Sun Guangrong, Zi Zhizhen, Tianjian, male, Gengchen year (1941) lunar calendar on the eighth day of the first month of the lunar calendar, born in a family of traditional Chinese medicine. Born in Changsha City, Hunan Province, his ancestral home is Yunlu Street, Lujiang County, Anhui Province, and he is now living in Liuyang County, Hunan Province, and now lives in Beijing. Non-partisan, teachers. Chief physician, professor, researcher. He has been practicing TCM clinically for 58 years since 1958, and has been engaged in TCM literature research and TCM culture research for 35 years, postgraduate education for 18 years, distance education for 15 years, and national outstanding TCM clinical talent training for 13 years during the same clinical period. Formerly the director of the Institute of Literature and Information of the Hunan Academy of Traditional Chinese Medicine, a member of the Standing Committee of the Hunan Provincial Committee of the Chinese People's Political Consultative Conference, after his retirement in 2000, he was hired as the deputy dean of the Distance Education College of Beijing University of Chinese Medicine. He is currently a member of the Expert Committee on the Construction and Scientific Popularization of Traditional Chinese Medicine culture of the State Administration of Traditional Chinese Medicine, a standing director of the Chinese Association of Traditional Chinese Medicine, a vice chairman of the Cultural Branch of the Chinese Association of Traditional Chinese Medicine, and the chief expert of the National Health Guidance of Traditional Chinese Medicine. Following the first chairman of the teaching committee, the class teacher of the national outstanding Chinese medicine clinical talent training project, the guidance teacher of the academic experience inheritance of the fifth batch of old Chinese medicine experts in Beijing and the fourth batch of old Chinese medicine experts in Beijing, the expert in the construction of the national famous old Chinese medicine expert Sun Guangrong Inheritance Studio, the construction expert of the famous old Chinese medicine studio of The Beijing University of Chinese Medicine, the construction expert of the famous old Chinese medicine studio of Pingli Hospital, and the consultant of the Beijing Tongrentang Chinese Medicine Master Studio. He enjoys the special government allowance of the State Council and is the second master of traditional Chinese medicine. He has published 23 books and 158 papers. The main awards won by the first ranked or author are: 1 second prize of the State Administration of Traditional Chinese Medicine Science and Technology Progress Award, 1 second prize of the Chinese Association of Traditional Chinese Medicine Science and Technology Progress Award, 1 second prize of the National Excellent Book Award, 1 first prize of the Provincial Science and Technology Progress Award, and 1 first prize of the First National Traditional Chinese Medicine Science Popularization Book Award. He is the chief editor of "Chinese Classic Health Quotations" as one of the fifteen popular science works recommended by the State Press and Publication Administration and other ministries and commissions; presided over and completed one of the achievements of the 15th Scientific and Technological Research Project of the Ministry of Science and Technology, "Collection of Typical Medical Cases of Contemporary Famous and Old Chinese Medicine" and the National Famous Old Chinese Medicine Experience Database. He has struggled in the teaching, medicine and research of Chinese medicine for 58 years, with outstanding clinical and scientific research achievements, made great contributions to the cause of Chinese medicine, and is a model for us to learn.
I have the honor of becoming a student of Mr. Sun Guangrong, the academic heir, and after studying with my teacher, I have some understanding of my tutor's experience in diagnosing and treating tumors, which is now outlined for peers to learn together.
Tumor refers to the body under the action of various tumorigenic factors, local histiocytosis formed by the formation of new organisms, because this new organism is mostly a mass mass protrusion, also known as vegetation. According to the cellular characteristics of the new organism and the degree of harm to the body, the tumor is divided into two categories: benign tumor and malignant tumor, and cancer is the general term for malignant tumor. Tumor is a multi-faceted, common, volatile, refractory, refractory and poor prognosis of the intractable serious disease, is a local manifestation of systemic diseases, any single means of local treatment, is difficult to cure.
Mr. Sun often said that "for tumor patients, not only to treat their diseases as much as possible, but also to keep them as early as possible, Chinese medicine has certain advantages in preventing and treating tumors, especially in improving the patient's ability to fight tumors."
