▲Zhou Zhongying, Master of Traditional Chinese Medicine (1928-)
Zhou Zhongying, a master of traditional Chinese medicine, is a well-known Chinese medicine scientist in mainland China, who has been practicing for more than 60 years, and is good at the clinical diagnosis and treatment of difficult and miscellaneous diseases, especially the diagnosis and treatment of malignant tumors in various systems.
Zhou Zhongying believes that liver qi stagnation is the key to the occurrence and development of breast cancer. It is located in the breast, which is closely related to the liver and kidney, involving the spleen, stomach and gallbladder. The main pathological factors are phlegm, stasis and dampness, which are intertwined with cancer and toxin, and the course of the disease is long, the disease is recurrent, the syndrome is complex, and the overall pathogenesis is characterized by the coexistence of internal deficiency and toxic accumulation. According to the main and secondary conditions of various pathological factors, the treatment should be based on soothing the liver and relieving depression, invigorating blood circulation and removing stasis, softening and dissipating knots, clearing away heat and detoxification, and diluting dampness and phlegm.
Etiology and pathogenesis
Phlegm, stasis and poison are the main pathogenic factors
The pathological factors of breast cancer include phlegm, stasis, and toxicity. Emotional failure leads to liver loss and discharge, poor qi and qi organs, liver qi and stomach, acquired luck and dereliction of duty, endogenous stubborn phlegm, blocking the meridians, and causing cancerous tumors; phlegm drinking is endogenous, hindering qi and organs, and can aggravate qi congestion and turn into diseases. Qi stagnation, qi deficiency, cold condensation, and heat condensation can all lead to poor blood flow and stagnation and condensation, or blood accumulation from menstruation, blood stasis and obstruction, and stagnation in the breast. Zhou Zhongying believes that cancer toxicity is the key pathogenesis leading to the occurrence and development of malignant tumors, but it is not caused by a single pathogenesis, and is mostly caused by a compound pathogenesis with other pathologies, often intertwined with pathological factors such as phlegm, stasis, and dampness.
The disease is located in the breast, which is closely related to the liver and kidneys, involving the spleen, stomach, and gall bladder
The meridian theory of traditional Chinese medicine believes that the nipple belongs to the foot syncope yin and liver meridians, the breasts belong to the foot yang and stomach meridians, and the outside belongs to the foot and yang gallbladder meridians. The liver is closely related to the breast, and the stagnation of liver qi leads to liver loss and discharge, which affects the rise and fall of qi, and is easy to form qi stagnation, which cannot promote the flow of water and yin blood, so that blood stasis and phlegm coagulate; at the same time, it has a close relationship with Chong Ren's dysfunction, and Chong Ren's disorder is related to Chong Ren's dysfunction, which is due to liver and kidney insufficiency, qi deficiency and blood weakness, abnormal qi and blood operation, or even qi stagnation and blood stasis, and for a long time, phlegm will accumulate and poison, and each other will beat each other in the breast to form a cancerous tumor; if Chong Ren's two pulses are empty, the spleen and stomach will be damaged, the phlegm will be turbid and endogenous, and the qi stagnation and phlegm will coagulate, and it will accumulate in the breast and become cancerous over time.
The course of the disease is long, and the pathogenesis is characterized by the coexistence of evil and reality, good and false
Breast cancer has a long course of disease, and the overall pathogenesis is characterized by the coexistence of internal deficiency and toxic aggregation, but in the process of prolongation, it is more common to mix virtual and real, and the disease is repeated and the syndrome is complex. In the early days, it was mainly evil, including external and internal causes, the internal causes were due to poor emotional will, phlegm and stasis, and the stagnation of qi and blood, and the external causes included the external senses and the six lewdness, evil poison and internal invasion. In the middle stage, the pathogenesis develops into the fact that the real evil has not been dispelled, the righteous qi has been deficient, and the evil poison is unable to drive the evil poison out, the evil poison is accumulated in the body, and the phlegm, stasis, and poison are cemented in the mammary network. In the late stage, it can be seen that the five organs are deficient in yin and yang, the righteous qi is lacking, the cancer toxin grows and spreads rapidly, and the pathogenesis is mainly positive and deficiency, but the breast still has phlegm and stasis and cancer toxin intermingle or other viscera has cancer toxin invasion, so it can be seen that the whole is deficient and the part is true.
