treatment according to syndrome differentiation
1. Lung stagnation with phlegm and blood stasis
Main symptoms: unsmooth cough, bloody sputum, chest pain or chest tightness and shortness of breath, purple lips, dry mouth, constipation, dark red tongue with ecchymosis or petechiae, white or yellow fur, and slippery pulse.
Treatment: dispersing lung and regulating qi, removing blood stasis and resolving phlegm.
Prescription: Qianjin Weijing Decoction (a secret recipe from outside Taiwan). Rhizoma Phragmitis 15g, Semen Persicae 10g, Coicis Semen 30g, Semen Benincasae 15g, Rhizoma Arisaematis 15g (fried first), Rhizoma Pinelliae 15g (fried first), Radix Platycodi 12g, Radix Platycodi.
Plus or minus: Rhizoma Curcumae 15g and Rhizoma Corydalis15g for patients with chest pain; Patients with hemoptysis are given 30 grams of cogongrass rhizome, 30 grams of agrimony and 20 grams of Eclipta prostrata; ; Cortex Moutan 15g, Fructus Forsythiae 15g, and Radix Scutellariae 10g are added for patients with bloody phlegm and dark tongue.
2. Spleen deficiency and phlegm-dampness type
Main symptoms: cough with excessive phlegm, chest tightness and shortness of breath, mental fatigue, laziness in speaking, anorexia and emaciation, abdominal distension and loose stool, teeth marks on the tongue, white and greasy tongue coating, full and slow pulse.
Treatment: invigorating spleen and eliminating dampness, regulating qi and resolving phlegm.
Prescription: Chen Xia and Liu Jun made their own soup. 30g of Radix Codonopsis, 20g of Poria, Atractylodis Rhizoma 15g, 6g of dried tangerine peel, raw Pinellia ternata 15g, raw Arisaema 15g, 30g of Coicis Semen, Trichosanthis Radix 15g, Platycodon grandiflorum 12g, Fritillaria thunbergii 12g.
Addition and subtraction: white mustard seed 15g and immature bitter orange15g are added for patients with excessive phlegm and saliva; Ginseng 10g and astragalus 30g are added for those who feel sleepy.
3. Yin deficiency and phlegm-heat type
Main symptoms: cough with little phlegm, dry cough without phlegm, or blood in sputum, coughing up blood, chest tightness, shortness of breath, hot flashes, night sweats, dizziness and tinnitus, vexation, dry mouth, red urine, thin coating or tongue without coating, and weak pulse.
Treatment: nourishing kidney and clearing lung, resolving phlegm and resolving hard mass.
Prescription: Baihe Gujin Decoction (Shenzhai suicide note). 20g of Radix Rehmanniae, Lily 15g, Scrophularia 15g, Angelica sinensis 10g, Fritillaria thunbergii 10g, Shougong 6g, Prunella vulgaris 15g, Trichosanthes kirilowii 15g and Polyporus 20g.
Add or subtract: for those with yellow phlegm and foul smell, add Houttuynia cordata 30g, Anemarrhena asphodeloides 15g and Anemarrhena asphodeloides10g; Mulberry skin; 5. Cortex Moutan 15g and Cortex Phellodendri15g are added for those who are upset and hot; 20g of Trichosanthes root,15g; Add asparagus to those who are thirsty; Dry stool with Cannabis 15g and Magnolia officinalis 10g.
4. Deficiency of both Qi and Yin
Main symptoms: dry cough with little phlegm, low cough sound, or a little blood in sputum, sallow complexion, listlessness, dry mouth and shortness of breath, anorexia and emaciation, reddish or fat tongue, dry or no fur, and thready pulse.
Treatment: invigorating qi and nourishing yin, strengthening body resistance and removing accumulation.
Prescription: Modified Dabuyuan Decoction (Jing Yue Quan Shu). Ginseng 15g, yam 30g, Radix Rehmanniae 15g, Angelica sinensis 10g, Cornus officinalis 10g, Agrimonia pilosa 30g, American ginseng 10g, Ophiopogon japonicus 15g and Schisandra chinensis/kloc-0.
