A Case Study: One and a Half Years of Pure TCM Treatment for Ms. He with Follicular Lymphoma

First consultation, December 7, 2017

Ms. He, female, born in 1981, a native of Mianyang, Sichuan. After graduating she went to work in Nanning and has long resided there. Married with children; office worker; does not often stay up late. The patient denied any history of infectious diseases such as hepatitis B, denied any family history of inherited tumors, had never traveled to epidemic areas, denied any occupational exposure, denied any history of sexual promiscuity, denied smoking and drinking, and reported no bad habits. Seven years ago she was diagnosed with thalassemia. Blood pressure and blood glucose were normal. The pulse was deep, fine and slightly rapid; the tongue coating was thick and greasy.

In August 2017, the patient was diagnosed by puncture at the First Affiliated Hospital of Guangxi University of Chinese Medicine (inpatient no. 00514967) as having stage 3-4 follicular lymphoma. Multiple enlarged lymph nodes of varying size were palpable on both sides of the neck, both axillae, and both groins. More than ten pieces of lymphoid tissue were removed from below the left groin for biopsy; the pathology report showed follicular lymphoma.

The patient had previously been treated locally in Guangxi for several months without effect; the lymphatic tumor kept growing. By the time she came for consultation, the enlarged cervical lymph nodes had made her face look puffy.

Considering that this disease is hard to treat and that the patient would need long-term medication, I hoped at the first visit to prescribe mainly patent medicines, so as to avoid long-term decoction that her stomach might not tolerate.

Patent medicines: Neixiao Luoli Wan (Tongrentang or Foci Pharmaceutical) (follow package instructions); Shenqi Shiyiwei Keli (Shangao Pharmaceutical) (follow package instructions); Xihuang Wan (Beijing Tongrentang), taken once each night before bed, 3-6-9-12-12 g; Xiaojin Wan (Beijing Tongrentang), taken once each morning on an empty stomach, 1.5-3-4.5-6-6 g; Fufang Banmao Jiaonang (Guizhou Yibai Pharmaceutical), twice daily, 3 capsules each time; Neixiao Sanjie Jiaonang, twice daily, 2 capsules each time; Pingxiao Pian (Xi'an Zhengda), three times daily, 4-8 tablets each time; Erzhi Wan, twice daily, 9 g each time.

For all the above medicines: take for five days, then stop for two days; suspend during colds and fever; suspend during the first two days of menstruation.

Dietary restrictions: citrus fruits, seafood, pickled vegetables, barbecue, shrimp, crab, common carp.

Follow-up visit, March 27, 2018

After the first visit, because of a cold and menstruation, she stopped the medicine for about a month. The lymph nodes had increased in number and size. After resuming the medicine, the lymph nodes stabilized and showed no further change.

Recently sleep quality had been good; the menstrual period had shortened (formerly eight to nine days, gradually about seven days after medication), and the color had lightened. Sometimes there was clear leukorrhea without odor. There was diarrhea, but after diarrhea her energy was unaffected. The pulse was fine, slippery and rapid; the tongue coating was thin and white.

Decoction formula:

Pugongying 30g, Rendongteng 30g, Jinyinhua 15g, Lianqiao 15g, Diding 15g, Yejuhua 10g, Tiankuizi 15g, Chaihu 10g, Huangqin 10g, Wuweizi 10g, Huoxiang 10g, Peilan 10g, Sheng Huangqi 30g, Nüzhenzi 15g, Mohanlian 15g, Haizao 30g, Kunbu 30g, Huangyaozi 15g, Shancigu 15g, Xuanshen 12g, Zhebeimu 12g, Sheng Muli 30g (decoct first), Zhi Biejia 24g (decoct first), Guiban 15g (decoct first), Xiakucao 15g, Chonglou 15g, Sanleng 10g, Ezhu 10g, Chanyi 6g, Chao Jiangcan 10g, Pian Jianghuang 6g, Baihua Sheshicao 30g, Banzhilian 30g, Tusizi 15g, Shayuanzi 15g, Dangshen 30g, Chao Baizhu 30g, Fuling 30g, Yiyiren 60g, Cangzhu 10g, Huangbo 10g, Jiao Sanxian 15g each.

Each packet may be taken over 1-2 days, in 2-3 divided doses per day. Thereafter this formula may be processed by decocting the herbs into a thick extract, grinding the tuber-type herbs into powder, mixing them into a medicinal paste, and making into pills; take three times daily, 6-10 g each time.

Patent medicines: Xihuang Wan; Xiaojin Wan; Neixiao Sanjie Wan; Fufang Banmao Jiaonang; Duoying Wan.

Follow-up visit, October 15, 2018

After the previous visit she continued taking the medicine for some time. Recently, by appearance, the tumors had visibly shrunk, though the B-ultrasound showed little change. She had not caught a cold for a long time (previously she caught colds frequently). After taking the previous formula she had diarrhea; after stopping Xiaojin Wan the diarrhea improved. Since childhood she has been prone to boils and sores; she had shingles one year, and after taking an old TCM doctor's medicine developed a string-like pain along the skin, which later improved after cupping at the Xuehai point. In the past half year she has had two episodes. Suspected gout. The left pulse was deep, fine and weak; the right pulse was deep, fine and moderate; the tongue was slightly pale. This indicated deficiency of qi and blood.