Pathogenesis evolution
The initial pathogenesis of breast cancer is mainly liver qi stagnation and internal invasion of cancer toxins, and long-term illness can cause spleen and stomach deficiency, chong ren disorder, qi and blood weakness, liver and kidney insufficiency, etc.; if the course of the disease is long, or after surgical blood loss, radiotherapy and chemotherapy and other heat poisons, drug poison and other injuries, then qi and yin deficiency, spleen and kidney deficiency will appear; advanced patients, multiple organs are invaded, cancer poison is scurry, water poison stasis of the brain, damp poison accumulation of liver, cancer poison attack on the lungs, drinking stop chest and flank, cancer tumor invasion of bone marrow and other changes, at this time, the pathogenesis is mostly qi, blood, yin and yang five organs are deficient, Qi and blood are depleted, phlegm, stasis and cancer poison are deep in the viscera and hidden bone marrow and blood vessels, and the disease is irreversible. In addition, after breast cancer surgery, there will also be corresponding pathogenesis changes, such as skin flap necrosis, skin ulcers, edema of the upper limbs, numbness of the knuckles of the arm, etc., which are local qi and blood stagnation and meridian damage.
Key points of dialectic
Identify pathological factors
Depressed
Breast cancer is more common in women, which is closely related to liver qi stagnation caused by emotional imbalance. As Zhu Danxi said: "Qi and blood are harmonious, all diseases are not born, and once there is depression, all diseases are born", so qi, blood, phlegm, dampness, heat, and food are the first among the six depressions. The formation of breast cancer begins with the invisible qi, and then becomes the tangible quality, when the viscera qi is reversed, depressed but not extended, it is easy to appear that the qi is not covered and the phlegm is coagulation, and the qi and blood are blocked to form stasis, and a variety of pathological factors such as wind, cold, heat, dampness, etc., and the poison and evil are mutually depressed and cause disease.
Phlegm poison
The incidence of breast cancer is related to factors such as liver and kidney insufficiency and impulse disorder. The liver and kidney are homologous, the liver is lost and the kidney is lost and gasified, and the condensate is gathered into phlegm, coupled with poor qi depression, meridian congestion, and phlegm and toxicity are stagnant. In addition, the poisonous evil retains the mammary meridians, hindering the operation of the meridian qi, and if the fluid cannot be infused normally, it will remain as phlegm, and the poisonous evil and the phlegm will form "phlegm poison", forming a lump, which is soft or hard, or hard as a rock, and cannot be moved.
Stasis
Liver Qi stagnation, Qi is not smooth, Qi stagnation leads to blood stasis, liver stagnation turns into fire, consumes yin fluid, Yin blood condenses and becomes stasis, Kidney Qi deficiency leads to blood vascularity, kidney yang deficiency leads to blood loss of warmth, kidney yin deficiency generates internal heat and burns Yin blood, blood stasis can occur. Blood stasis and coagulation, fighting with poison and evil, and stasis and poison are blocked in the mammary and become lumps.
Hot poison
The patient's mood is not smooth, and he becomes depressed for a long time and turns into heat and fire, or he is infected with the evil of fiery fire and enters the blood, causing heat poison. Blood and heat are knotted, qi and blood run abnormally, and qi, blood, phlegm, turbidity, heat, and poison obstruct the mammary network, which accumulates over time and becomes a cancerous tumor. As breast cancer lasts for a long time, it can be seen that the heat and poison are abundant, and the skin and flesh can be seen in the milk, the skin and flesh are purple and black, the tumor nucleus is hard, or the ulceration and oozing smelly blood and water can be seen.
Cancerous toxins
Qi stagnation, blood stasis, phlegm coagulation, dampness accumulation, heat toxicity and many other pathological factors affect and interact with each other. Breast cancer is caused by phlegm and stagnation, which obstructs the mammary network, and over time, it becomes cancerous.