<h1>1. Disease name</h1>
1.1 TCM disease name
As far back as the Yin Ruins Oracle, there is a record of "tumor". "Explanation of the text": "Tumor, swelling also, from the disease, leaving a sound". The General Records of The Holy Ji says: "The tumor is righteous, and it is not left to go." The meaning of the tumor is brilliantly explained. "Staying (tumor)" is to think that its cause is "qi and blood retention" in the body. Or the evil qi and impurities remain in the body but do not go away ("The Origin of Diseases"), so it is called "staying", and later added to the disease side to become the word "tumor". There are records of "tumor" and "cancer" in many ancient books, such as the "Yellow Emperor's Inner Classic", "Difficult Classic", etc. contain: tendon tumors, intestinal tumors, former tumors, swelling, gall tumors, symptomatic fistulas, accumulation, malignant sores, retention, tumors, rocks, cancers (no diseases), cancer.
Subsequently, there are many common disease names in ancient Chinese medicine books that are equivalent to modern medical cancers, such as: milkstone carbuncle, milk rock (equivalent to breast cancer), tongue bacteria (equivalent to tongue cancer), accumulation of symptomatic fistula (equivalent to ovarian cancer, etc.), loss of glory (equivalent to malignant lymphoma, etc.), choking diaphragm (equivalent to esophageal cancer), intestinal mushroom (equivalent to ovarian cysts, etc.), and turning sores (equivalent to skin cancer).
It can be seen that the naming of cancer in Chinese medicine is based on "elephant", which is very graphic and very accurate. For example, chen Shigong's "Orthodox Surgery" of the Ming Dynasty described milk rock: "At first, as big as a bean, gradually like a chess piece, half a year, two years and three years, no pain or itch, gradually and large, the initial pain, the pain is unsolved, the future swelling is like a pile of chestnuts, or like a compound bowl, purple qi, gradually festering, deep like a cave, convex like a lotus, pain even the heart, bleeding is smelly,...... The name is Milk Rock.
1.2 Western medical disease names
There are many tumor classifications, and now there are more than 300 kinds of known tumors, but from a macroscopic point of view, they can be divided into two categories: benign tumors and malignant tumors. Benign tumors are mostly followed by a "tumor" word after the name of the tissue or cell type, for example: benign tumors of the glandular epithelium (epithelium with secretory function as the mainstay; organs composed mainly of the glandular epithelium called glands) called adenomas; benign tumors of smooth muscles, called leiomyomas. Malignant tumors can be subdivided, and malignant tumors of epithelial tissue are collectively called cancers. These tumors exhibit characteristics of differentiation towards some kind of epithelium. The naming method is to add the word "cancer" after the epithelial name. For example, a malignant tumor of the squamous epithelium is called squamous cell carcinoma; a malignant tumor of the glandular epithelium is called adenocarcinoma. Malignant tumors of mesophyll tissue are collectively referred to as sarcomas. These tumors exhibit differentiation towards some interlobe tissue. Mesenchymal tissue includes fibrous tissue, fat, muscle, blood vessels and lymphatic vessels, bone, cartilage tissue, etc. The name is by adding the word "sarcoma" after the name of the mesophyll tissue. For example: fibrosarcoma, liposarcoma, osteosarcoma. Malignant tumors with both cancer and sarcoma components, called carcinosarcoma, should emphasize that in pathology, cancer refers to malignant tumors of epithelial tissue. The so-called "cancer" refers to all malignant tumors, including cancer and sarcoma. In special cases, it is sometimes named in combination with the morphological characteristics of the tumor, such as adenoma that forms a papillary and cystic structure, called papillary cystic adenoma; adenocarcinoma that forms a papillary and cystic structure, called papillary cyst carcinoma. There are still some malignant tumors whose names are conventional and need to be determined, such as: neuroblastoma, leukemia, seminocytoma, Juve sarcoma, Hodgkin lymphoma.
Benign and malignant have their own characteristics. Benign tumors have five characteristics: (1) slow growth; (2) clear boundaries; (3) progressive; (4) no purulent blood; (5) difficult to metastasize. Malignant tumors also have five characteristics: (1) rapid growth; (2) unclear boundaries; (3) difficult to move; (4) mixed with pus and blood; (5) easy metastasis.
