 2, 2007, the peripheral blood picture showed WBC 5.8×109/L RBC 4.29×1012/L HGB 144g/L PLT 118×109/L; bone marrow morphology showed active bone marrow proliferation with 8% primitive granulocytes; microscopic residual test (+). This suggests post-transplant relapse. The patient refused chemotherapy and was seen by the clinic. On first examination, the patient was clear, mentally fine, with a rosy complexion and no obvious anemic appearance. There was no bleeding or yellowing of the skin or mucous membranes. Superficial lymph nodes were not enlarged. There was no pressure pain in the sternum, and the heart and lungs were (-). The whole abdomen is soft, and the liver and spleen are not detected under the ribs. The tongue is purple and dark with thin white coating and fine pulse. Traditional Chinese medicine diagnosis: medullary toxicity (internalized evil toxicity, Qi and Yin deficiency with blood stasis). Western diagnosis: relapse of acute granulocytic leukemia after autologous hematopoietic stem cell transplantation. Treatment: Benefit Qi and nourish Yin, clear heat and detoxification, and also activate blood circulation and disperse blood stasis. Prescription: Experimental formula: Benefit Qi, detoxify and invigorate blood, plus reduction. Ginseng 10g first decoction, Radix Salviae Miltiorrhiza 10g, Radix Astragali 30g, Radix Pseudostellariae 10g, Rhizoma Polygonati 10g, Radix et Rhizoma Polygonati 10g, Pericarpium Citri Reticulatae 10g, Peach kernel 6g, Poria 10g, Radix Phellodendron 10g, Radix Salviae Miltiorrhizae 10g, Radix Puerariae Miltiorrhizae 12g, Job’s Tears 30g, Radix Astragali 10g, Rhizoma Polygonati 20g, 15 doses with water. Add 500ml of water to the first decoction and extract 100ml of juice, add 400ml of water to the second decoction and extract 80ml of juice, mix the two decoctions and deliver Xihuangwan 3g/time in 3 times. January 20, 2007, the second diagnosis: the patient is clear, the spirit can be, complained slightly tired, stool 2-3 times a day, yellow soft stool, purple and dark tongue to reduce, white greasy moss, the pulse is sunken and weak, the rest as before. Considering that the above formula is biased towards cold and spleen injury, the original formula was reduced to 12g of Tiger Balm, and 10g of Atractylodes Macrocephala, 10g of Poria, 10g of Glycyrrhiza glabra to strengthen the spleen and promote dampness. 15 doses were taken with water decoction, 1 dose daily. The patient complained of general condition, no obvious fatigue, no fever, no bleeding, nasal discharge, bowel movement, light tongue, slightly purple and dark at the edge, thin white moss, sunken and thin pulse. The peripheral blood picture was rechecked: WBC 4.6×109/L RBC 4.57×1012/L HGB 136g/L PLT 126×109/L; bone marrow morphology showed: active bone marrow proliferation, primitive granulocytes 4%; micro-residue test (+). Considering that the patient was in hematological remission again, there were still micro-residual lesions, so the effect was not changed, and the patient was given the original formula for the second consultation with water decoction, one dose per day, and Xihuangwan as before. On April 6, 2007, the fourth consultation: the bone marrow morphology showed that the bone marrow was actively proliferating, with 0% primitive granulocytes; microscopic residual test (-). Stopped taking Chinese medicine soup and changed to our preparation of Ginseng and Astragalus Clear Heat Granules (Prince’s ginseng, Astragalus, Radix Bupleurum, Radix et Rhizoma Polygonati, Rhizoma Polygonati, Rhizoma Polygonati, Peach kernel, Poria, Rhizoma Polygonati, Rhizoma Polygonati, Coix lacrymae, etc.), 10g/time, 3 times daily, and continued to deliver Xihuangwan. Following 3 months after the discontinuation of the drug, and then intermittently re-examined, no microscopic residue was seen, and no recurrence has been followed up to date. Case 2: The patient, male, 31 years old, Han nationality, native of Langfang City, Hebei Province, was seen on May 22, 2012, mainly due to acute granulocytic leukemia 19 months after allogeneic transplantation for 15 months and rash and yellow staining for 11 months. The patient was diagnosed by bone aspiration, immunophenotyping and fusion gene: “acute granulocytic leukemia (AML-M2a)” in October 2010 due to perianal pain, malaise with fever, outside the hospital. He was given IDA regimen for 1 course and achieved complete remission. Subsequently, one course of AA and one course of MA regimen was given for consolidation. On February 10, 2011, he underwent haploidentical hematopoietic stem cell transplantation, and the operation went smoothly. on April 25, 2011, the chimerism rate was 100% donor type, chromosomal abnormalities were not found. the AML-ETO fusion gene quantification was 0.035%. on June 24, 2011, due to skin rash, yellow staining, elevated transaminases, elevated bilirubin, etc. (specific details are not available), GVHD was considered outside the hospital, and anti-GVHD treatment such