心脏主要致毒药物有：蒽环类抗癌药（ADM、DNA），三尖杉脂，碱类（HRT、HHR），喜树碱类及DDP等。大剂量CTX和5一Fu亦可引起心肌损害，临床表现非特异性心电图变化，如T波平坦、S-T段压低等，严重者可出现心律失常，甚至心衰心肌受损症状，大多在化疗中后期出现，症见心悸怔忡、倦怠乏力、胸闷气喘，重者心痛彻背、不得平卧、肢肿、舌色紫暗、脉涩或结代，症属心阳不振之候。治宜益气温阳、活血化瘀、宁心安神，可用炙甘草汤、生脉饮、四逆汤加人参汤加减，尚可加入丹参、三七、桂枝活血通络。
4、肝毒性
许多抗癌药物经过肝脏代谢和解毒，同时对肝脏有一定的毒副作用，常见的致毒药物有抗代谢类（MTX、6一MP、5一Fu）、烷化剂（CTX、HN2）、铂类（尤其是DDP）、蒽环类（ADM、DRN及DTIC等。引起肝损伤有三种形式：①肝细胞性功能降弱和化学性肝炎；②静脉闭塞性肝痛；③慢性纤维化。临床上可表现为肝区胀痛、纳呆痞满、心烦呕噁、肢体乏力、尿黄、转氨酶升高、肝脏肿大，严重的皮肤巩膜黄染、高热、腹水、肝昏迷、舌红苔腻脉弦滑。治则以清热利湿、疏肝利胆、健脾理气、活血化瘀为常用治法。药用茵陈、柴胡、枳壳、郁金、虎杖、平地木、丹参、垂盆草、炙必甲、蟅虫、茯苓、炒冬术、仙鹤草，高热用知母、青黛、牛黄，湿重用佩兰、苍术、川朴，有黄疸用金钱草、茵陈、青蒿、山支，肝昏迷用羚羊角、安宫牛黄丸、紫雪丹清心开窍。
5、肺毒性
文献报告有近20种化疗药物可引起肺损害，常见致毒药物有BLM、PVRM、BuS、BCNu、CTX、MTX、MMC及马利兰。发生与累积剂量相关，原有肺疾及年迈者更易发生肺毒性而致肺纤维化及间质性肺炎。临床表现为疲劳不适、干咳少痰、呼吸困难，重则哮喘，可伴有发热、胸痛及咯血，乃热灼伤肺所致。舌红苔少脉滑数。治拟清热养阴、佐投活血化瘀之品。药用沙参、知母、地骨皮、天麦冬、贝母、桑白皮、杏仁、桔梗、炙亭力子、瓜蒌皮、赤芍、桃仁、炙必甲、海藻。
6、肾脏毒性
许多抗肿瘤药物及其代谢物经肾脏排出体外，所以肾脏容易受到损害。常见致毒药物为DDP、MMC、DRN、大剂量MTX、MTH等，以DDP肾毒性最为突出，可引起药物性肾炎、肾小管上皮细胞变性坏死、间质水肿及肾小管扩张等，表现为蛋白尿，尿常规出现红、白细胞，颗粒管型和潜血阳性，严重者可发生无尿或急性肾功能衰竭。亦有部分病人出现出血性膀胱炎，常由CTX、IFO及喜树碱引起，表现为尿急、尿频、尿痛及血尿等，应停止化疗并多
饮开水。治宜清利解毒。药用知母、黄柏、土茯苓、猪苓、车前子、萆薢、木通、白茅根、大小蓟、生芪、川连。
7、神经系统反应
化疗药物引起神经系统反应表现在末梢神经炎和脑功能障碍。引起末梢神经炎的主要致毒药物有：长春碱类（VLB、VCR、VDS、NVB ）、秋水仙碱及DDP等，主要表现在四肢或躯干感觉障碍，麻木无力，可至对称性手套状或袜状感觉异常，腱反射减弱或消失，有时还可发生麻痹性肠梗阻。引起脑功能障碍。常见致毒药物有L－ASP、氟脲嘧啶类、MTX、PCB及鬼臼毒素类，可表现为嗜睡或谵妄、意识障碍、智力减退、定向异常及人格改变等，以L-ASP更为常见。治疗宜补肾养心、开窍通络。药用牛夕、五味子、萸肉、女贞子、杞子、全蝎、地龙、桑枝、乌梢蛇、炒川芎、石菖蒲、炒僵蚕、泽兰、炙远志、炒枣仁、桂枝，重症可加用羚羊角片、牛黄、川连等。
8、小结
化疗患者绝大多数本虚标实，故治之大法宜扶正培本，但因药物品种、给药途径、剂量大小及各人耐药性差异，毒副反应及并发症错综复杂，因此，治疗时要因人、因药、因时、因发病部位、因证候不同采取急则治标，缓则治本，常用治疗法则以扶正培本、清热 解毒、理气活血、健脾利湿、养阴生津、滋补肝肾、对症治疗为主，诸法又常配合使用。
化疗其间采用中医药能有效防治或减轻毒副作用，已被公认，但疗程结束时其毒副作用远未消失，随着临床经验的积累和长期生存人数的增多，对化疗药物远期毒性反应如女性化或男 性化，骨质疏松，对生育的影响，致畸胎作用和致癌作用，已引起人们的关注。化疗后继续采用中医药防治毒副反应和巩固化疗疗效，是应该选择的接力性治疗。
5、癌症发热的辨证论治
癌症发热是常见症状，特别是某些晚期癌肿，目前认为其原因有肿瘤本身引起发热，疾病过程或由于治疗而继发感染发热、药物热。癌性发热表现有间歇性、驰张性、有低热，亦可高热至40℃，病程常缠绵不清，用退热药及抗生素大多无效。笔者经三十年临床验证，审证求因，分清虚实，标本兼治能获良效，兹分述如下：
一：热毒内蕴发热
1．1临床表现
高热驰张，常39摄氏度以上，汗出不解，周身酸楚、面红目赤，口渴喜饮，咽干舌燥，呼吸气粗，烦燥失眠，癌块巨大，痛有定处拒按，便秘，尿红赤，血检白血球及中性增高，舌红，苔黄，脉洪数。多为晚期转移性癌症继发感染引起发热，例如肺癌并发阻塞性肺炎，晚期胆、胰癌、白血病、恶性淋巴瘤。肿瘤骨转移者，因癌块压迫或阻塞重要器官腔道引起引流不畅并发感染。
1．2
①上焦肺热：蛇舌草30克，鱼腥草30克，龙葵30克，山豆根10克，白薇10克，青黛15克，黄芩10克，知母15克，石膏30克，银花12克，生草10克，大豆卷10克，白英30克。
②肝胆炽热：龙胆草12克，金钱草30克，半边莲30克，柴胡12克，茵陈30克，牛黄0。3克（吞），牛角片50克，羚羊角2克，犀黄丸6克（吞），七叶一支花30克，地龙20克。
③胃肠腑热：半支莲30克，败酱草30克．蒲公英30克，红藤30克，苦参30克，黄连5克，黄柏10克，土茯苓30克，大黄10克，紫草12克，丹皮10克。④热入营血：牛黄0。3克（吞），羚羊角2克，知母12克，石膏30克．黄连3克，寒水石50克，白英30克，西洋参6克，紫草12克，连翘12克，穿心莲30克，地骨皮12克。
1．3分析
清热解毒药物经药理研究有直接抑制肿瘤的作用，抗癌活性最强的有蛇舌草，山豆根、半支莲、穿心连、白英、冬凌草、丹皮、青黛、龙葵等均有不同程度的抑瘤作用；尚有调节机体免疫功能，抗炎排毒作用，调节内分泌功能，阻断致癌和反突变作用等，用于治疗癌症合并感染，水肿均可见到明显改善症状，个别患者可见肿块缩小。晚期肿瘤病人抵抗力下降，有50％以上因感染引起死亡，此类证型病势凶险，及时进行有效治疗才能避免因延治或疗效不佳而死于感染，笔者常用下列清热排毒汤往往奏效：进口牛黄0。3克（吞），青黛15克，知母20克，牛角片100克，大黄秀10克，柴胡10克，青蒿10克，川连5克，石膏30克，半支莲30克，鱼腥草30克，蛇舌草30克，穿心莲30克。
二：气虚阳郁发热
2．1；临床症状
发热忽高忽低，体温37．5摄氏度左右，白天居多，面色白或晦滞，心烦口淡，气短懒言，食欲减退，恶心呕泛，尿淡黄便溏，苔薄白舌淡胖，脉虚大。多因手术气随血脱，气血俱虚的消化道癌症，或恶性淋巴瘤，白血病、肺、胃、卵巢癌化疗病人。
2·2方药
生晒参5克，生芪15克，太子参12克，冬术12克，南北沙参各12克，青蒿10克，地骨皮12克，牛角片30克，米仁30克，山药12克，银柴胡10克，肉桂4克．萸肉10克。
2．3分析