Addition and subtraction: for patients with excessive phlegm, add Mulberry Leaf 10g, Bombyx Batryticatus 10g, and 30g clam shell; Semen Lepidii 15g, Poria 25g and Alisma orientalis15g are added for patients with facial edema; 5g of scorpion, 3g of centipede and 0/5 g of Acorus gramineus/kloc-were added to coma patients.
5. Kidney-yang deficiency type
Main symptoms: shortness of breath, wheezing when moving, or dull complexion, puffiness, spontaneous sweating, soreness of waist and knees, less cough and phlegm, fear of cold, tender tongue, and deep and thin pulse.
Treatment: Warming yang and tonifying kidney, calming qi and relieving asthma.
Prescription: Ginseng Gecko Powder (Yi Yuan Lei Rong). Gecko 1 pair, Ginseng 15g, Almond 10g, Bulbus Fritillariae Cirrhosae 10g, Cortex Mori 15g, Poria 15g, Eucommia ulmoides Oliv.
Addition and subtraction: for patients who breathe more but inhale less and have severe cough and asthma, add Lepidium Lepidii 15g and Jujube15g; For those with excessive phlegm and dyspnea caused by exercise, Perilla frutescens 15g, Peucedanum praeruptorum 15g and Fructus Aurantii10g; Be added; For those with cold limbs, Rhizoma Zingiberis 10g, Radix Angelicae Sinensis 10g, and cornu Cervi Degelatinatum 15g are added.
Dialectical treatment of lung cancer is the core of TCM treatment. In the specific diagnosis and treatment process, we can also refer to the academic thoughts and medication experience of famous Chinese medicine oncologists, Chinese medicine masters and famous Chinese medicine experts, such as,,, Park Bingkui, Pan,, Yu Rencun,, and so on. The duration of TCM treatment should be flexibly adjusted according to the patient's physical condition, clinical stage, treatment method and prognosis index; Generally speaking, it is suggested that the course of treatment of traditional Chinese medicine should be more than 1 year, and blood analysis, urine analysis and liver and kidney function should be checked regularly during medication.
Dialectical medication
Clinically, patients with lung cancer often have symptoms and complications such as cough, hemoptysis, chest pain, fatigue and pleural effusion. Can coexist with many diseases. In treatment, drugs can be added and subtracted on the basis of syndrome differentiation to improve symptoms.
1. Cough
Cough is located in the lung, related to the spleen and liver, and related to the kidney for a long time. Syndrome differentiation of cough, first of all, we must distinguish exogenous diseases, internal injuries, and true and false. Most patients with lung cancer suffer from internal injuries and cough. Due to lung qi deficiency, spleen deficiency, phlegm, liver fire invading the lung or kidney failing to absorb qi, lung qi failure and lung qi upwelling are caused. In terms of treatment, dispersing lung and resolving phlegm is the basic treatment principle, and drugs are used according to syndrome differentiation of deficiency and excess and viscera.
Cough, itchy throat, thin white sputum, runny nose, aversion to cold and fever are mostly caused by wind and cold. The treatment is to dispel wind and cold, and to disperse lung and relieve cough. Herba Ephedrae, Herba Schizonepetae, Caulis Perillae, Semen Armeniacae Amarum and Radix Platycodi can be used.
Dry cough, sore throat, less expectoration, or bloodshot sputum, red dry tongue, thin yellow fur and floating pulse, which are mostly caused by wind dryness and lung injury, can be treated by clearing lung and moistening dryness. Mulberry leaves, almonds, Fritillaria cirrhosa, Adenophora adenophora and loquat leaves are all acceptable.
Shortness of breath, low voice, multi-colored and white sputum, spontaneous sweating, aversion to wind, fatigue and fatigue, pale tongue, white fur and weak pulse are mostly caused by deficiency of both lung and spleen, which can be treated by invigorating spleen and lung, benefiting soil and generating gold. Codonopsis pilosula, Atractylodis Rhizoma, Pericarpium Citri Tangerinae and Rhizoma Pinelliae Preparata can be selected.