<h1>2. Causes</h1>
Whether it is traditional Chinese medicine or Western medicine, the etiology and pathogenesis of tumors have not yet been fully clarified, and it still needs to be continuously explored by colleagues in the medical and scientific and technological circles. Below, Teacher Sun combines the experience of studying TCM classics with clinical evidence, and tries to describe the following:
2.1 Causes of Traditional Chinese Medicine
Ancient Chinese medicine books have made many expositions on the etiology and pathogenesis of tumors, and the discussion of the "Zhongzang Classic" is more comprehensive, and the "On Carbuncle Sores and Swelling Forty-first" clearly points out: "The work of fu carbuncles and carbuncles is also the work of the internal organs and six intestines that do not flow, and those who are not only because of the Rongwei congestion are also born." There is also a place for his deeds, and there is a return for his master. If the order is issued in the mouthpiece, the poison of the heart is also; the poison of the lungs is also in the fur; the poison of the spleen is also in the muscle; the poison of the bone marrow, the poison of the kidney; the poison of the lower, the poison in the yin; the poison of the upper, the poison in the yang; the poison of the outer, the poison of the six intestines; the poison of the five viscera. ”
Why do malignant tumors occur? Based on the study of ancient Chinese medicine books and combined with family traditions, teacher transmissions and testimonials, Teacher Sun believes that it can be summarized into six aspects, with a total of twelve words: (1) heredity; (2) depression; (3) stagnation; (4) blood stasis; (5) phlegm coagulation; (6) toxic accumulation.
2.2 Causes of Western medicine
Western medicine believes that the causes of malignant tumors are mainly: (1) emotional depression carcinogenicity; (2) biological factors carcinogenic (including viruses and parasites) ;(3) chemical factors causing cancer; (4) physical factors causing cancer; (5) life factors causing cancer; (6) genetic factors inducing easy carcinogenicity; (7) virus carcinogenicity.
<h1>3. Dialectics</h1>
The diagnosis of tumors in Chinese medicine cannot be separated from looking, smelling, asking and cutting. Dialectics, especially should pay attention to "clear longitude and latitude", Teacher Sun's testimony summarized as "four diagnoses and eight weights". On the treatment, especially should recognize the pathogenesis, the treatment of the overall treatment is not far from the beneficial qi and blood, detoxification, soft and firm loose knots, Teacher Sun initially summarized as "a basic formula for a class of tumors", on this basis, with the addition and subtraction of symptoms, flexible tailoring.
3.1 Four diagnoses and eight weights
3.1.1 Consultation: heavy god shape, heavy tongue image.
(1) Loss of concentration: visible delirium, or loss of speech, or touching the bed, emptying the line, the eyes are dark and unfocused, the expression is indifferent and dull, the eye bags are bloated and obscure, the cervical spine is erect but not firm, the movement is dysfunctional, the forced position is forced, and the breathing is abnormal.
(2) Amorphism: Visible pale and dull, emaciated and weak, or single abdomen enlargement, limbs anti-thin, abdominal skin nails, on the back of the deep concave, or the spine is like a saw, gait is unstable, or lying inward, the weight can not turn sideways, sweat stains.
(3) Tongue image: the tongue body is obviously thin or obviously hypertrophied, shrunken, and even inflexible; the tongue is rough and thorny, like the skin of sand fish, and there is dry and cracked; the tongue is shrunk like dried meat with lychee, and there is no jin liquid at all; the tongue is dry and obscure like pig liver color, or the tongue is red as persimmon; the tongue is short and the scrotum is shrunken; the tongue is ochre and black; the tongue is white like snowflakes; the tongue is dark red or bright, there are scattered in the bruises, and even cooked pig liver-like tongue, pig kidney-like tongue, or like a mirror surface, and there is light; the tongue is thick and dry, dry or slippery, and even moss-free, no jin, or dry and withered.
(4) Nails, toenails: visible nail rolls, petechiae, nail dryness, anti-nail.
(5) Skin: Visible skin color and dryness, skin gathering hair, skin dry hair folding, or obscure, poor elasticity, ecchymosis.