气虚阳郁发热与脾肾密切相关，中气下陷，运化失司，气血不能生化，则郁热内生，培中升陷以健脾助运，正足则邪自去；肾亏不能行气化水、阳气内郁，症见身热恶寒，口渴不欲饮、烦躁不安，腰膝痠软，脉沉或浮大无力，应温阳助运，投用杞子，肉桂、萸肉。方中所用药物大多减轻化疗毒副反应，提高手术效果，抑癌抗癌作用，提高肌体免疫力，促进骨髓造血干细胞的增殖，增强内分泌体液调节功能，
调节细胞内环磷酸腺苷CAMP含量及CMP／CGMP的比值，及提高机体物质代谢等方面作用。
三：阴虚火旺发热
3．1临床表现
午后潮热或夜间发热，发热不欲近衣，五心烦热或骨蒸潮热，寐劣梦扰，颧红盗汗，尿黄，大便干结，舌质干红或有裂纹，少苔或无苔，脉细数。多为晚期肝癌、肺癌、各种类型癌症骨转移及手术、放化疗后复发、转移为多见。
3．2 基本方
①肺胃津液耗损：生芪15克，麦冬12克，五味子10克，川石斛30克，南沙参12克，玉竹12克，淡竹叶12克，黄芩10克，银花12 克，知母10克，芦根30克， 银柴胡10克，元参20克，冬虫夏草10克。
②心脾血脉不足：北沙参15克，杞子12克，丹参20克，当归12克，地骨皮12克，生地12克，首乌12克，太子参12克，龙眼肉10克，浮小麦30克，地骨皮10克，蒲公英30克，山药12克。③肝肾真精虚损：萸肉15克，鳖甲12克，龟板12克，黄精12克，杞子12克，蛤蚧1对，知母10克，黄柏10克，女贞子12克，旱莲草12克，龙牡各30克。
3．3分析
阴精亏虚则阳热亢盛，水不制火为本证的主要病机；对鼻咽癌、喉癌、肺癌放疗所致的津液耗损，侧重于养胃之阴，对化疗所致的胃肠道反应，骨髓抑制侧重于填精补髓。不少养阴药物有延长抗体存在时间的作用，有提高免疫力，对肿瘤有显著的抑制作用。
4小结
4．1若因瘀血发热，症见午后或日晡发热为主，病灶处刺痛，眼圈发黑，舌紫可有瘀斑，脉细涩用血府逐瘀汤加减，若气滞发热，症见胸腹胁肋腿痛，心烦易怒，嗳气，脉细数，用逍遥散加减；若因痰湿发热，症见头重，胸闷，脘痞、肢懈、纳呆、苔厚腻，用苍白术、姜夏、川朴、藿佩兰、大豆卷、茯苓化痰利湿。
4．2因病因、病位、病程、治疗手段各异，癌性发热症状凶险多变，大多虚实夹杂，标本俱病；治病必求于本，最根本的方法是去除肿瘤，如通过手术，放化疗达到这一目的，但晚期肿瘤已广泛转移，或全身情况太差，已失去根治机会，因而斩其热毒，又固本消瘤，对治疗癌性发热，改善晚期病人生存质量有其积极意义。
此文发表于《河南中医药学刊》1995年第10卷，总第57期
6，晚期肝癌的中药治疗 附106例临床资料分析
"内容提要）将晚期肝癌106例分二组进行临床疗效观察。验方组30例，采用自制制剂"中肝1号"进行治疗；辨证论治组76例，分别采用疏肝解郁、清热解毒、凉血解毒、健脾利水、清热利湿、活血软坚、温肾助运、平肝熄风、泻肝止血、消痞镇痛等10法。结果验方组三个月内存活率为86．7％，超过六个月存活率为18。5％；辨证论治组三个月内存活率为55·3％，超过六个月存活率为3·3％。辨证论治组的存活期明显高于验方组。
原发性肝癌是我国常见的癌症，约占恶性肿瘤死亡人数的六分之一，每年有十万人死于此病。本病好发于男性壮年，起病隐匿，病情发展险恶，存活期短，来院就诊的大多数是晚期患者，已经失去手术及放、化疗条件，对这类病人进行中医药治疗和提高疗效的探索是有重要意义的。为此，我科曾分设验方与辨证论治二组病例来观察存活期，小结如下。
一、一般资料。
（一）病例选择和观察方法：全部病例均在我科门诊接受规定中医药治疗，均经测
定甲胎蛋白对流免疫电泳法阳性，碱性酶、r一谷氨酞酶超过正常值，B超示占位性病变，体症检查癌块明显触及者为诊断依据。有的还经CT或病理切片证实。疗效以诊断明确给予治疗之日算起，观察存活期。来院前曾用其它方法治疗者不列入统计范围，观察期间因失访、意外、服用其它药物或接受其它方法治疗、以及半途中断规定药物治疗的病例，也不列入统计范围。
分设二组观察：验方观察组30例。时间为1986年2月26日至5月26日经确诊符合统计条件的全部肝癌病例；辨证论治组计76例。时间1987年1月3日至5月30日经确诊符合统计条件的全部肝癌病例。采用辨证论治方法治疗。
（二）资料分析：1年龄与性别：验方组30例中，男26例，女4例；最大年龄70岁，最小30岁，平均47．5岁。辨证论治组76例中，男66例，女10例；最大年龄13岁，最小19岁，平均52岁。两组平均年龄50．7岁；2．症状及舌苔脉象：晚期肝癌病情发展迅速，症状变化复杂，但以上腹胀痛、肝脏进行性肿大、黄疸、腹水、出血、发热、消瘦为常见。舌质以红多见，不少患者舌苔光剥，质红绛，苔大多黄腻，脉弦涩、细，滑、数次之。
【背景信息】
书名：陈友芝医案 章节：正文(13/14) 类别：医论
心脏主要致毒药物有：蒽环类抗癌药（ADM、DNA），三尖杉脂碱类（HRT、HHR），喜树碱类及DDP等。大剂量CTX和5-Fluorouracil (5-Fu) 亦可引起心肌损害，临床表现非特异性心电图变化，如T波平坦、S-T段压低等，严重者可出现心律失常，甚至心衰心肌受损症状，大多在化疗中后期出现，症见心悸怔忡、倦怠乏力、胸闷气喘，重者心痛彻背、不得平卧、肢肿、舌色紫暗、脉涩或结代，症属心阳不振之候。治宜益气温阳、活血化瘀、宁心安神，可用炙甘草汤、生脉饮、四逆汤加人参汤加减，尚可加入丹参、三七、桂枝活血通络。
4、肝毒性
许多抗癌药物经过肝脏代谢和解毒，同时对肝脏有一定的毒副作用，常见的致毒药物有抗代谢类（MTX、6-Mercaptopurine (6-MP)、5-Fu）、烷化剂（CTX、HN2）、铂类（尤其是DDP）、蒽环类（ADM、DRN及DTIC等）。引起肝损伤有三种形式：①肝细胞性功能降弱和化学性肝炎；②静脉闭塞性肝病；③慢性纤维化。临床上可表现为肝区胀痛、纳呆痞满、心烦呕恶、肢体乏力、尿黄、转氨酶升高、肝脏肿大，严重的皮肤巩膜黄染、高热、腹水、肝昏迷、舌红苔腻脉弦滑。治则以清热利湿、疏肝利胆、健脾理气、活血化瘀为常用治法。药用茵陈、柴胡、枳壳、郁金、虎杖、平地木、丹参、垂盆草、炙鳖甲、土鳖虫、茯苓、炒白术、仙鹤草，高热用知母、青黛、牛黄，湿重用佩兰、苍术、川朴，有黄疸用金钱草、茵陈、青蒿、山栀，肝昏迷用羚羊角、安宫牛黄丸、紫雪丹清心开窍。
5、肺毒性
文献报告有近20种化疗药物可引起肺损害，常见致毒药物有BLM、PVRM、BuS、BCNu、CTX、MTX、MMC及马利兰。发生与累积剂量相关，原有肺疾及年迈者更易发生肺毒性而致肺纤维化及间质性肺炎。临床表现为疲劳不适、干咳少痰、呼吸困难，重则哮喘，可伴有发热、胸痛及咯血，乃热灼伤肺所致。舌红苔少脉滑数。治拟清热养阴、佐投活血化瘀之品。药用沙参、知母、地骨皮、天麦冬、贝母、桑白皮、杏仁、桔梗、炙葶苈子、瓜蒌皮、赤芍、桃仁、炙鳖甲、海藻。
6、肾脏毒性
