Dr. Chen Guosheng's Experience in Treating Brain Tumors with the Sphen-Strengthening, Phlegm-Transforming Method
The 4th issue of Jiangxi Journal of Traditional Chinese Medicine (1998) carried an article by Dr. Chen Guosheng of Baishui Central Health Center, Longhai, Fujian Province, titled “Experience in Treating Brain Tumors by the Spleen-Strengthening and Phlegm-Transforming Method” (p. 24 of that issue). It introduced Dr. Chen’s experience in treating 12 brain tumor patients: 4 had ependymoma, 3 schwannoma, 3 craniopharyngioma, and 2 brain metastases. All 12 had dizziness and headache; 8 had nausea and vomiting; 9 had visual or hearing impairment; and 7 had limb dysfunction (hemiparesis).
Dr. Chen’s empirical formula is Yiqi Huatan San (Qi-Boosting Phlegm-Transforming Powder). Its base formula is: Huangqi (Astragalus) 20 g, Baizhu (Atractylodes) 20 g, Jiangcan (Stiff Silkworm) 10 g, Fabanxia (prepared Pinellia) 10 g, Baifuzi (Typhonium) 10 g, Dannangxing (bile Arisaema) 6 g, Quanxie (Scorpion) 6 g, Shichangpu (Acorus) 6 g, Wugong (Centipede) 3 g. For qi and yin dual deficiency, add Shengshaishen (sun-dried ginseng) 10 g, Maidong (Ophiopogon) 10 g, Wuweizi (Schisandra) 6 g; for static blood internal binding, add Taoren (Peach kernel) 10 g, Honghua (Safflower) 10 g, Chuanxiong (Sichuan Lovage) 10 g; for phlegm-dampness obstruction, add Baijiezi (Mustard seed) 10 g, Haizao (Sargassum) 20 g, Kunbu (Ecklonia) 20 g; for exuberant heat-toxin and fire, add Xiakucao (Self-heal spike) 20 g, Huangqin (Scutellaria) 10 g, Zhizi (Gardenia) 10 g, Longdancao (Gentiana) 6 g. One decoction per day, divided into two doses. Once symptoms ease, grind the herbs into a fine powder, 9 g twice daily, taken with warm water. For cerebral edema and intracranial hypertension, combine with intravenous mannitol and dexamethasone; after symptoms ease, prolong the interval between mannitol and dexamethasone doses until withdrawal, but the Chinese medicine must be continued.
According to Dr. Chen’s report, of his 12 patients: 2 were basically cured (tumor disappeared on follow-up CT and the body returned to normal), 3 had marked effect (tumor shrank on CT, systemic symptoms basically gone, able to work normally, survival over 3 years), 4 had some effect (tumor did not enlarge further on CT, systemic symptoms improved, survival over 1 year), and 3 had no effect (tumor continued to grow or was unchanged, symptoms unimproved). The total effective rate was 75%.
The author’s note: brain tumors, whether primary or secondary, are hard to treat. The cranial environment is special; the blood-brain barrier prevents many drugs from reaching the site. TCM treatment of intracranial tumors is mainly symptomatic, based on the patient’s clinical presentation. Brain tumor patients often develop intracranial circulatory disturbances, cerebral edema and intracranial hypertension, with dizziness, headache, nausea, vomiting, diplopia or blurred vision, tinnitus and deafness. In TCM these belong to the pattern of phlegm clouding the clear orifices; TCM diseases such as headache, dizziness, qingmang (blindness) and stroke present with these symptoms.
When phlegm clouds the clear orifices, one must open the orifices and transform phlegm. TCM holds that the root of phlegm-dampness lies in spleen deficiency: a deficient spleen cannot transport and transform water-dampness. Therefore the root treatment of phlegm is to fortify the spleen and boost qi; Dr. Chen’s empirical formula uses Huangqi and Baizhu to do this. Jiangcan, Fabanxia, Baifuzi, Dannangxing and Shichangpu are phlegm-transforming herbs; among them Baifuzi and Shichangpu specifically treat head and face disorders. Quanxie and Wugong level the liver and extinguish wind, using poison to attack poison, anti-cancer and mass-resolving. Overall, Dr. Chen’s empirical formula is both simple and comprehensive.
For qi-yin dual deficiency patients, Dr. Chen combined this formula with Shengmai San; the added Shengshaishen, Maidong and Wuweizi are precisely Shengmai San. For static-blood binding patients, while using Yiqi Huatan San he also borrowed the rationale of Taohong Siwu Tang, adding Taoren, Honghua and Chuanxiong. For phlegm-dampness obstruction he used Baijiezi (which warmly transforms cold-phlegm) and Haizao and Kunbu (which soften hardness and transform phlegm). For exuberant heat-toxin, while using this formula he borrowed the rationale of Longdan Xiegan Tang.
Dr. Chen’s reasoning in treating brain tumors is clear; he essentially modified and adapted classical TCM formulas. TCM classical formulas, tested through countless clinical practices, are mostly reliably effective and can provide good symptomatic treatment. Treating along Dr. Chen’s lines can improve brain tumor patients’ symptoms, prolong survival and bring real help. Dr. Chen does not reject integrated Chinese-Western medicine either; when cerebral edema and intracranial hypertension are severe, he uses dexamethasone and mannitol together with Chinese medicine to relieve suffering.
I personally think Dr. Chen’s treatment approach is worth learning from, and his description of clinical efficacy is objective and rational, hence trustworthy. His formula does not use Niuhuang (cow-bezoar), Shexiang (musk) or Lingyangjiao (antelope horn), commonly used for brain tumors. Perhaps this relates to those herbs being very expensive, while most of Dr. Chen’s patients had limited means and could not afford such costly medicinal materials.