as Pulcolocort, methylprednisolone and primaquine was given. After anti-GVHD treatment, the patient improved. In February 2012, the patient’s hands and feet were red, swollen, numb and painful, and the skin papules were dark red and yellowish, etc. He was given cyclosporine and methylprednisolone anti-GVHD and symptomatic supportive treatment such as liver protection and anti-yellowing, but the effect was not good. The patient complained of malaise, fever, no sweating, nausea, poor appetite, tasteless diet, gastric discomfort, sleep, yellow urine, yellowish-brown watery stool, 3-4 times a day, about 800 ml/d. He was clear, depressed, with a weak, yellowish face, and no petechiae or petechiae on the peripheral skin or mucous membranes. The sclera and skin were yellowish, with a vivid yellow color like orange, the hands and feet were red, swollen, numb and painful, the skin papules were dark red, the scrotal rash was red and swollen, and the epidermis was broken. Speech is clear, no cough is heard, no peculiar odor is smelled. Scrofula and Y obstruction are not cut. The tongue is dark and pale, with yellowish white thick greasy coating and smooth pulse. Laboratory examination: blood routine showed: WBC 2.53×109/L RBC 2.54×1012/L HGB 83g/L PLT 39×109/L; biochemistry: AST 196U/L ALT 152U/L TP 40.8g/L ALB 30.2g/L GLB 10.6g/L TBIL 516.46umol/L DBIL 303.73umol/L IBIL 212.73umol/L LDH 374U/L. Traditional Chinese medicine diagnosis: jaundice (damp-heat type of liver and gallbladder) Western medicine diagnosis: 1. acute granulocytic leukemia after allograft transplantation 2. chronic graft-versus-host disease Treatment: clear damp-heat, strengthen the spleen and stomach. Prescription: Experimental formula for anti-rejection Ⅰ. Gentiana 15g Gardenia 10g Scutellaria 10g Radix Scutellariae 10g Radix Angelicae 15g Radix et Rhizoma 15g Tongcao 10g Radix Bupleurum 10g Plantago ovata 10g Radix et Rhizoma Dioscorea 10g Radix bitter ginseng 10g Baishenpi 10g Atractylodis Macrocephalae 10g Radix codonopsis 10g Atractylodis Macrocephalae 10g Pericarpium 10g Jiao Sanxian 10g Huo Xiang 10g 7 doses, decoction in water, 1 dose daily. In addition, moist burn cream was applied externally to skin rashes and scrotal lesions. The original cyclosporine, methylprednisolone and other drugs were taken as prescribed by the outside hospital. On May 29, 2012, the patient complained that he had passed a large amount of yellowish-brown watery stool for the first 3 days after taking the medication, which gradually decreased and turned into yellow loose stool yesterday, 1 to 2 times a day; fatigue and poor appetite were reduced and food intake increased; skin papules became darker and partially faded, scrotal lesions were less painful and had a tendency to heal. The sclera and skin yellow staining decreased, but the urine was still yellow. Dry mouth and dry eyes have appeared in the last two days. The tongue is light red, the coating is yellowish-white and thick and greasy to a lesser extent, the fluid is scarce, and the pulse is smooth and thin. Considering that dampness and heat injure yin for a long time, plus the above bitter cold, and the appearance of Jin injury, so the original formula discretionary addition of Xuan Shen 10g, Sha Shen 10g, Dan Pi 10g and other nourishing Yin products, and then give 7 payments. June 5, 2012, the third diagnosis, June 12, the fourth diagnosis: the patient above symptoms gradually alleviated, food increased, jaundice subsided, the rash, lesions reduce the scope, all the original formula again into. Western medicine treatment was the same as before. Fifth consultation on June 19, 2012: The patient had mild yellowing, redness and swelling of the hands and feet, tingling and fear of heat at the ends of the fingers, a small amount of skin rash, healed scrotal lesions, slightly dry eyes, mouth ulcers, dry and cracked ulcers at the corners of the mouth, acceptable food, slightly yellow urine, frequent and urgent painful urination, red and vivid tongue, yellowish-brown and cracked tongue coating, thin and stringy pulse. Laboratory tests: blood count: WBC 3.46×109/L RBC 3.94×1012/L HGB 98g/L PLT 67×109/L; biochemistry: AST 36U/L ALT 142U/L TP 46.0g/L ALB 33.6g/L GLB 15.6g/L TBIL 67.18umol/L DBIL 29.09 Considering that the dampness is gradually cleared but the residual heat is not yet exhausted, the patient is suffering from increased fluid depletion. The treatment is to benefit Qi, nourish Yin, generate fluid and clear heat and dampness. 12g Gardenia jasminoides 6g Bamboo rhizome 6g Radix Codonopsis pilosulae 10g Rhizoma Atractylodis Macrocephalae 10g 7 doses, decoction in water, one dose daily. Afterwards, the above two prescriptions were applied with addition and subtraction according to the severity of dampness, heat and injury to yin, and the dosage of cyclosporine and methylprednisolone was gradually reduced after 3 months. The symptoms were relieved and the disease is now stable, and GVHD has basically disappeared.