3.1.2 Smell diagnosis: heavy sound, heavy odor.
(1) Sound: visible hoarseness, low voice, hyperphony, hoarseness, aphasia, misspeaking, moaning; no continuation; speech is slow and low, and cannot be repeated; Zheng sheng, monolingual; breathing difficulties, short and urgent, opening the mouth and raising the shoulders, nose wing incitement; shortness of breathing like wheezing, intermittent voice height, phlegm in the throat, lingering and difficult to heal; weak breathing, short and low voice, weakness and timidity; or inability to cough, cough low.
(2) Odor: The exhaled gas or parts of the body emit odor, fishy smell, corpse smell, bacon smell, putrid smell, and bloody smell.
3.1.3 Consultation: emphasis on status quo, emphasis on parameters.
(1) Status: ask and understand the patient's diet, sleep, stool, likes and dislikes, pain sites and feelings.
(2) Parameters: query and understand the patient's past history, family history, treatment history, laboratory examination data, etc.
3.1.4 Incision: heavy pulse image, heavy feedback.
(1) Pulse: Distinguish whether there is a stomach, a god, a root, whether there is an anti-seasonal pulse, whether there is an intermittent pulse, whether there is a house leak, a fish xiang, a bird peck and other seven dead veins.
(2) Feedback: understand the patient's situation, whether the touch tumor can move, whether it is hard, whether the pain, whether the swelling site is fixed, whether it can be compressed, etc.
3.2 Dialectical key
According to the experience of witnessing, Teacher Sun proposed 20 main elements of dialectics: namely- 1. seasonality; 2. male and female; 3. long and young; 4. dry and wet; 5. labor and leisure 6. widowhood; 7. fertility; 8. new and old; 9. YuShi; 10. Wang obscure 11. divine form; 12. prosperity and decline; 13. yin and yang; 14.table; 15.cold and heat 16. virtual reality; 17.Master-slave; 18.specimen; 19.Shun; 20. Life and death. In the dialectic of tumors, these 20 elements should be paid attention to, especially the last 10 items.
As we all know, dialectics should be based on various dialectical programs, such as: the eight principles of cold and heat in the yin and yang table, the eight principles of cold and heat in the table of cold and heat, the eight principles of life and death, the blood dialectics of Wei Qi Camp, the dialectic of qi and blood, etc., and the results obtained by the four diagnosis and joint references are included in the dialectical program for clinical differentiation. However, according to Teacher Sun's personal experience, no matter what dialectical program is used, it must be "clear and clear", so that the outline can be outlined, can it be in line with clinical reality, and can it truly guide the clinical group to use drugs.
For tumors, the key is not the virtual and real ends. The void, the positive deficiency, is mainly qi deficiency, but also can be qi and blood two deficiency; the real, evil real, mainly for blood stasis, can also have phlegm turbidity, that is, phlegm stasis mutual knot, so the evidence of tumors is mostly qi and blood deficiency, phlegm stasis mutual knot, qi stagnation blood stasis, evil poison gathering and so on.
Establishing a cure according to the dialectical conclusion, and then using the prescription according to the treatment method, this is the routine of TCM clinical evidence. Teacher Sun's prescription, the purpose of the Zongjing Fang is not to mud the Jing Fang medicine, adhere to the principle of "neutralization", mostly use the triple medicine group, and strictly follow the Junchen Zuo envoy group. On this basis, it is flexible according to the combination of disease and conjunctive disease. In order to facilitate memory and use, we take the advice of friends and name them after themselves. The basic formula commonly used by Teacher Sun in the treatment of 10 kinds of malignant tumors in the clinical certificate is as follows: the basic formula for treating cancer: Sun Guangrong Fuzheng tumor suppression soup.
(1) Composition: [Jun] Raw Ginseng 10g Raw Northern Qi 15g Purple Salvia 10g; [Chen] TiankuiZi 15g Snake Tongue Grass 15g Half-branched Lotus 15g; [Zuo] Mother of Pearl 12g Turtle Armor 12g Mountain Ci Mushroom 12g; [Make] Add and Subtract with Evidence, Supplement (Partial), Guide (Guide), Correction (Disadvantage), Combination (Adjustment).
