As elsewhere, cancer is one of the leading causes of death in
China. It is characterized by the uncontrollable growth of cells
originating from abnormal tissues which can kill the host by
means of local extension or distant spread (metastasis). The
etiology of cancer is not completely clear, but the fundamental
mechanisms governing the etiology of human cancer have recently
become clearer as new information about cancer genes, viruses,
carcinogens, cell growth and differentiation emerges.
Over the past three decades, Chinese researchers have studied
the role of traditional Chinese medicine in treating cancer.
They have obtained significant results.
Etiology and Pathogenesis
1. Insufficient vital essence
Insufficient vital essence causes deficiency syndromes. Since
various deficiency syndromes may occur in cancer patients,
insufficient vital essence is considered the basic pathogenesis
of cancers. Insufficient vital essence results from congenital
defects, senility, protracted illness, overexertion, improper
diet, over indulgence in sexual activity or invasion by
exogenous pathogenic factors.
2. Blood stasis and phlegm accumulation
Traditional Chinese medicine holds that cancerous tumors are the
result of blood stasis or phlegm accumulation or both. Qi
activates and governs blood circulation. Deficiency of qi may
cause blood stasis. Stagnation of qi, which is usually due to an
emotional upset or affection by exopathogens, is another common
factor that impedes the normal flow of blood and results in
blood stasis and eventually tumor formation. Accumulation of
phlegm is related to the various deficiency sates described
above, particularly deficiency of spleen qi characterized by
failure in transporting and transforming the refined substances
from food and water which leads to the formation of phlegm.
3. Invasion of exogenous pathogenic factors
Exogenous pathogenic heat or cold can invade the body, disturb
the smooth flow of qi and blood and, as a result, cause the
retention of qi and blood and the formation of tumors.
Differential Diagnosis of Syndromes
1. Qi deficiency
Primary manifestations: general lassitude, shortness of breath,
weak breathing and speaking, spontaneous sweating that worsens
on exertion, pale tongue with thin, white coating and weak
pulse.
Conditions associate with cough and expectation of copious thin
sputum indicate a deficiency of lung qi; poor appetite, fullness
in the abdomen after meals, loose stool or edema indicate a
deficiency of spleen qi; palpitations or arrhythmia may appear
in cases with deficiency of heart qi.
2. Yang deficiency
Primary manifestations: intolerance of cold, cold limbs, slow
pulse with the manifestations of qi deficiency.
Deficiency of kidney yang is manifested as weakness of the loins
and knees, impotence, frequent urination at night, incontinence
of urine, diarrhea before dawn or edema complicated by the
general manifestations of yang deficiency.
3. Blood deficiency
Primary manifestations: Pallor or sallow complexion, pale tongue
with thin, white coating and thready pulse. Additional
manifestations may include palpitations, insomnia, amnesia and
dream-disturbed sleep, suggesting deficiency of heart blood;
blurred vision, dizziness, ringing in the ears, numbness of the
hands and feet or scanty menstrual flow, indicate deficiency of
liver blood.
4. Yin deficiency
Primary manifestations: Dry mouth with preference for beverages,
absence of tongue coating, constipation and concentrated urine,
indicating consumption of body fluids; feverish sensation in the
palms, sole, and chest, afternoon fever, night sweating, deep
red tongue without coating and fine rapid pulse, suggesting
interior heat due to yin deficiency. Patients with yin
deficiency, suffering from restlessness, dizziness, dryness of
the eyes, nocturnal emissions, soreness and weakness of the
loins and knees, can be diagnosed as having yin deficiency of
the liver and kidneys. Those with yin deficiency, suffering from
dry cough or cough with expectation of scanty, sticky sputum,
can be diagnosed as having yin deficiency of the lungs.
5. Stagnation of liver qi
Primary manifestations: Fullness and distending pain in the
hypochondriac regions, irritability, belching, loss of appetite,
distending sensations in the breast, thin, white tongue coating
and taut pulse.
6. Blood stasis
Primary manifestations: Fixed pain or mass in a given region of
the body, petechiae or bleeding, dark complexion, dry scaly
skin, dysmenorrhea with discharge of dark-red blood or clots,
purple or dark-red tongue and fine and hesitant pulse.