Decoction formula:

Pugongying 30g, Rendongteng 30g, Jinyinhua 15g, Lianqiao 15g, Diding 15g, Yejuhua 10g, Tiankuizi 15g, Chaihu 10g, Huangqin 10g, Wuweizi 10g, Sheng Huangqi 30g, Nüzhenzi 15g, Mohanlian 15g, Huangjing 30g, Haizao 30g, Kunbu 30g, Huangyaozi 15g, Shancigu 15g, Xuanshen 12g, Zhebeimu 12g, Sheng Muli 30g (decoct first), Zhi Biejia 24g (decoct first), Guiban 15g (decoct first), Xiakucao 15g, Chonglou 15g, Sanleng 10g, Ezhu 10g, Chanyi 6g, Chao Jiangcan 10g, Pian Jianghuang 6g, Baihua Sheshicao 30g, Banzhilian 30g, Tengligen 30g, Shiwei 30g, Daji 20g, Xiaoji 20g, Tusizi 15g, Shayuanzi 15g, Dangshen 30g, Danggui 30g, Chao Baizhu 30g, Fuling 30g, Yiyiren 60g, Cangzhu 10g, Huangbo 10g, Huai Niuxi 15g, Jiao Sanxian 15g each.

Each packet may be taken over 1-2 days, in 2-3 divided doses per day. Thereafter this formula may be processed by decocting the herbs into a thick extract, grinding the tuber-type herbs into powder, mixing them into a medicinal paste, and making into pills; take three times daily, 6-10 g each time.

Patent medicines: Xihuang Wan; Neixiao Sanjie Wan; Fufang Banmao Jiaonang; Duoying Wan; Herong Sanjian Wan.

Follow-up visit, June 4, 2019

After the previous visit she continued taking the above formula until now. Tumors all over the body, except at the left groin (the original biopsy site), have shrunk by more than half.

The right pulse was deep, fine and slightly rapid; the left pulse was deep, soft and forceless. Def sweating had greatly diminished and she no longer sweats. She no longer feels cold. The menstrual blood contains clots and flocculent matter.

Decoction formula:

Pugongying 30g, Rendongteng 30g, Jinyinhua 15g, Lianqiao 15g, Diding 15g, Yejuhua 10g, Tiankuizi 15g, Huangqin 10g, Sheng Huangqi 30g, Nüzhenzi 15g, Mohanlian 15g, Huangjing 30g, Haizao 30g, Kunbu 30g, Huangyaozi 15g, Shancigu 15g, Xuanshen 12g, Zhebeimu 12g, Sheng Muli 30g (decoct first), Zhi Biejia 24g (decoct first), Guiban 15g (decoct first), Xiakucao 15g, Chonglou 15g, Sanleng 10g, Ezhu 10g, Chanyi 6g, Chao Jiangcan 10g, Pian Jianghuang 6g, Baihua Sheshicao 30g, Banzhilian 30g, Tengligen 30g, Shiwei 30g, Daji 20g, Xiaoji 20g, Tusizi 15g, Shayuanzi 15g, Dangshen 10g, Wuweizi 10g, Danggui 10g, Huai Niuxi 15g, Jiao Sanxian 15g each.

Each packet may be taken over 1-2 days, in 2-3 divided doses per day. Thereafter this formula may be processed by decocting the herbs into a thick extract, grinding the tuber-type herbs into powder, mixing them into a medicinal paste, and making into pills; take three times daily, 6-10 g each time.

Patent medicines: Xihuang Wan, once daily, 6 g each time; Neixiao Sanjie Wan, twice daily, 8 pills each time; Hualiu Wan, twice daily, 30-60 pills each time; Demethylcantharidin tablets, twice daily, 5-15 mg each time; Duoying Wan, three times daily, 5-15 pills each time; Herong Sanjian Wan, twice daily, 30-60 pills each time.

The patient is currently undergoing further treatment.

After being diagnosed with follicular lymphoma, this patient decided to give up Western medicine. After the first visit, under my treatment, although the cervical swelling shrank very noticeably, B-ultrasound showed that the tumor size had not actually changed. The patient did not panic and persisted with TCM; during this period the lymphoma even once enlarged. I myself was deeply anxious, but the patient still believed that TCM could solve her problem.

This patient's spirit was sufficiently strong. In the first year of treatment the tumor did not visibly shrink, but the patient felt that various symptoms, including the submandibular lumps, were clearly diminishing (this reduction in lumps may have been the shrinking of inflammatory masses around the tumor rather than of the tumor itself), so she refused to abandon TCM. Every three to six months she traveled a long distance to see me for a follow-up, and after each visit she persisted in taking the medicine for a while. Finally, in the most recent half year, the tumors began to shrink noticeably.

In addition, the lesion at which the biopsy was punctured has indeed progressed faster than the other lesions since the puncture. Patients often worry that puncturing will stimulate the cancerous focus and promote its growth, and this concern is not without basis.