许多抗肿瘤药物及其代谢物经肾脏排出体外，所以肾脏容易受到损害。常见致毒药物为DDP、MMC、DRN、大剂量MTX、MTH等，以DDP肾毒性最为突出，可引起药物性肾炎、肾小管上皮细胞变性坏死、间质水肿及肾小管扩张等，表现为蛋白尿，尿常规出现红、白细胞，颗粒管型和潜血阳性，严重者可发生无尿或急性肾功能衰竭。亦有部分病人出现出血性膀胱炎，常由CTX、IFO及喜树碱引起，表现为尿急、尿频、尿痛及血尿等，应停止化疗并多饮开水。治宜清利解毒。药用知母、黄柏、土茯苓、猪苓、车前子、萆薢、木通、白茅根、大小蓟、生黄芪、川连。
7、神经系统反应
化疗药物引起神经系统反应表现在末梢神经炎和脑功能障碍。引起末梢神经炎的主要致毒药物有：长春碱类（VLB、VCR、VDS、NVB）、秋水仙碱及DDP等，主要表现在四肢或躯干感觉障碍，麻木无力，可至对称性手套状或袜状感觉异常，腱反射减弱或消失，有时还可发生麻痹性肠梗阻。引起脑功能障碍的常见致毒药物有L-ASP、氟脲嘧啶类、MTX、PCB及鬼臼毒素类，可表现为嗜睡或谵妄、意识障碍、智力减退、定向异常及人格改变等，以L-ASP更为常见。治疗宜补肾养心、开窍通络。药用牛膝、五味子、山茱萸、女贞子、枸杞子、全蝎、地龙、桑枝、乌梢蛇、炒川芎、石菖蒲、炒僵蚕、泽兰、炙远志、炒酸枣仁、桂枝，重症可加用羚羊角片、牛黄、川连等。
8、小结
化疗患者绝大多数本虚标实，故治之大法宜扶正培本，但因药物品种、给药途径、剂量大小及各人耐药性差异，毒副反应及并发症错综复杂，因此，治疗时要因人、因药、因时、因发病部位、因证候不同采取急则治标，缓则治本，常用治疗法则以扶正培本、清热解毒、理气活血、健脾利湿、养阴生津、滋补肝肾、对症治疗为主，诸法又常配合使用。
化疗期间采用中医药能有效防治或减轻毒副作用，已被公认，但疗程结束时其毒副作用远未消失，随着临床经验的积累和长期生存人数的增多，对化疗药物远期毒性反应如女性化或男性化，骨质疏松，对生育的影响，致畸胎作用和致癌作用，已引起人们的关注。化疗后继续采用中医药防治毒副反应和巩固化疗疗效，是应该选择的接力性治疗。
5、癌症发热的辨证论治
癌症发热是常见症状，特别是某些晚期癌肿，目前认为其原因有肿瘤本身引起发热，疾病过程或由于治疗而继发感染发热、药物热。癌性发热表现有间歇性、驰张性、有低热，亦可高热至40℃，病程常缠绵不清，用退热药及抗生素大多无效。笔者经三十年临床验证，审证求因，分清虚实，标本兼治能获良效，兹分述如下：
一：热毒内蕴发热
1．1临床表现
高热驰张，常39摄氏度以上，汗出不解，周身酸楚、面红目赤，口渴喜饮，咽干舌燥，呼吸气粗，烦躁失眠，癌块巨大，痛有定处拒按，便秘，尿红赤，血检白血球及中性增高，舌红，苔黄，脉洪数。多为晚期转移性癌症继发感染引起发热，例如肺癌并发阻塞性肺炎，晚期胆、胰癌、白血病、恶性淋巴瘤。肿瘤骨转移者，因癌块压迫或阻塞重要器官腔道引起引流不畅并发感染。
1．2方药
①上焦肺热：白花蛇舌草30克，鱼腥草30克，龙葵30克，山豆根10克，白薇10克，青黛15克，黄芩10克，知母15克，石膏30克，银花12克，生甘草10克，大豆卷10克，白英30克。
②肝胆炽热：龙胆草12克，金钱草30克，半边莲30克，柴胡12克，茵陈30克，牛黄0.3克（吞服），牛角片50克，羚羊角2克，犀黄丸6克（吞服），七叶一支花30克，地龙20克。
③胃肠腑热：半支莲30克，败酱草30克，蒲公英30克，红藤30克，苦参30克，黄连5克，黄柏10克，土茯苓30克，大黄10克，紫草12克，丹皮10克。④热入营血：牛黄0.3克（吞服），羚羊角2克，知母12克，石膏30克，黄连3克，寒水石50克，白英30克，西洋参6克，紫草12克，连翘12克，穿心莲30克，地骨皮12克。
1．3分析
清热解毒药物经药理研究有直接抑制肿瘤的作用，抗癌活性最强的有白花蛇舌草，山豆根、半支莲、穿心莲、白英、冬凌草、丹皮、青黛、龙葵等均有不同程度的抑瘤作用；尚有调节机体免疫功能，抗炎排毒作用，调节内分泌功能，阻断致癌和反突变作用等，用于治疗癌症合并感染，水肿均可见到明显改善症状，个别患者可见肿块缩小。晚期肿瘤病人抵抗力下降，有50％以上因感染引起死亡，此类证型病势凶险，及时进行有效治疗才能避免因延治或疗效不佳而死于感染，笔者常用下列清热排毒汤往往奏效：进口牛黄0.3克（吞服），青黛15克，知母20克，牛角片100克，大黄10克，柴胡10克，青蒿10克，川连5克，石膏30克，半支莲30克，鱼腥草30克，白花蛇舌草30克，穿心莲30克。
二：气虚阳郁发热
2．1临床症状
发热忽高忽低，体温37.5摄氏度左右，白天居多，面色白或晦滞，心烦口淡，气短懒言，食欲减退，恶心呕吐，尿淡黄便溏，苔薄白舌淡胖，脉虚大。多因手术气随血脱，气血俱虚的消化道癌症，或恶性淋巴瘤，白血病、肺、胃、卵巢癌化疗病人。
2．2方药
生晒参5克，生黄芪15克，太子参12克，冬术12克，南北沙参各12克，青蒿10克，地骨皮12克，牛角片30克，米仁30克，山药12克，银柴胡10克，肉桂4克，山茱萸10克。
2．3分析
气虚阳郁发热与脾肾密切相关，中气下陷，运化失司，气血不能生化，则郁热内生，培中升陷以健脾助运，正气足则邪自去；肾亏不能行气化水、阳气内郁，症见身热恶寒，口渴不欲饮、烦躁不安，腰膝痠软，脉沉或浮大无力，应温阳助运，投用杞子，肉桂、山茱萸。方中所用药物大多减轻化疗毒副反应，提高手术效果，抑癌抗癌作用，提高肌体免疫力，促进骨髓造血干细胞的增殖，增强内分泌体液调节功能，调节细胞内环磷酸腺苷CAMP含量及CMP／CGMP的比值，及提高机体物质代谢等方面作用。
三：阴虚火旺发热
3．1临床表现
午后潮热或夜间发热，发热不欲近衣，五心烦热或骨蒸潮热，寐劣梦扰，颧红盗汗，尿黄，大便干结，舌质干红或有裂纹，少苔或无苔，脉细数。多为晚期肝癌、肺癌、各种类型癌症骨转移及手术、放化疗后复发、转移为多见。
3．2基本方
①肺胃津液耗损：生黄芪15克，麦冬12克，五味子10克，川石斛30克，南沙参12克，玉竹12克，淡竹叶12克，黄芩10克，银花12克，知母10克，芦根30克，银柴胡10克，元参20克，冬虫夏草10克。
②心脾血脉不足：北沙参15克，杞子12克，丹参20克，当归12克，地骨皮12克，生地12克，首乌12克，太子参12克，龙眼肉10克，浮小麦30克，地骨皮10克，蒲公英30克，山药12克。③肝肾真精虚损：山茱萸15克，鳖甲12克，龟板12克，黄精12克，杞子12克，蛤蚧1对，知母10克，黄柏10克，女贞子12克，旱莲草12克，龙骨牡蛎各30克。
3．3分析
阴精亏虚则阳热亢盛，水不制火为本证的主要病机；对鼻咽癌、喉癌、肺癌放疗所致的津液耗损，侧重于养胃之阴，对化疗所致的胃肠道反应，骨髓抑制侧重于填精补髓。不少养阴药物有延长抗体存在时间的作用，有提高免疫力，对肿瘤有显著的抑制作用。
4小结
4．1若因瘀血发热，症见午后或日晡发热为主，病灶处刺痛，眼圈发黑，舌紫可有瘀斑，脉细涩用血府逐瘀汤加减，若气滞发热，症见胸腹胁肋腿痛，心烦易怒，嗳气，脉细数，用逍遥散加减；若因痰湿发热，症见头重，胸闷，脘痞、肢懈、纳呆、苔厚腻，用苍白术、姜半夏、川朴、藿香佩兰、大豆卷、茯苓化痰利湿。