Identify the location of the viscera
The disease is located in the breast and is mainly related to the liver
Women are born with the liver, if they are depressed and hurt the liver, the liver qi is stagnant, the liver qi is abnormal, the liver is abnormal or the liver blood is insufficient, the body loses nourishment, and the qi and blood flow is not smooth, which can lead to qi and blood stagnation, obstruction in the mammary network, and breast cancer.
Involves the spleen and kidneys
The spleen and stomach are the foundation of the day after tomorrow and the source of qi and blood. Cold diet, damage to the spleen and yang, loss of transport, water and jin do not spread, stay in the body, condense into phlegm or chongren disorder over time, resulting in weakness of the spleen and stomach, abnormal flow of qi and blood, phlegm, dampness, qi and blood are intertwined in the mammary network, so it is seen to be accumulated.
Modern medical research has also shown that the prognosis of breast cancer is significantly correlated with the menstrual status of women, and the treatment methods and drugs before and after menopause are different. Therefore, the imbalance of yin and yang in the kidney, and the dysfunction of gasification can easily lead to the lack of essence and blood biochemistry, and the imbalance of Tianqi secretion, and the dystrophy of Chongren, thus causing breast disease. Deficiency of kidney yang or deficiency of kidney yin can lead to the accumulation of phlegm and turbidity, forming in the mammary network, and turning into cancer.
Breast cancer can also have symptoms such as water poisoning and stasis of the brain, dampness and poison accumulation of the liver, cancer poison attack on the lungs, chest and flank drinking, and cancer tumor invasion of bone marrow, such as syncope syndrome, headache, vomiting, jaundice, hypochondria pain, cough, lung distention, hemoptysis, phlegm drinking, chest pain, low back pain and other symptoms.
Pay attention to staging and virtual reality
Evil and good and false have different emphases in the different stages of the occurrence and development of breast cancer
During the onset of breast cancer, the positive qi will change differently due to the evolution of the disease. In the early stage, the righteousness is sufficient, and due to the external sense of the six lewdness and the internal invasion of evil poison, the pathogenesis is mainly evil and the truth; the evil of cancer poison gradually consumes the righteous qi, and it can be seen that the evil reality and the positive deficiency coexist; in the advanced stage, the cancer poison metastasizes to other organs, and the positive deficiency is the main cause (if it is transferred to the lungs, it can be seen that the lung qi deficiency and lung yin deficiency; if it metastasizes to the bones, the liver and kidney are deficient).
Evil and positive and false change accordingly due to the different treatment methods for breast cancer
In general, the disease stage of breast cancer is always characterized by the coexistence of evil and good, and the cohesion of cancer toxin runs through the whole pathogenesis stage. However, the treatment methods of modern medicine have different effects on the body's righteousness. During chemotherapy, due to the adverse reactions of drugs, patients suffer from nausea and vomiting, loss of appetite, and evidence of spleen and stomach weakness, spleen and kidney deficiency; radiotherapy is a heat evil, which is easy to consume yin fluid, resulting in lung yin deficiency and lung qi deficiency; targeted drug trastuzumab has certain cardiotoxicity, which often injures heart yang, resulting in heart qi deficiency and heart yang deficiency; the mechanism of endocrine therapy is mainly antagonistic estrogen, and patients often have symptoms similar to pre- and postmenopausal syndrome, which are manifested as kidney qi deficiency, Symptoms such as renal yin insufficiency and chong ren disorder.
Treatment and medication
Evil runs through the whole process, and the treatment should be based on dispelling evil
Breast cancer is based on liver stagnation and qi stagnation and cancer toxin cohesion, and the treatment should focus on soothing the liver and regulating qi, detoxifying and dissolving stasis and dispersing knots, and the treatment process should also be used to protect healthy qi. Therefore, the basic treatment principle for the treatment of breast cancer should be "dispelling evil spirits and supplementing correction".
The occurrence of breast cancer is related to liver stagnation and qi stagnation, qi and blood stasis, and patients have long-term symptoms such as swelling, pain, belching, depression, irritability and irritability before the onset of the disease. Once cancer is formed, the stagnation of qi is heavier, and pathological products such as phlegm and stasis continue to accumulate, and are combined with other evils such as cancer poison, heat poison, and damp poison.
