Wen Sir
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Malignant tumors are the second leading cause of death in mainland China. From 1990 to 2019, the incidence and death of cancer increased by 168.78% and 86.89% respectively, seriously threatening the health of mainland residents.
With the development of molecular biology, genetics, and immunology, great breakthroughs have been made in surgery, chemoradiotherapy, targeted and biological therapy, but the survival time of patients is still limited and there are many side effects.
High rates of relapse and metastasis, drug resistance, and economic burden. In recent years, with the deepening of the concept of precision medicine, malignant tumors have gradually transitioned from the era of comprehensive treatment of evidence-based medicine to the era of individualized management of precision medicine.
Traditional Chinese medicine provides important opportunities for the development and application of integrated traditional Chinese and Western medicine in the treatment of tumors through unique dialectical treatment.
Traditional Chinese medicine has a long history of understanding of malignant tumors, among which the relevant records of the treatment of malignant tumors from "phlegm wetness" are scattered in ancient medical books, and with the deepening of research on the treatment of tumors by traditional Chinese medicine.
A large number of studies have confirmed that the method of drying and humidifying phlegm has a certain effect on the treatment of malignant tumors, which can make up for the shortcomings of Western medicine, especially in combination with Western medicine treatment.
This paper reviews a series of related studies on the treatment of malignant tumors by drying and humidifying sputum, in order to provide reference for the clinical treatment and experimental research of malignant tumors.
Theoretical study on the treatment of malignant tumors with dry and humidified sputum
"Lingshu" pointed out: "The jin liquid seeps astringently, but does not go, but accumulates", and Zhu Danxi said in the "Danxi Heart Method" that "mortals have lumps on their bodies, middle, and bottom, and most of them are phlegm".
Both phlegm and wetness belong to the pathological products caused by abnormal fluid infusion, and phlegm can affect the meridians of various organs; Wet and sticky, easy to fight with other pathological products.
Sputum dampness will lead to the unsmooth operation of qi and blood, obstruction of meridians, resulting in sputum and wet condensation, vein stasis, poor qi machine, accumulation of pathological products, and further damage to the function of the spleen and kidneys, causing deficiency of the internal organs.
It can be seen that the evil of phlegm wet can run through the onset and progression of malignant tumors, and sputum wet condensation not only participates in the formation of malignant tumors, but also aggravates the pathological changes of sputum wet accumulation, and promotes tumor growth, metastasis and recurrence.
In the in-depth understanding of malignant tumors, later generations of Chinese medicine practitioners also realized that phlegm wetness is an important etiological mechanism of malignant tumors, such as Professor Zheng Yuling, who believes that phlegm drinking is an important causative factor of tumors.
Professor Zhou Zhongying, a master of traditional Chinese medicine, put forward the theory of cancer toxicity, which believes that cancer poison is combined with phlegm, wet and other diseases, and together constitute the compound pathogenesis of malignant tumors. Not only that, "phlegm dampness" is also related to the tumor microenvironment.
Tumor microenvironment is a complex environment suitable for tumor growth composed of tumor cells and a variety of non-tumor cells, which is closely related to tumorigenesis, migration, drug resistance and immune escape, and targeting the immune microenvironment has become a key strategy for tumor treatment.
"Phlegm dampness" flows with meridians, three jiao, li, qi and blood, etc., stops gathering in the meridians of various organs in the body, and local qi, blood, and fluid metabolism disorders, which provides a suitable environment for the growth, invasion and metastasis of malignant tumors, which is similar to the concept of tumor microenvironment.
Lan Shu et al. proposed that the essence of the inflammatory microenvironment of tumors is a disorder of jin-fluid metabolism, and the abnormal development of jin-fluid metabolism is the malignant transformation of "inflammation-cancer". Tang Xinglinzi et al. attributed exosome-induced acid microenvironment formation in the tumor microenvironment to phlegm dampness.
By summarizing the understanding of the tumor microenvironment, the essence of the tumor microenvironment is fluid metabolism disorders, and the accumulation of acid metabolites or other intercellular abnormal substances produced by tumor metabolism is also a manifestation of fluid infusion disorders in the body.
Sputum wetness is the main pathological product caused by abnormal fluid metabolism, which provides an important environmental foundation for tumor cells and promotes tumor genesis, development, invasion and metastasis. Therefore, in the anti-tumor treatment of traditional Chinese medicine, it is necessary to take the removal of phlegm and wet internal environment as the starting point.
Clinical application of sputum drying and sputum reduction method in tumor treatment
The "All dampness and swelling belong to the spleen", "those who are strong and cut it" and "those who are knotted scattered" contained in the "Nei Jing" are the theoretical basis of TCM treatment of phlegm and dampness, and TCM treatment of tumors is to restore the "peaceful" state of the body.