4．2因病因、病位、病程、治疗手段各异，癌性发热症状凶险多变，大多虚实夹杂，标本俱病；治病必求于本，最根本的方法是去除肿瘤，如通过手术，放化疗达到这一目的，但晚期肿瘤已广泛转移，或全身情况太差，已失去根治机会，因而斩其热毒，又固本消瘤，对治疗癌性发热，改善晚期病人生存质量有其积极意义。
此文发表于《河南中医药学刊》1995年第10卷，总第57期
6，晚期肝癌的中药治疗 附106例临床资料分析
"内容提要）将晚期肝癌106例分二组进行临床疗效观察。验方组30例，采用自制制剂"中肝1号"进行治疗；辨证论治组76例，分别采用疏肝解郁、清热解毒、凉血解毒、健脾利水、清热利湿、活血软坚、温肾助运、平肝熄风、泻肝止血、消痞镇痛等10法。结果验方组三个月内存活率为86.7％，超过六个月存活率为18.5％；辨证论治组三个月内存活率为55.3％，超过六个月存活率为3.3％。辨证论治组的存活期明显高于验方组。
原发性肝癌是我国常见的癌症，约占恶性肿瘤死亡人数的六分之一，每年有十万人死于此病。本病好发于男性壮年，起病隐匿，病情发展险恶，存活期短，来院就诊的大多数是晚期患者，已经失去手术及放、化疗条件，对这类病人进行中医药治疗和提高疗效的探索是有重要意义的。为此，我科曾分设验方与辨证论治二组病例来观察存活期，小结如下。
一、一般资料。
（一）病例选择和观察方法：全部病例均在我科门诊接受规定中医药治疗，均经测定甲胎蛋白对流免疫电泳法阳性，碱性酶、r-谷氨酰酶超过正常值，B超示占位性病变，体症检查癌块明显触及者为诊断依据。有的还经CT或病理切片证实。疗效以诊断明确给予治疗之日算起，观察存活期。来院前曾用其它方法治疗者不列入统计范围，观察期间因失访、意外、服用其它药物或接受其它方法治疗、以及半途中断规定药物治疗的病例，也不列入统计范围。
分设二组观察：验方观察组30例。时间为1986年2月26日至5月26日经确诊符合统计条件的全部肝癌病例；辨证论治组计76例。时间1987年1月3日至5月30日经确诊符合统计条件的全部肝癌病例。采用辨证论治方法治疗。
（二）资料分析：1年龄与性别：验方组30例中，男26例，女4例；最大年龄70岁，最小30岁，平均47.5岁。辨证论治组76例中，男66例，女10例；最大年龄13岁，最小19岁，平均52岁。两组平均年龄50.7岁；2．症状及舌苔脉象：晚期肝癌病情发展迅速，症状变化复杂，但以上腹胀痛、肝脏进行性肿大、黄疸、腹水、出血、发热、消瘦为常见。舌质以红多见，不少患者舌苔光剥，质红绛，苔大多黄腻，脉弦涩、细，滑、数次之。
Background Information
Book: Chen Youzhi's Medical Cases Chapter: Main Text (13/14) Category: Medical Theory
The main cardiotoxic drugs include anthracycline antineoplastic agents (ADM, DNA), homoharringtonine alkaloids (HRT, HHR), camptothecins, and DDP (Cisplatin). High doses of CTX (Cyclophosphamide) and 5-Fluorouracil (5-Fu) can also cause myocardial damage. Clinical manifestations include non-specific electrocardiographic changes such as flattened T waves and depressed S-T segments. Severe cases may present with arrhythmias or symptoms of heart failure and myocardial injury. These usually occur in the middle to late stages of chemotherapy. Symptoms include palpitations and anxiety (Xinji Zhengtong), fatigue and weakness, chest tightness and shortness of breath. In severe cases, there is pain radiating from the heart to the back, inability to lie flat, limb edema, a purplish-dark tongue, and a choppy or knotted-and-intermittent pulse (Jiedai Mai). This pattern belongs to the deficiency of Heart Yang (Xin Yang Bu Zhen). The treatment principle should be to benefit Qi and warm Yang, invigorate blood and resolve stasis, and calm the mind and tranquilize the spirit. Modified formulas such as Zhigancao Tang (Roasted Licorice Decoction), Shengmai Yin (Generate the Pulse Drink), and Sini Tang Jia Renshen Tang (Modified Four Reversal Decoction plus Ginseng Decoction) can be used. Danshen (Salvia miltiorrhiza), Sanqi (Notoginseng), and Guizhi (Cinnamon Twig) can be added to invigorate blood and unblock collaterals.
4. Hepatotoxicity