After breast cancer treatment, the lump may shrink or disappear, and the lesion may even be surgically removed to achieve clinical cure. However, the emotional factors of cancer patients have a great impact on the development of the disease, and long-term emotional anxiety and depression are often prone to recurrence or metastasis. If the patient's visceral qi and blood function has not returned to normal, pathological products such as cancer toxins and phlegm stasis are easy to remain in the body or re-breed, so qi and blood stagnation is an important pathological state for cancer recurrence, which should be adjusted in time, and the method of regulating qi and activating blood should be used during the treatment process.
Cancer poison is the most poisonous evil, the toxicity is deep, its nature is wandering, it is easy to consume and hurt the righteousness, resulting in the deficiency of righteousness. If we blindly correct and stubbornly do not attack, the cancer poison will take advantage of the void, the city will be difficult to defend, the cancer poison will continue to be consumed, the deficiency will continue to worsen, the power of inhibition and internal stability will decline, the cancer poison will spread, and eventually the multiple organs will metastasize, and the viscera will fail. The most empty place is the place where the evil is located, so the treatment should be based on exorcising the evil spirit, supplemented by the righteousness, so that the evil can go away and be at ease, and at the same time, the place of refuge is stable. Of course, medicine is also selected to drive away evil spirits and do not harm the good.
For example, heat-clearing and detoxification drugs: white flower snake tongue grass, half-branch lotus, meritorious leaves, leaky reeds, Iwami wearing, dandelion, Poria cocos, mountain bean root, Chonglou, swollen wind, etc.; soft and hard scattered knot drugs: mountain mushroom, turtle insect, pangolin, turtle beetle, sea clam shell, raw oyster, etc.; phlegm detoxification drugs: Nanxing, Prunella vulgaris, scorched silkworm, mulberry white bark, coria seed, white mustard seed, Fabanxia, seaweed, kelp, etc.; Sometimes, for patients with sufficient righteousness and strong cancer poison, it can be used to attack poison products, such as whole scorpions, centipedes, toads, beehives, strychnine, yew and other insect drugs or toxic drugs, so as to search for and dispel evil and detoxify.
For patients with advanced breast cancer who have metastasized to multiple organs, the function of the viscera has declined significantly, and the yin and yang are seriously imbalanced. For example, if the cancer tumor of breast cancer bone metastasis invades the bone marrow and suffers pain, it should be supplemented with nourishing the liver and kidneys, filling the essence and strengthening the bones, and invigorating blood to relieve pain; if the lung metastasis causes cancer to attack the lungs or the chest and flank is stopped, according to the syndrome, the methods of cultivating soil and generating gold, nourishing yin and clearing the lungs, cultivating soil to make water, and diarrhoea and water are added as appropriate; patients with liver metastasis are manifested as damp toxin accumulation in the liver, due to stasis and internal knots, it can be seen that the body and eyes are yellow, the flank pain, abdominal distention, and poor appetite need to be applied. Drowsy, convulsions and even coma, mostly due to stasis and internal resistance, poison into the peak, the condition is critical, and heavy drugs are needed, often added to dispel wind and phlegm, relieve spasmodic, and open the body and awaken the mind.
Use toxic drugs in moderation to fight poison with poison
Zhou Zhongying believes that one of the main pathogenesis of breast cancer is the cohesion of cancer toxin, and put forward the tumor treatment concept that detoxification is to help the right, and if the evil is not removed, the right will be injured. The main toxic drugs include whole scorpions, centipedes, toads, beehives, strychnine, yew, etc. Among them, strychnine has the function of channeling and relieving pain, dispersing knots and reducing swelling. Clinically, strychnine powder is used, 0.3g each time, in capsules, 2 times a day.