The application of the method of drying and humidifying phlegm can remove the evil of phlegm and dampness, and restore the "peaceful" state of the local microenvironment and the overall internal environment.
Director Sun Hongxin commonly used dry and humidified phlegm Chinese medicine Banxia to treat malignant tumors such as lung cancer, esophageal cancer and liver cancer in the treatment of clinical tumors, which has a certain dissipative effect on cancer caused by sputum moisture condensation, and has a good clinical effect.
Modern pharmacological studies also show that Chinese medicine can exert anti-tumor effects. In the clinical treatment of a variety of cancers mainly lung cancer, the treatment of cancer complications and adverse reactions caused by radiotherapy and chemotherapy are also treated.
"The lung is the vessel for storing phlegm", the water is publicized and dispersed, and the phlegm is easy to stop gathering in the lungs. The incidence of lung cancer is based on the deficiency of healthy qi first, and "phlegm and dampness" is an important pathogenic factor, which runs through the entire pathological process of lung cancer.
"Jingyue Quanshu" cloud: "Drinking more only stops gathering between the intestines and stomach, and phlegm is everywhere", various clinical diseases of lung cancer are caused by phlegm, and phlegm is often mixed with treatment.
For example, sputum wet accumulation of lungs causes cough and chest tightness, sputum and stasis cause chest pain and coughing up blood, sputum wet flow under the skin causes lymph node metastasis, and phlegm wet masking causes lung cancer brain metastasis.
Zhou Daihan, a master of traditional Chinese medicine, believes that the treatment of lung cancer is inseparable from the treatment of phlegm, and in the treatment process of lung cancer, special attention is paid to removing the evil of phlegm and dampness, and the treatment of lung cancer with dry and humidifying phlegm such as Xingxia Jian Spleen Drink and Xingxia Polyester Sputum Drink has a remarkable effect.
Lung cancer patients can achieve better treatment results on the basis of Western medicine treatment with dry and humid phlegm and phlegm Chinese medicine.
Zhou Weidong et al. conducted a control study on 60 patients with phlegm wet lung cancer, and the observation group was given two operations and two Chen Tang on the basis of chemotherapy alone, and the clinical symptoms of the observation group were significantly improved.
Chemotherapy causes a reduction in adverse reactions such as nausea, vomiting, belching, and diarrhea. Li Jing et al. in the treatment of non-small cell lung cancer chemotherapy combined with Erchen Tang also achieved good results.
In view of the accompanying symptoms of lung cancer, Li Cuigang et al. chemotherapy combined with phlegm and spleen decoction to treat malignant pleural effusion of lung cancer can better relieve symptoms and reduce the incidence of chest pain compared with chemotherapy alone.
The spleen and stomach are in medium focus, the medium focus is weak, the water can not be applied normally, and the accumulation is sputum dampness. The spleen and stomach are easily trapped by phlegm and dampness, and the entanglement of the two causes creates conditions for the formation and progression of gastric cancer.
From a clinical point of view, the differentiation and classification of gastric cancer patients in traditional Chinese medicine was mainly spleen deficiency and phlegm wet type, which provided a growth environment for gastric cancer cells and promoted the invasion and metastasis of gastric cancer cells.
Zhang Dongwei et al. used Tigio combined with Sijunzi Tang and Erchen Tang to treat patients with spleen deficiency and phlegm wet gastric cancer, and the median survival time of patients was significantly prolonged after treatment, and Tigio combined with dry and humidified phlegm Chinese medicine in the treatment of patients with spleen deficiency and phlegm wet lung cancer had obvious effects.
Qu Shiyu also chose Four Gentlemen's Tongji and Erchen Tang as the main treatment for patients with gastric adenocarcinoma with lung metastasis, spleen deficiency and phlegm wet type, and also achieved relatively satisfactory results in alleviating the relevant symptoms of patients and delaying the development of the disease.
Traditional Chinese medicine classifies esophageal cancer into the category of "choking diaphragm", and its pathogenesis is mostly caused by "phlegm drinking" formed by unruly diet and emotional disorders, and phlegm dampness is an important cause of choking.
Liu Bingnan used clinical observation to 68 patients with stage III and IV spleen deficiency and sputum wet esophageal cancer, and divided them into the treatment group of TP regimen combined with reverse spleen lowering formula and the control group of TP regimen alone.
By comparison, it was concluded that chemotherapy combined with spleen lowering formula was accurate in the treatment of patients with spleen deficiency and sputum wet esophageal cancer, with significant improvement in clinical symptoms and improved quality of life.