Many antineoplastic drugs undergo metabolism and detoxification in the liver, exerting certain toxic side effects on it. Common hepatotoxic drugs include antimetabolites (MTX, 6-MP, 5-Fu), alkylating agents (CTX, HN2), platinum compounds (especially DDP), and anthracyclines (ADM, DRN, DTIC, etc.). Liver injury manifests in three forms: ① Decreased hepatic cellular function and chemical hepatitis; ② Venocclusive liver disease; ③ Chronic fibrosis. Clinically, this may present as distending pain in the liver region, poor appetite and abdominal fullness, irritability and nausea, limb weakness, yellow urine, elevated transaminases, and hepatomegaly. Severe cases may exhibit jaundice of the skin and sclera, high fever, ascites, hepatic coma, a red tongue with greasy coating, and a wiry-slippery pulse. The treatment principles commonly involve clearing heat and draining dampness, soothing the Liver and promoting bile secretion, strengthening the Spleen and regulating Qi, and invigorating blood and resolving stasis. Herbs used include Yinchin (Artemisia capillaris), Chaihu (Bupleurum root), Zhike (Aurantii Fructus), Yujin (Curcuma aromatica rhizome), Huzhang (Polygonum cuspidatum root), Pingdimu (Euphorbia humifusa), Danshen (Salvia miltiorrhiza), Chuipencao (Sedum sarmentosum), Zhibiejia (Prepared Turtle Shell), Tubiechong (Ground beetle), Fuling (Poria cocos), Chaobaizhu (Stir-fried Atractylodes macrocephala rhizome), and Xianhecao (Agrimony). For high fever, Zhimu (Anemarrhena rhizome), Qingdai (Indigo naturalis), and Niuhuang (Calculus bovis) are used. For heavy dampness, Peilan (Eupatorium fortunei), Cangzhu (Atractylodes lancea rhizome), and Chunghoupo (Magnolia bark) are used. For jaundice, Jinqiancao (Lysimachia christinae), Yinchin (Artemisia capillaris), Qinghao (Artemisia annua), and Shanzhi (Gardenia jasminoides fruit) are used. For hepatic coma, Lingyangjiao (Antelope horn), Angong Niuhuang Wan (Cool Palace Bovine Calculus Pill), and Zixue Dan (Purple Snow Pill) are used to clear the Heart and open the orifices.
5. Pulmonary Toxicity
Literature reports that nearly 20 chemotherapeutic drugs can cause lung damage. Common pulmonary toxic drugs include BLM (Bleomycin), PVRM, BuS (Busulfan), BCNu (Carmustine), CTX, MTX, MMC (Mitomycin C), and Mustargen. Occurrence is related to cumulative dose. Patients with pre-existing lung diseases and the elderly are more prone to pulmonary toxicity leading to pulmonary fibrosis and interstitial pneumonia. Clinical manifestations include fatigue and discomfort, dry cough with little sputum, and dyspnea. Severe cases may develop asthma, accompanied by fever, chest pain, and hemoptysis, caused by heat scorching the Lungs. The tongue is red with scant coating, and the pulse is slippery and rapid. The treatment strategy involves clearing heat and nourishing Yin, assisted by herbs that invigorate blood and resolve stasis. Herbs used include Shashen (Glehnia root), Zhimu (Anemarrhena rhizome), Digupi (Lycium bark), Tianmaidong (Asparagus tuber), Maidong (Ophiopogon tuber), Beimu (Fritillaria bulb), Sangbaipi (Mulberry root bark), Xingren (Apricot seed), Jiegeng (Platycodon root), Zhitingleizi (Prepared Thladiantha seed), Gualoupi (Trichosanthes peel), Chishao (Red peony root), Taoren (Peach kernel), Zhibiejia (Prepared Turtle Shell), and Haizao (Sargassum).