However, it is necessary to observe whether the patient has numbness of the tongue, difficulty swallowing, and involuntary twitching of facial muscles to prevent poisoning. In addition, yew is often used in the treatment of breast cancer, paclitaxel is the main chemotherapy drug for the treatment of breast cancer in the clinical application of modern medicine, and paclitaxel is a secondary metabolite of yew. The usual dose of yew is 10~20g, into the decoction, for digestion, respiratory system and heart have a certain toxicity, need to be cautious when taking medicine, once the patient has nausea and vomiting, dyspnea, chest tightness and palpitation, etc., stop the drug in time.
Use animal drugs to dissolve stasis and disperse knots
For breast cancer, removing stasis and phlegm, and dissolving softening and firmness are one of the commonly used and very critical treatments. Zhou Zhongying believes that for stubborn diseases, long-term diseases, difficult syndromes, and serious diseases, because of their deep disease, it is difficult for general plant drugs to be effective, while insect drugs are yin and yang, which have the functions of breaking blood and activating blood, dissolving phlegm and dispersing knots, detoxifying and relieving pain, and it is easy to improve the efficacy if appropriately selected.
For example, the use of scorched turtle beetle, turtle insect, shell pangolin, raw oyster, sea clam shell and other insect drugs or shellfish drugs, soft and hard to disperse knots, the use of whole scorpion, centipede, beehive, earth dragon, zombie silkworm and other stasis and phlegm. However, clinical attention should be paid to the examination of the syndrome and the identification mechanism, and the compatibility between other drugs and animal drugs. According to the severity of the disease, the appropriate selection, at the beginning of the disease is still good, you can choose to use the medicine of the good, the long-term illness of the righteous qi deficiency, or the weak constitution of the elderly, young children, should be equipped with products to nourish qi and blood, or change to pills and other dosage forms in order to slow down the attack.
For the special location of breast cancer, use heat-clearing and detoxification, and qitongli drugs
The mammary gland is a part of the liver meridian, and the onset of the disease is related to emotion, so the use of some drugs to clear heat and detoxify, and promote qi and Tongli often has a good curative effect. Such as leaky reed, contained in the "Shennong Materia Medica", said: "Leaky reed taste bitter, salty and cold." Heat, malignant wounds, hemorrhoids, and lower milk ...... A wild blue, born valley. It is often used to treat cradle carbuncle swelling and pain, carbuncle back, scrofula poison, milk blockage, heat poison and blood dysentery, hemorrhoids and bleeding. For breast cancer caused by heat and toxin, the treatment effect is better.
Typical medical cases
The patient is a 47-year-old female. First visit on March 15, 2012. In September 2011, it was found that the right breast mass gradually grew, and on November 25, 2011, he underwent radical resection of right breast cancer, and the postoperative pathology was: right breast invasive ductal carcinoma grade III., axillary lymph nodes (2/16), estrogen receptor (ER) (2+), progesterone receptor (PR) (-), Her-2 (2+), Ki-67 (30%). After the operation, 6 courses of chemotherapy were performed (the description of the chemotherapy regimen was unclear), and the chemotherapy had been completed by the time of consultation, and there were no obvious adverse reactions of chemotherapy. On March 9, 2012, CT results of chest and abdomen: multiple hypodense foci in the liver, metastasis was considered, and both kidney stones were formed. Destruction of the 10th thoracic vertebrae, metastasis is considered. At present, I feel chest pain, pain in my right shoulder and arm, multiple bulges can be seen on both sides of the neck and collarbone, swelling and shape, and dry stools. The moss is pale yellow and greasy, dark in texture, and the veins are small and smooth.
Diagnosis: (Qi stagnation and blood stasis, phlegm and poison mutual junction type) milk rock (Western medicine called right breast invasive ductal carcinoma stage IV).
Prescription: Vinegar Bupleurum 6g, Red Peony 10g, Xiangfu 10g, Prunella vulgaris 15g, Spiral Mulch Flower (Bao Tang) 5g, Turmeric 10g, Madder Root 10g, Corn Herb 3g, Lycium Plum 10g, Silkworm 10g, Lacquer 20g, Whole Melon 20g, Nanxing 12g, Lulutong 10g, Burnt Scorpion 5g, Nansha Ginseng 12g, Northern Sand Radix 12g, Tiandong 10g, Ophiopogon 10g, Prince's Radix 12g, Turtle Insect 5g. 21 doses, decoction in water, 1 dose per day, divided into morning and evening after meals.