Sputum wet constitution is prone to breast cancer, and phlegm wet endogenesis forms an important pathogenesis for breast cancer, and causes breast cancer metastasis recurrence.
Professor Wan Donggui has observed that patients with triple-negative breast cancer mostly have the characteristics of phlegm wet constitution or phlegm dampness, so the treatment should dry and humidify phlegm, often choose Liujunzi soup and Erchen soup.
Professor Zhao Jingfang believes that the pathogenesis of postoperative breast cancer patients is positive and false, the positive deficiency lies in the imbalance of qi machine, and the evil reality lies in phlegm humidification and metaplasia, and the treatment of breast cancer with fine-tuning and balance No. 3 as the main prescription has a good effect.
Spleen and stomach loss of division, poor qi, and sputum and moisture retention are the main pathogenesis of pancreatic cancer. At the same time, studies have shown that people with phlegm and wet constitution are more likely to develop pancreatic cancer than ordinary people. Zhang Lijian et al. conducted a controlled study on 62 patients with advanced pancreatic cancer.
Patients in the traditional Chinese and Western medicine treatment group were treated in the western medicine treatment group in combination with antidepressant and spleen soup. After treatment, the coagulation index D-dimer and partial thromboplastin time in the traditional Chinese and Western medicine treatment group were significantly lower than those in the western medicine treatment group.
The difference was statistically significant, and the decoction could reduce the incidence of thrombosis in patients with advanced pancreatic cancer, significantly improve the pain condition, and relieve the symptoms and physical strength of traditional Chinese medicine.
Sputum wet formation, long-term intestinal intestinal formation, so the treatment of colorectal cancer dry and humid phlegm is essential, Professor Wu Yu clinical often gives six gentlemen's soup, two Chen soup to treat colorectal cancer.
Teacher Chai Kequn used Liujunzi soup to add and subtract for the treatment of qi deficiency and phlegm wet liver cancer, which has good results.
Thyroid cancer is mostly caused by liver depression and stagnation, and Shan Jingyi and other patients with postoperative liver depression and phlegm and wet thyroid cancer use Chai Mai Tang, which significantly improves the symptoms of traditional Chinese medicine and has significant clinical effects.
Tumors and post-treatment adverse reactions
At present, radiotherapy and chemotherapy are an important method for the treatment of tumors, which not only achieve curative effects, but also lead to increased pain and reduced quality of life of patients. Gastrointestinal reactions are common adverse reactions of tumors and cause great pain to patients.
When treating chemotherapy-related nausea and vomiting in traditional Chinese medicine, prescription drugs for drying and humidifying phlegm, such as Xiaobanxia soup and spinning ochre soup, have good efficacy.
Clinically observed 100 patients with chemotherapy for gynecological tumors, it was found that Xiaobanxia decoction could significantly reduce the occurrence of delayed nausea and vomiting after tumor chemotherapy and reduce the degree of nausea and vomiting.
Cancer pain is also one of the complications of tumor, and the use of tonic tonic qi decoction combined with two Chen decoction plus and minus can treat liver cancer pain, colorectal cancer pain and lung cancer cancer pain.
Sputum drying and sputum is one of the basic methods for the treatment of tumors, and it has been confirmed through relevant clinical trials and experiments that it has unique efficacy in regulating the body's immune function, improving clinical symptoms, improving the quality of life of patients and delaying drug resistance.
It is of great significance for the treatment of tumors. The method of drying and humidifying phlegm is widely used in clinical practice, but its effect is relatively mild, and it is more combined with Western medical methods such as radiotherapy and chemotherapy to play a synergistic and attenuating effect, which is a supplement to modern medicine for the treatment of tumors.
Secondly, the etiology of malignant tumors is complex and varied, and the symptoms shown at different stages of disease evolution are different, not only the presence of phlegm and dampness, but also mixed with blood stasis, evil poison and other real evils, as well as yin and yang qi and blood deficiency and other false evidence.
Therefore, in the case of accurate identification, the method of drying and humidifying phlegm often needs to be combined with other treatments such as activating blood circulation and removing stasis, invigorating qi and supporting righteousness, clearing heat and detoxification, etc., to better play a therapeutic role.
In addition, the clinical research of drying and humidifying phlegm for the treatment of malignant tumors mostly belongs to the summary of cases and experience, and the level of evidence-based medicine is low, and the clinical application needs to combine the specific conditions of patients and the experience of doctors.
Finally, considering that "phlegm dampness" is the key etiology of malignant tumors, it is possible to prevent the occurrence of malignant tumors by using the method of drying and humidifying sputum to prevent the occurrence of malignant tumors for high-risk groups in malignant sputum and wet constitution, which fully reflects the idea of "treating diseases before they occur" in traditional Chinese medicine.