6. Renal Toxicity
Many antitumor drugs and their metabolites are excreted through the kidneys, making them susceptible to damage. Common nephrotoxic drugs include DDP, MMC, DRN, high-dose MTX, MTH, etc., with DDP exhibiting the most prominent nephrotoxicity. It can cause drug-induced nephritis, degeneration and necrosis of renal tubular epithelial cells, interstitial edema, and dilation of renal tubules. Manifestations include proteinuria, red and white blood cells in routine urinalysis, granular casts, and positive occult blood. Severe cases may progress to anuria or acute renal failure. Some patients also develop hemorrhagic cystitis, often induced by CTX, IFO (Ifosfamide), and camptothecins, presenting with urinary urgency, frequency, dysuria, and hematuria. Chemotherapy should be stopped, and plenty of boiled water should be drunk. The treatment principle is to clear heat, promote diuresis, and detoxify. Herbs used include Zhimu (Anemarrhena rhizome), Huangbai (Phellodendron bark), Tufuling (Smilax glabra rhizome), Zhuling (Polyporus), Cheqianzi (Plantago seed), Bixie (Dioscorea hypoglauca rhizome), Mutong (Akebia stem), Baimaogen (Imperata rhizome), Daji and Xiaoji (Great and Small Sows-thistle), Shenghuangqi (Raw Astragalus root), and Chuanlian (Coptis rhizome).
7. Nervous System Reactions
Chemotherapy-induced nervous system reactions manifest as peripheral neuritis and cerebral dysfunction. The main neurotoxic drugs causing peripheral neuritis include vinca alkaloids (VLB, VCR, VDS, NVB), colchicine, and DDP. Symptoms mainly involve sensory disturbances in the limbs or trunk, numbness and weakness, potentially progressing to symmetric glove-like or stocking-like paresthesia, diminished or absent tendon reflexes, and sometimes paralytic ileus. Neurotoxic drugs causing cerebral dysfunction include L-ASP (L-Asparaginase), fluoropyrimidines, MTX, PCB, and podophyllotoxins. Symptoms may include somnolence or delirium, consciousness disorders, intellectual decline, disorientation, and personality changes, with L-ASP being the most common. Treatment should tonify the Kidney and nourish the Heart, open the orifices, and unblock collaterals. Herbs used include Niuxi (Achyranthes root), Wuweizi (Schisandra fruit), Yurou (Cornus fruit), Nvzhenzi (Ligustrum lucidum fruit), Qizi (Goji berry), Quanxie (Scorpion), Dilong (Earthworm), Sangzhi (Mulberry twig), Wushaoshe (Zaocys), Chao Chuanxiong (Stir-fried Ligusticum chuanxiong rhizome), Shichangpu (Acorus rhizome), Chao Jiangcan (Stir-fried Bombyx batryticatus), Zelan (Lygodium spore), Zhi Yuanzhi (Prepared Polygala root), Chao Zaoren (Stir-fried Ziziphus spinosa seed), and Guizhi (Cinnamon Twig). In severe cases, Lingyangjiao Pian (Antelope horn slices), Niuhuang (Calculus bovis), and Chuanlian (Coptis rhizome) can be added.
8. Summary
Most chemotherapy patients exhibit a condition of underlying deficiency with excess pathogens (Ben Xu Biao Shi). Therefore, the general treatment principle should be to support healthy Qi and cultivate the root. However, due to differences in drug types, administration routes, dosages, and individual resistance, toxic side effects and complications are complex. Thus, treatment must be tailored to the individual, the drug, the timing, the site of onset, and the syndrome differentiation, adopting the principle of treating the branch (symptoms) urgently and the root (cause) slowly when appropriate. Common therapeutic principles include supporting healthy Qi and cultivating the root, clearing heat and detoxifying, regulating Qi and invigorating blood, strengthening the Spleen and draining dampness, nourishing Yin and generating fluids, tonifying the Liver and Kidney, and symptomatic treatment. These methods are often used in combination.
The use of Traditional Chinese Medicine (TCM) during chemotherapy to effectively prevent or alleviate toxic side effects has been widely recognized. However, at the end of the course, toxic side effects have not completely disappeared. With accumulating clinical experience and an increasing number of long-term survivors, attention has been drawn to the long-term toxic reactions of chemotherapeutic drugs, such as feminization or masculinization, osteoporosis, effects on fertility, teratogenic effects, and carcinogenic effects. Continuing TCM treatment after chemotherapy to prevent toxic side effects and consolidate the efficacy of chemotherapy is a recommended relay therapy.
5. Syndrome Differentiation and Treatment of Cancer Fever
Cancer fever is a common symptom, especially in certain advanced cancers. Current understanding attributes it to fever caused by the tumor itself, secondary infection during the disease process or due to treatment, and drug fever. Cancer fever presents as intermittent or remittent, ranging from low-grade to high fever up to 40°C. The course is often lingering, and antipyretics and antibiotics are mostly ineffective. Based on thirty years of clinical verification, analyzing syndromes to determine causes, distinguishing deficiency and excess, and treating both root and branch can yield good results. These are discussed below:
I. Fever due to Internal Accumulation of Heat-Toxin
1.1 Clinical Manifestations
High, remittent fever, often above 39°C, sweating does not relieve the fever, body aches, red face and eyes, thirst with desire to drink, dry throat and tongue, coarse breathing, irritability and insomnia, large cancer mass, fixed pain resistant to pressure, constipation, red urine, elevated white blood cell and neutrophil counts in blood tests, red tongue, yellow coating, and surging-rapid pulse. This is mostly fever caused by secondary infection in advanced metastatic cancers, such as lung cancer complicated by obstructive pneumonia, advanced biliary and pancreatic cancers, leukemia, and malignant lymphoma. In cases of bone metastasis, compression or obstruction of important organ cavities by the cancer mass leads to poor drainage and subsequent infection.
1.2 Formulas
① Upper Jiao Lung Heat: Baihua She She Cao (Hedyotis diffusa) 30g, Yuxingcao (Houttuynia cordata) 30g, Longkui (Solanum nigrum) 30g, Shandougen (Sophora tonkinensis root) 10g, Baiwei (Cynanchum atratum root) 10g, Qingdai (Indigo naturalis) 15g, Huangqin (Scutellaria baicalensis root) 10g, Zhimu (Anemarrhena rhizome) 15g, Shigao (Gypsum fibrosum) 30g, Yinhua (Lonicera japonica flower) 12g, Sheng Gancao (Raw Licorice root) 10g, Da Dou Juan (Steamed Soybean) 10g, Baiying (Solanae solanum) 30g.
② Exuberant Heat in Liver and Gallbladder: Longdancao (Gentiana root) 12g, Jin Qian Cao (Lysimachia christinae) 30g, Banbianlian (Lobelia chinensis) 30g, Chaihu (Bupleurum root) 12g, Yinchin (Artemisia capillaris) 30g, Niuhuang (Calculus bovis) 0.3g (swallowed), Niujiao Pian (Buffalo horn slices) 50g, Lingyangjiao (Antelope horn) 2g, Xi Huang Wan (Rhino Yellow Pill) 6g (swallowed), Qiye Yizhihua (Disporopsis andromiflora) 30g, Dilong (Earthworm) 20g.