7. Phlegm-dampness
Primary manifestations: Cough, expectations of mucoid white
sputum, loss of appetite, abdominal distension, white, greasy
tongue coating and slippery pulse.
Treatment
1. Qi deficiency
Principle of treatment: Invigorate qi.
Formula of choice: Four Gentlemen Decoction; the most commonly
used herbs to tonify qi: Ginseng, codonopsis root, and
astragalus root. For deficiency of lung qi, use Lung-Tonifying
Decoction, in which ginseng, astragalus root, replenish lung qi,
tangerine peel and aster root descend lung qi and prepared
rehmannia root and schisandra berry invigorate the kidneys, the
root of qi.
For deficiency of spleen qi, Ginseng, Poria, Ovate Atractylodes
Powder is an effective formula. It includes the ingredients of
the decoction of Four Gentleman Decoction, as well as lablab
bean, dioscorea root, coix seed, and lotus seed which invigorate
spleen qi; amomum fruit which enlivens the spleen and
strengthens the action of principal drugs; and platycodon root
which acts as guiding drug. For the cases with deficiency of
heart qi, use Heart-Nourishing Decoction, in which ginseng,
astragalus root, licorice root, and schisandra berry replenish
heart qi; cinnamom bark invigorates heart yang; tangkuei and
ligusticum root nourish the heart blood; and jujube, poria,
polygala root and biota seed ease the mind.
2. Yang deficiency
Principle of treatment: Replenish yang with herbs warm in
nature.
Formula of choice: Aconite Center-Rectifying Decoction for
deficiency of spleen yang; in this formula, prepared lateral
root of aconite and blast-fried ginger, both of which are
pungent in flavor and hot in property, restore yang of the
spleen and stomach by warming the middle-warmer to dispel cold;
add ginseng, ovate atractylodes root and licorice root to
replenish qi and strength the spleen.
Right-Restoring is an effective recipe for treating deficiency
of kidney yang.
3. Blood deficiency
Principle of treatment: Nourish blood.
Formula of choice: Four Ingredients Decoction to replenish liver
blood; the treatment of blood deficiency is usually combined
with herbs that invigorate qi and nourish the kidneys, for
example, Tangkuei Blood-Supplementing Decoction, which includes
a large dosage of astragalus root; Spleen-Returning Decoction is
frequently prescribed for deficiency of heart blood.
4. Yin deficiency
Principle of treatment: Nourish yin and increase body fluids.
Formula of choice: Since yin deficiency frequently causes heat,
methods for nourishing yin are often used with those for
expelling heat; use Major Origin-Supplementing Decoction to
treat yin deficiency of the liver and kidneys, in which ginseng,
dioscorea root and licorice root replenish the spleen, prepared
rehmannia root and tangkuei nourish liver yin and cornus fruit
and lycium berry invigorate kidney yin.
Deficiency of lung yin can be treated with Lily Bulb
Metal-Securing Decoction, in which rehmannia root nourishes yin
and clears away heat from the blood; ophiopogon root,
scrophularia root and lily bulb nourish yin, ,moisten the lungs,
remove phlegm and arrest cough; tangkuei and white peony root
invigorate blood and nourish yin; and licorice root and
platycodon root eliminate phlegm and coordinate the effects of
the other ingredients in the formula.
5. Stagnation of liver qi
Principle of treatment: Regulate liver qi.
Formula of choice: Bupleurum Liver-Soothing Powder.
6. Blood stasis
Principle of treatment: Promote blood circulation to remove
blood stasis.
Formula of choice: Infradiaphragmatic Stasis-Expelling
Decoction, in which tangkuei, ligusticum root, peony root, peach
kernel, carthamus flower, flying squirrel's droppings, moutan
bark promote blood circulation to remove blood stasis, and
cyperus root, bitter orange, lindera root and corydalis tuber
regulate qi to alleviate pain.
7. Phlegm-dampness
Principle of treatment: Remove dampness and phlegm.
Formula of choice: Stomach-Calming Powder and Six Gentlemen
Decoction; in these recipes, ginseng, ovate atractylodes root,
poria, and licorice root invigorate qi, strengthen the spleen
and eliminate dampness; atractylodes root and pinellia root are
added to remove dampness, magnolia bark and tangerine peel
regulate qi and dispel wetness and ginger and jujube to regulate
the function of the stomach.
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