Second diagnosis on April 5: the patient complained of reduced chest tightness, pain in the left hypochondrium, back pain, pain in the operation of the right breast, swelling and bulging on the two clavicles, but the hand was not hard to touch, consciously related to a large dose of dexamethasone, fatigue and weakness, stool once a day is not loose, and the diet is good. Moss is light yellow and greasy, dark and smooth. The original medicinal recipe is added with 5g of nine spice worms, 10g of curcuma, 20g of white flower snake tongue grass, 20g of half branch lotus, 15g of leaky reed, 21 doses, decoction method is the same as before.
On April 26, the third diagnosis: complained that the pain in the left hypochondrium has been basically relieved recently, the pain in the right hypochondrium is also mild, the two fingers have a feeling of swelling, the right little finger and ring finger are numb, the right armpit is uncomfortable, and the fatigue is not tolerated. The moss is yellow and greasy, dark and has thin veins. The original medicinal prescription was followed by 21 doses, and the decoction method was the same as before.
Fourth diagnosis on May 24: complaining of shortness of breath, pain in the right supraclavicular flank during inhalation, limited lifting of the left shoulder and arm, yellow and greasy, dark purple, and smooth pulse. Add 10g of fried suzi in front, 12g of boiled mulberry white skin, 15g of fried Yanhusuo, 21 doses, and the decoction method is the same as before.
On June 21, the fifth diagnosis: the heart was swollen and painful, the hand touch was faintly tangible, the right hypochondrium pain was better than before, and the food was acceptable. The moss is light yellow and greasy, and the veins are dark and smooth. Go to the white flower snake tongue herb, half branch lotus, leaky reed, 21 doses, decoction in water, 1 dose a day, take it after breakfast and dinner.
After continuing to take traditional Chinese medicine, his condition was stable after 1 year of follow-up.
Note: At the initial diagnosis, the patient could see multiple bulges on the neck and clavicle, swelling and shape, CT showed liver and bone metastasis, and the pathogenesis was liver loss and leakage, phlegm, stasis and poison. Therefore, vinegar bupleurum, incense attached, swirling flowers, road and road to dredge the liver and regulate qi, prunella vulgaris, zombie silkworm, whole melon, southern star, turtle insect, whole scorpion phlegm and detoxification, red peony, turmeric, madder root, incense, wolfberry plum, lacquer to invigorate blood stasis and detoxification, prince ginseng, Nansha ginseng, northern sand ginseng, Tiandong, wheat winter to nourish qi and nourish yin. Breast cancer is characterized by liver loss and leakage, in which phlegm, stasis, poison, and evil are intertwined, and qi and blood coagulate and accumulate in the mammary network. Therefore, it is used to soothe the liver and regulate qi, and is compatible with drugs that clear away heat and dissolve phlegm, dissolve stasis and detoxify, reduce swelling and disperse knots, and dredge the veins.
brief summary
To sum up, Zhou Zhongying believes that "cancer toxicity" is the key pathogenic factor and pathological basis for the occurrence and development of breast cancer, and liver qi stagnation is also an important pathogenesis of breast cancer. For patients in the advanced stage with poor physical condition, the method of attacking poison should be used cautiously as appropriate, and it can be combined with products that nourish qi and blood, with the main purpose of improving the quality of life. Zhou Zhongying found that breast cancer is dangerous in the long-term clinical syndrome, the course of the disease is long, and it is easy to metastasize to important organs such as the liver, lungs, and brain.
[Solemnly reaffirmed]
Since each person's constitution and condition are different, the prescription and dosage in this case are only applicable to the patient's condition at that time. Without TCM syndrome differentiation diagnosis and treatment, the prescription and dosage in this case must not be copied. If necessary, readers should go to a regular hospital for diagnosis and treatment to avoid delaying their condition. ■
[The content is compiled from: "China Traditional Chinese Medicine News" September 8, 2021 Fifth Edition, Author: Gu Yu, Department of General Internal Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Wu Mianhua, First Clinical Medical College, Nanjing University of Traditional Chinese Medicine]