Dry cough, short cough, dry mouth and throat, hoarseness, hot flashes in the afternoon, night sweats, emaciation, red tongue, little fur and thready pulse, which are mostly caused by lung yin loss. Ophiopogon japonicus, Radix Asparagi, Trichosanthis Radix, Flos Farfarae and Radix Asteris can nourish yin, clear heat, moisten lung and relieve cough.
The phlegm is white and thin, and the tongue is pale and the coating is white and slippery, which belongs to cold phlegm. Asarum, dried ginger, gecko and Pinellia ternata are commonly used to warm cold phlegm. Cough is heavy and turbid, phlegm is white and thick, and chest tightness is mostly caused by phlegm-dampness accumulating in the lungs. Pinellia ternata, Poria, Pericarpium Citri Tangerinae, Semen Sinapis Albae, Rhizoma Atractylodis and Exocarpium Citri Grandis can be used for treating damp phlegm, regulating qi and relieving cough.
Cough is accompanied by chest pain, thick phlegm, or yellow thick, dry mouth and thirst, red tongue, yellow greasy fur, slippery pulse, mostly phlegm heat and depressed lung, which can be treated by clearing heat and resolving phlegm, calming lung and relieving cough. Scutellaria baicalensis Georgi, Anemarrhena asphodeloides, Trichosanthes root, Taraxacum mongolicum, Houttuynia cordata, etc.
After radiotherapy, patients often have dry cough, burning throat, little yellow and thick phlegm, difficulty in coughing, occasional body heat, red tongue, little moss, slippery or thin pulse, which are mostly caused by injury of both qi and yin or accumulation of pathogenic heat in the lungs. Treatment can be based on invigorating qi and nourishing yin or nourishing yin and clearing heat. Radix Adenophorae, Radix Ophiopogonis, Fructus Forsythiae, Rhizoma Anemarrhenae, Radix Platycodi and Radix Rehmanniae can be selected.
hemoptysis
Hemoptysis belongs to the category of "blood syndrome", and the disease is located in collaterals. Syndrome differentiation of hemoptysis needs to distinguish between deficiency and excess. The excess syndrome is mostly fiery blood stasis, which causes blood to burn and force blood to rush, or blood overflows and blood stasis blocks collaterals. Deficiency syndrome is generally caused by qi deficiency and blood not returning to menstruation. In terms of treatment, fire, qi and blood are the main drugs, and the combination of deficiency and excess is used.
Blood in sputum or coughing up blood, dry mouth, itchy throat or sore throat, body heat, bad wind and headache are mostly caused by dryness and heat, which can be treated by clearing away heat and moistening lung, smoothing collaterals and stopping bleeding. Mulberry leaves, Adenophora adenophora, lotus root nodes and arborvitae leaves can be selected.
Blood in sputum or hemoptysis, cough pain leads to chest and hypochondriac symptoms, irritability, red eyes and bitter taste, red tongue, thin yellow fur and rapid pulse, which are mostly caused by liver fire invading the lungs. Clearing liver and purging lung, cooling blood and stopping bleeding can be done with Agrimonia pilosa, Scutellaria baicalensis Georgi, Gypsum Fibrosum, Anemarrhena asphodeloides and Radix Rubiae.
Blood in the sputum or coughing up blood, dark blood, stabbing pain in the chest and hypochondrium, fixed position, blue tongue with ecchymosis and astringent pulse, mostly caused by blood stasis blocking collaterals. The therapy can be used for dredging collaterals, removing blood stasis, cooling blood and stopping bleeding. Radix Notoginseng, Radix Salviae Miltiorrhizae, Radix Rehmanniae and Carapax Trionycis can be selected.
Excessive cough, pale blood color, mental fatigue, loss of appetite, pale tongue with white fur and thready pulse, mostly caused by qi deficiency and spleen failing to control blood. Ginseng Radix, Radix Astragali, Poria, Colla Corii Asini, Radix Rubiae and processed ginger charcoal can be used for treatment.