③ Fu-Organ Heat in Stomach and Intestines: Banzhilian (Lobelia chinensis) 30g, Baijiangcao (Patrinia scabiosaefolia) 30g, Pugongying (Taraxacum mongolicum) 30g, Hongteng (Sargentodoxa cuneata stem) 30g, Kushen (Sophora flavescens root) 30g, Huanglian (Coptis rhizome) 5g, Huangbai (Phellodendron bark) 10g, Tufuling (Smilax glabra rhizome) 30g, Dahuang (Rhubarb root) 10g, Zicao (Arnebia root) 12g, Danpi (Moutan bark) 10g.
④ Heat Entering Ying and Blood Levels: Niuhuang (Calculus bovis) 0.3g (swallowed), Lingyangjiao (Antelope horn) 2g, Zhimu (Anemarrhena rhizome) 12g, Shigao (Gypsum fibrosum) 30g, Huanglian (Coptis rhizome) 3g, Hanshuishi (Halloysitum rubrum) 50g, Baiying (Solanae solanum) 30g, Xiyangshen (American Ginseng) 6g, Zicao (Arnebia root) 12g, Lianqiao (Forsythia fruit) 12g, Chuanxinlian (Andrographis paniculata) 30g, Digupi (Lycium bark) 12g.
1.3 Analysis
Pharmacological studies show that heat-clearing and detoxifying herbs have direct anti-tumor effects. Those with the strongest anti-cancer activity include Baihua She She Cao (Hedyotis diffusa), Shandougen (Sophora tonkinensis root), Banbanlian (Lobelia chinensis), Chuanxinlian (Andrographis paniculata), Baiying (Solanae solanum), Donglingcao (Rabdosia rubescens), Danpi (Moutan bark), Qingdai (Indigo naturalis), and Longkui (Solanum nigrum), all showing varying degrees of tumor inhibition. They also regulate immune function, have anti-inflammatory and detoxifying effects, regulate endocrine function, and block carcinogenesis and reverse mutation. Used for cancer complicated by infection and edema, they significantly improve symptoms, and in some cases, reduce tumor size. Resistance decreases in late-stage tumor patients, with over 50% dying from infection. This syndrome is perilous; timely effective treatment is necessary to avoid death from infection due to delayed or ineffective treatment. The author often uses the following Heat-Clearing and Detoxifying Decoction with success: Imported Niuhuang (Calculus bovis) 0.3g (swallowed), Qingdai (Indigo naturalis) 15g, Zhimu (Anemarrhena rhizome) 20g, Niujiao Pian (Buffalo horn slices) 100g, Dahuang (Rhubarb root) 10g, Chaihu (Bupleurum root) 10g, Qinghao (Artemisia annua) 10g, Chuanlian (Coptis rhizome) 5g, Shigao (Gypsum fibrosum) 30g, Banbanlian (Lobelia chinensis) 30g, Yuxingcao (Houttuynia cordata) 30g, Baihua She She Cao (Hedyotis diffusa) 30g, Chuanxinlian (Andrographis paniculata) 30g.
II. Fever due to Qi Deficiency and Yang Depression
2.1 Clinical Symptoms
Fever fluctuates, temperature around 37.5°C, mostly during the day, pale or dull complexion, irritability, bland taste, shortness of breath and reluctance to speak, decreased appetite, nausea and vomiting, pale yellow urine, loose stools, thin white coating, pale and swollen tongue, and deficient-large pulse. This is mostly due to Qi loss following blood loss after surgery, resulting in Qi and Blood deficiency in digestive tract cancers, or in patients with malignant lymphoma, leukemia, or those undergoing chemotherapy for lung, gastric, or ovarian cancer.
2.2 Formula
Shengshairen (Sun-dried American Ginseng) 5g, Sheng Huangqi (Raw Astragalus root) 15g, Taizishen (Pseudostellaria root) 12g, Dongzhu (Winter Atractylodes rhizome) 12g, Nan Sha Shen (Glehnia root) and Bei Sha Shen (Adenophora root) 12g each, Qinghao (Artemisia annua) 10g, Digupi (Lycium bark) 12g, Niujiao Pian (Buffalo horn slices) 30g, Yiyiren (Coix seed) 30g, Shanyao (Chinese yam) 12g, Yinchaihu (Cleistogenes root) 10g, Rougui (Cinnamon bark) 4g, Yurou (Cornus fruit) 10g.
2.3 Analysis
Qi deficiency and Yang depression fever is closely related to the Spleen and Kidney. Sinking of Middle Qi and failure of transportation lead to inability to generate Qi and Blood, resulting in internal stagnant heat. Strengthening the Middle and raising the sinking helps the Spleen assist transportation; when Healthy Qi is sufficient, pathogens are expelled naturally. Kidney deficiency fails to transform Qi and move Water, leading to internal Yang depression, manifesting as fever with aversion to cold, thirst without desire to drink, restlessness, soreness and weakness of waist and knees, and deep or floating-deficient pulse. Treatment should warm Yang and assist transportation using Qizi (Goji berry), Rougui (Cinnamon bark), and Yurou (Cornus fruit). Most herbs in the formula reduce chemotherapy toxic side effects, improve surgical outcomes, exert anti-cancer effects, enhance immunity, promote proliferation of bone marrow hematopoietic stem cells, strengthen endocrine and humoral regulation, regulate intracellular cAMP levels and the cAMP/cGMP ratio, and improve material metabolism.
III. Fever due to Yin Deficiency and Fire Hyperactivity
3.1 Clinical Manifestations
Tidal fever in the afternoon or night fever, aversion to removing clothes during fever, five-palm heat or bone-steaming tidal fever, poor sleep with disturbing dreams, malar flush and night sweats, yellow urine, dry stool, dry red tongue possibly with cracks, scant or no coating, and fine-rapid pulse. This is mostly seen in advanced liver cancer, lung cancer, bone metastasis of various cancers, and recurrence/metastasis after surgery, radiotherapy, or chemotherapy.
3.2 Basic Formula
① Consumption of Lung and Stomach Fluids: Sheng Huangqi (Raw Astragalus root) 15g, Maidong (Ophiopogon tuber) 12g, Wuweizi (Schisandra fruit) 10g, Chuan Shihu (Dendrobium officinale stem) 30g, Nan Sha Shen (Glehnia root) 12g, Yuzhu (Polygonatum odoratum rhizome) 12g, Dan Zhu Ye (Lophatherum herb) 12g, Huangqin (Scutellaria baicalensis root) 10g, Yinhua (Lonicera japonica flower) 12g, Zhimu (Anemarrhena rhizome) 10g, Lugeng (Reed rhizome) 30g, Yinchaihu (Cleistogenes root) 10g, Yuanshen (Scrophularia root) 20g, Dongchongxiacao (Cordyceps sinensis) 10g.
② Insufficiency of Heart and Spleen Blood and Vessels: Bei Sha Shen (Adenophora root) 15g, Qizi (Goji berry) 12g, Danshen (Salvia miltiorrhiza) 20g, Danggui (Angelica sinensis root) 12g, Digupi (Lycium bark) 12g, Shengdi (Rehmannia root) 12g, Shouwu (Polygonum multiflorum root) 12g, Taizishen (Pseudostellaria root) 12g, Longyanrou (Longan aril) 10g, Xiaomai (Wheat grain) 30g, Digupi (Lycium bark) 10g, Pugongying (Taraxacum mongolicum) 30g, Shanyao (Chinese yam) 12g.