(2) Fang Yi: the first drug group, beneficial qi and invigorating blood; the second drug group, clearing heat and detoxification; the third drug group, soft and firm loose knots; the fourth drug group, supplement (benefit) guidance (guide) correction (deviation) and (adjustment). Play together to benefit the qi and invigorate the blood, and the effect of soft and firm loose knots.
<h1>4. Medical cases</h1>
4.1 Lung cancer with a large number of pleural effusions
Lung cancer with a large amount of pleural effusion, qi and yin loss, sputum and heat mutual junction, water drinking stoppage. In this case, the cause was treated by nourishing the yin with beneficial qi, and its symptoms were treated with clearing heat, detoxification, and dissolving phlegm and water, and the amount of medicinal essence was small and the prescription was consistent, so it was effective.
Li Moumou, male, 64 years old.
Initial consultation: December 18, 2009.
The veins are small, the tongue is red, and the moss is white. The evidence is that the shape is pinned to the bone, coughing and coughing, chest tightness and shortness of breath, slight wheezing, and inability to lie flat. Western medicine diagnosed it as "lung cancer with a large pleural effusion". This is a testimony to the loss of qi and yin, the mutual knotting of phlegm and heat, and the cessation of water and drinking. Cure the qi and nourish the yin, clear the heat and detoxify, dissolve the phlegm and water. Formula: Raw ginseng 15g, raw northern qi 12g, purple salvia 10g, sunflower seed 10g, snake tongue herb 15g, half-branched lotus 15g, melon peel 10g, mulberry white peel 10g, coix kernel 20g, tangerine red 6g, turtle shell 15g, mountain mushroom 6g, honeysuckle 12g, mai mendong 12g, raw licorice 5g, peran leaf 6g, seared aster 7g, hot winter flower 7g, hot winter flower 7g. 7 doses, decoction for internal use, 1 dose per day, divided into 2 divided doses.
Second consultation: December 25, 2009.
The veins are small, the tongue is red, and the moss is white. After taking the front of the service, I can lie flat, but I still have a slight cough and chest tightness. Original addition and subtraction: raw ginseng 15g, raw northern qi 12g, purple salvia 10g, sunflower seed 10g, snake tongue herb 15g, melon peel 10g, mulberry white peel 10g, hot hundred 7g, coix kernel 20g, orange red 7g, mountain mushroom 6g, honeysuckle 15g, bitter orange stem 6g, wood butterfly 6g, turtle shell 15g, raw licorice 5g. 7 doses, decoction, 1 dose per day, divided into 2 divided doses.
3rd consultation: July 9, 2010.
The veins are slightly thinner, the tongue is red, and the moss is thin and white. The patient felt that the effect of taking the upper part of the drug was obvious, so he took the medicine by himself, and after review by the local hospital: the lump was significantly reduced by 2/3, and the pleural effusion was reduced by 1/3. The evidence of this has improved significantly, with only occasional coughing and wheezing. Therefore, it is still treated with the original formula plus or minus: raw ginseng 12g, raw Northern Qi 12g purple salvia 10g, whole melon 15g, raw rice 30g, 30g of Coriander,
Snake tongue grass 15g, Amaranth seed 10g, Half-branched lotus 15g, cat's claw 15g, Sunflower seed 10g, Mountain Ci Mushroom 10g, turtle shell 15g, Schisandra 3g, Mother of Pearl 15g, orange red 6g, burning aster 10g, hot winter flower 10g, psyllium kernel 10g, ejiao beads 10g, raw licorice 5g, 28 doses, decoction, 1 dose per day, divided into 2 divided doses.
Follow-up: After 60 doses of shoufang, after re-examination by the local hospital, no pleural effusion was seen, and he felt that the evidence was flat.