3. Pleural effusion
Pleural effusion belongs to the category of "phlegm drinking" and "hanging drinking", and the disease is located in triple energizer. Phlegm drinking is a disease, with deficiency in reality, deficiency in reality and deficiency in reality. Differentiation of symptoms and signs must first distinguish between primary and secondary. Suspended drinking is mainly due to ignoring the gasification of triple energizer and the imbalance of lung, spleen and kidney function, which is under threat. In the treatment, we should first review the yang-transforming and use drugs according to the syndrome differentiation of deficiency and excess.
Chest and hypochondriac pain, dyspnea, cough and asthma, inability to lie flat, or lying on one side only after stopping drinking, full intercostal space on the affected side, pale tongue with white fur, and heavy or slippery pulse. In order to stop drinking in the chest and hypochondrium, purge the lung and eliminate drinking, prickly heat, mulberry bark, polyporus, plantain and Ji Fang can be used.
Choking cough, dry mouth and throat, hot flashes in the afternoon, feverish hands and feet, red tongue, little fur, and rapid pulse, which belong to yin deficiency and internal heat, can be treated by nourishing yin and clearing away heat, such as Radix Adenophorae, Radix Ophiopogonis, Cortex Mori, Trichosanthis Radix, Radix Pseudostellariae, Dendrobium, Polygonatum, etc.
Asthma and shortness of breath, especially chest distress during exercise, loss of appetite, cold limbs, listlessness, pale tongue, fat, white and slippery fur, and heavy pulse can be treated by warming spleen and tonifying kidney, such as Radix Aconiti Lateralis Preparata, Ramulus Cinnamomi, Zingiberis Rhizoma, Radix Astragali, Atractylodis Macrocephalae, Fructus Psoraleae and Gecko.
4. Chest pain
Chest pain belongs to the category of "pain", and the disease is located in collaterals, which leads to pain. In lung cancer, chest pain is dominated by deficiency and excess, with deficiency in attack and deficiency in remission. Syndrome differentiation starts with distinguishing deficiency from excess and is divided into cold, heat, phlegm and blood stasis. In terms of treatment, "it is not based on strengthening the body, but on attacking evil."
Pain in the chest and hypochondrium, aggravated by mood swings, red eyes and bitter mouth, red tongue, thin yellow fur and rapid pulse, mostly caused by liver-fire invading the lungs. Dandelion, Scutellaria baicalensis Georgi, Gypsum Fibrosum, Anemarrhena asphodeloides, etc. Can be used for clearing liver and purging lung.
Chest and hypochondriac swelling and pain, with fixed position, aggravated when moving, blue tongue with ecchymosis and astringent pulse, which are mostly caused by blood stasis blocking collaterals, can be treated by methods such as dredging collaterals and removing blood stasis, promoting blood circulation and relieving pain. Radix Notoginseng, Carapax Trionycis, Shougong, Lumbricus and Bombyx Batryticatus can be selected.
Chest pain, uncertain position, aggravated rainy days, colorful phlegm, white and sticky, mostly caused by phlegm-dampness accumulating in the lungs. Pinellia ternata, Poria, Pericarpium Citri Tangerinae and Fructus Aurantii can be used for eliminating dampness and resolving phlegm, regulating qi and relieving pain.
Chest pain, dyspnea, shortness of breath, excessive inhalation, little breathing, low voice, cold sweat, pale tongue, thin white fur and weak pulse, which are mostly caused by deficiency of both lung and kidney. Ginseng, Atractylodis Rhizoma, Radix Aconiti Lateralis Preparata and Gecko can be used for treating deficiency of both lung and kidney.
Medication based on disease differentiation
On the basis of syndrome differentiation and treatment, 2-3 kinds of Chinese herbal medicines such as Hedyotis diffusa, Fritillaria thunbergii, Gecko, Scutellaria barbata, Lobelia chinensis, Shā rotto Katakuri, Ranunculus ternatus, Nidus Vespae, Houttuynia cordata, Solanum nigrum, and Herba Rubiae can be added.
References. , yellow,. Expert knowledge of diagnosis and treatment of lung cancer with integrated traditional Chinese and western medicine [J]. Journal of Oncology of TCM, 202 1, 3 (06): 1- 17.