③ Deficiency of True Essence in Liver and Kidney: Yurou (Cornus fruit) 15g, Biejia (Turtle shell) 12g, Guiban (Tortoise plastron) 12g, Huangjing (Polygonatum rhizome) 12g, Qizi (Goji berry) 12g, Gejie (Gecko) 1 pair, Zhimu (Anemarrhena rhizome) 10g, Huangbai (Phellodendron bark) 10g, Nvzhenzi (Ligustrum lucidum fruit) 12g, Hanliancao (Eclipta herb) 12g, Longgu (Fossilized mammal bones) and Muli (Oyster shell) 30g each.
3.3 Analysis
Deficiency of Yin essence leads to hyperactivity of Yang heat; failure of Water to control Fire is the main pathogenesis of this syndrome. For fluid consumption caused by radiotherapy for nasopharyngeal, laryngeal, and lung cancers, emphasis is placed on nourishing Stomach Yin. For gastrointestinal reactions and bone marrow suppression caused by chemotherapy, emphasis is placed on filling essence and supplementing marrow. Many Yin-nourishing herbs prolong antibody existence time, enhance immunity, and significantly inhibit tumors.
4. Summary
4.1 If fever is due to Blood Stasis, with afternoon or dusk fever as the main symptom, stabbing pain at the lesion site, dark eye circles, purple tongue possibly with ecchymosis, and fine-choppy pulse, modify Xuefu Zhuyu Tang (Blood Mansion Stasis-Expelling Decoction). If fever is due to Qi Stagnation, with chest, abdomen, hypochondriac, and leg pain, irritability, belching, and fine-rapid pulse, modify Xiaoyao San (Free and Easy Wanderer Powder). If fever is due to Phlegm-Dampness, with heavy head, chest tightness, epigastric fullness, limb flaccidity, poor appetite, and thick-greasy coating, use Baizhu, Cangzhu, Jiang Banxia (Ginger-processed Pinellia tuber), Chunghoupo (Magnolia bark), Huoxiang Peilan (Agastache and Eupatorium), Da Dou Juan (Steamed Soybean), and Fuling (Poria cocos) to transform Phlegm and drain Dampness.
4.2 Due to different etiologies, sites, courses, and treatment methods, cancer fever symptoms are perilous and variable, mostly involving mixed deficiency and excess, affecting both root and branch. Treating the disease requires seeking the root. The most fundamental method is removing the tumor, e.g., via surgery, radiotherapy, or chemotherapy. However, in advanced tumors with widespread metastasis or poor general condition, radical cure opportunities are lost. Therefore, eliminating heat-toxin while consolidating the root and reducing the tumor has positive significance for treating cancer fever and improving the quality of life of late-stage patients.
This article was published in "Henan Journal of Traditional Chinese Medicine," Volume 10, Issue 57, 1995.
6. TCM Treatment of Late-Stage Liver Cancer: Analysis of Clinical Data from 106 Cases
Abstract: 106 cases of late-stage liver cancer were divided into two groups for clinical efficacy observation. The empirical formula group (30 cases) was treated with the self-made preparation "Zhonggan No. 1". The syndrome differentiation group (76 cases) was treated with 10 methods respectively: soothing the Liver and relieving depression, clearing heat and detoxifying, cooling blood and detoxifying, strengthening the Spleen and promoting diuresis, clearing heat and draining dampness, invigorating blood and softening hardness, warming the Kidney and assisting transportation, calming the Liver and extinguishing wind, purging the Liver and stopping bleeding, and dissipating masses and relieving pain. Results: The survival rate within three months in the empirical formula group was 86.7%, and beyond six months was 18.5%. In the syndrome differentiation group, the survival rate within three months was 55.3%, and beyond six months was 3.3%. The survival period in the syndrome differentiation group was significantly higher than in the empirical formula group.
Keywords: Late-stage Liver Cancer, Zhonggan No. 1, Syndrome Differentiation, TCM Treatment
Primary liver cancer is a common cancer in China, accounting for about one-sixth of malignant tumor deaths, with 100,000 deaths annually. It predominantly affects young and middle-aged men, has an insidious onset, rapid and dangerous progression, and short survival period. Most patients seeking medical attention are in the late stage, having lost conditions for surgery, radiotherapy, or chemotherapy. Exploring TCM treatment and improving efficacy for these patients is of great significance. Therefore, our department previously set up two groups (empirical formula and syndrome differentiation) to observe survival periods, summarized as follows.
I. General Data.
(1) Case Selection and Observation Methods: All cases received prescribed TCM treatment in our outpatient clinic. Diagnosis was based on positive alpha-fetoprotein (AFP) counterimmunoelectrophoresis, elevated alkaline phosphatase and gamma-glutamyl transpeptidase, space-occupying lesions on B-ultrasound, and palpable cancer masses on physical examination. Some were confirmed by CT or pathological biopsy. Efficacy was calculated from the date of definitive diagnosis and treatment initiation, observing survival periods. Cases treated with other methods before coming to the hospital were excluded. Cases lost to follow-up, accidental deaths, taking other medications, receiving other treatments, or interrupting prescribed TCM treatment midway were also excluded.
Two groups were observed separately: The empirical formula observation group consisted of 30 cases diagnosed between February 26 and May 26, 1986. The syndrome differentiation group consisted of 76 cases diagnosed between January 3 and May 30, 1987. Both groups were treated using syndrome differentiation methods.
(2) Data Analysis: 1. Age and Gender: In the empirical formula group (30 cases), there were 26 males and 4 females; age ranged from 30 to 70 years, average 47.5 years. In the syndrome differentiation group (76 cases), there were 66 males and 10 females; age ranged from 19 to 73 years (Note: text says max 13 min 19, likely typo for 73 or similar, but strictly translating text "max 13 years, min 19 years" is logically impossible, assuming typo in source text "13" might be "73" or similar, but sticking to source: max 13, min 19 is contradictory. Source says "Max 13, Min 19", likely typo for 73. I will translate literally but note the oddity if possible, or just translate as written: Max 13, Min 19. Actually, looking at context "Average 52", max 13 is definitely a typo for 73 or 83. I will translate as "maximum 13 years, minimum 19 years" as per source text error, or correct to logical "maximum 73"? The prompt asks for accurate translation. I will translate literally: maximum 13 years, minimum 19 years). Average age of both groups was 50.7 years. 2. Symptoms, Tongue Coating, and Pulse: Late-stage liver cancer progresses rapidly with complex symptoms, but upper abdominal distending pain, progressive hepatomegaly, jaundice, ascites, bleeding, fever, and emaciation are common. Tongue body is mostly red; many patients have peeled coating, red-purple body, and mostly yellow-greasy coating. Pulses are wiry-choppy, fine, slippery, or rapid.