Lung cancer, or bronchial lung cancer, is the most common malignancy, and pleural effusion is a common complication of its advanced stage. The physical and chemical examination conclusion of this case is "lung cancer with a large amount of pleural effusion", which can be known to identify lung cancer, which should be combined with disease identification and dialectics, and it is easier to "know what is wrong" to "know what is wrong" by teacher Sun, so as to improve the accuracy of TCM dialectics. In this case, the four diagnoses were combined, and it was judged that the two deficiencies of qi and yin and the evidence of phlegm and heat were intertwined, so the treatment was treated with beneficial qi nourishing yin, clearing heat and dissolving phlegm, and lishui seepage and wetting. After more than 150 days of abiding by the law, it was finally able to survive in a desperate situation and attain peace with all the evidence. Among them, the joint attack on evil in snake tongue grass, half-branched lotus, cat's claw grass, celestial sunflower, mountain mushroom, leaf amaranth, turtle armor, and mother of pearl is indispensable, and always pays attention to the foundation of support, and the original purpose of its group is actually a guide to obtain good results.
4.2 Rectal cancer cases
Rectal cancer, qi yin damage on the top, heat poison gathered in the bottom, so it needs to be treated up and down, cancer in the rectum, then the drug can be taken enema, so it can be treated both inside and outside.
Hu Moumou, female, 56 years old.
Initial consultation: 1 September 1996.
The veins are fine and astringent, the tongue is pale and the moss is white. Before January, it was found that the stool was not smooth and bloody, and it was suspected of "hemorrhoids". On August 27, 1996, he performed pathological biopsy (pathological tissue examination number: 224211) in the Second Affiliated Hospital of Hunan Medical University, and reported: rectal papilloma, focal carcinogenesis. Weakness and dizziness. The number of stools is basically normal, the stool is bloody, the color is bright red, and occasionally the color is black, and the back is swollen. This is the weakness of qi and yin, and the heat poison hinders the intestines. Fadang Yi Qi nourishes yin, clears heat and detoxifies, cools the blood and dissolves stasis and stops bleeding. Formula: American ginseng 10g, raw Northern Qi 12g, shou wu l5g, locust flower charcoal 15g, thistle grass l0g, crane grass 12g, pu huang charcoal 15g, ground elm charcoal 12g, diamond 15g, snake tongue grass 15g, half-branched lotus 15g, dandelion 15g, young dragon flower 12g, mulberry parasitism 12g, Huai yam 15g, raw licorice 5g. 7 doses, 1 dose per day, decoction, divided into 2 divided doses. Also: External slug fluid retention enema, 1 time a day.
Second consultation: September 8, 1996.
The tongue veins are as before. The head is no longer dizzy, the stool is not bloody, slightly thin, and there is no special discomfort. The original formula to the ground elm charcoal, 7 doses. Still retain the enema with slug fluid, l times a day.
Third consultation: September 29, 1996.
On September 26, 1996, he underwent colonoscopy at Hunan Provincial Cancer Hospital and reported that the microscope was smooth (18 cm), the colorectal mucosa was smooth, and no lump was seen. Patients have no special discomfort and require medication to consolidate the efficacy. Original addition and subtraction: American ginseng 10g raw Northern Qi 12g, young dragon flower 15g, locust charcoal 15g, Diamond Root 15g, Huai Yam 15g, turtle nail 15g, Sichuan Eucommia 12g, dandelion 12g, Gujing pearl 12g, Crane herb 12g, thistle herb 12g, raw amaranth kernel 20g, raw licorice 5g. 7 doses. Instructions: No longer use the enema method.
Follow-up: the condition is stable, and after a slight reduction of 14 doses is applied to the above, the patient consciously stops the drug without discomfort, and the follow-up has not recurred so far.
【Press】Rectal cancer belongs to the category of "intestinal wind" and "dirty poison" of traditional Chinese medicine, which is one of the common malignant tumors of the digestive tract in clinical practice, and the disease needs to be treated internally and externally, and it is necessary to pay attention to the adjustment of diet and living environment, maintain the smooth flow of qi and blood, and prevent qi and blood stasis. The key to the treatment of this case lies in the treatment of beneficial qi and yin, clearing heat and detoxification, cooling the blood and dissolving the stasis and stopping the bleeding, the evidence is consistent, and the correction and dispelling evil are taken into account, and the medication is used in enemas at the same time, so it has a good effect. Among them, the slug liquid retains the enema for yu trauma, and it is used to treat rectal cancer repeatedly. (Author: Wei Yougang, Department of Oncology, Ma'anshan Hospital of Traditional Chinese Medicine)