"Da Bu Yuan Jian" (Major Qi-Blood Supplementing Decoction) for Easing Chemotherapy Side Effects in Cancer Patients

“Da Bu Yuan Jian” (Major Restore the Origin Decoction) originates from the Jingyue Quanshu; in the Jingyan Guangji it has an alternative name, “Bu Yuan Jian” (Restore the Origin Decoction).

The formula is composed as follows: Renshen (Ginseng Radix), from 1–2 qian (3–6g) at the low end to 1–2 liang (30–60g) at the high end; Shanyao (Dioscoreae Rhizoma, stir-fried) 2 qian (6g); Shudihuang (processed Rehmanniae Radix), from 2–3 qian (6–9g) at the low end to 2–3 liang (60–90g) at the high end; Duzhong (Eucommiae Cortex) 2 qian (6g); Danggui (Angelicae Sinensis Radix) 2–3 qian (6–9g); Shanzhuyu (Corni Fructus) 1 qian (3g); Gouqizi (Lycii Fructus) 2–3 qian (6–9g); Zhigancao (honey-fried Glycyrrhizae Radix) 1–2 qian (3–6g).

Decoct the above herbs with one large bowl of water (about 400ml) down to seven-tenths of a bowl (about 280ml); take warm after meals, twice daily. This formula supplements and boosts qi and blood, and secures the root and cultivates yuan. It mainly treats severe depletion of qi and blood with loss of the spirit, presenting with a pale complexion, sore and weak lower back and knees, dizziness and blurred vision, fatigue and lack of strength, cold limbs, dry mouth (or not), and poor appetite (or unaffected appetite).

Here, the dosage of Renshen and Shudihuang should be determined by the degree of the patient's weakness. If the patient is very weak—for example, after massive hemorrhage, unable even to stand—then Renshen may be used in large doses, up to 30–60g, and Shudihuang up to 60–90g. But note to increase the herbs gradually. We may use large doses of Renshen and Shudihuang, but when giving them to the patient, start with one-tenth of the dose; if there is no adverse reaction, increase slowly. In emergencies, take one-tenth of the dose each time, every 15–30 minutes, closely observing the patient's reaction.

Because large-dose Renshen may cause ginseng abuse syndrome, presenting with a flushed face and ears, dry mouth and tongue, restlessness and agitation, constipation, and a surging pulse. If these side effects appear, let the patient quickly take half to one raw white radish, which relieves them. Large-dose Shudihuang may also cause restlessness and diarrhea, but relatively speaking, its side effects are milder than those of Renshen.

This formula can be used to ease chemotherapy side effects in cancer patients, such as leukopenia, nausea, fatigue, abdominal distension, diarrhea, anemia, hair loss, liver and kidney function damage, and myocardial damage.

If the patient has insufficient original yang with cold extremities, add Rougui (Cinnamomi Cortex), Fuzi (Aconiti Radix), Ganjiang (Zingiberis Rhizoma), Paojiang (blast-fried Ginger), etc. If qi deficiency is marked with severe leukopenia, add Sheng Huangqi (raw Astragalus), Zhi Huangqi (honey-fried Astragalus), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangjing (Polygonati Rhizoma), Dangshen (Codonopsis), etc. If the appetite is poor, add Jiao Shanzha (charred hawthorn), Jiao Maiya (charred malt), Jiao Shenqu (charred medicated leaven), etc. If nausea and vomiting are severe, add Chenpi (Citri Reticulatae Pericarpium), Fabanxia (processed Pinellia), Zhuru (Bambusae Caulis in Taeniam), Xuanfuhua (Inulae Flos), Daizheshi (Haematitum), Pipaye (Eriobotryae Folium), etc. If hair loss is severe, add Mohanlian (Ecliptae Herba), Nuzhenzi (Ligustri Lucidi Fructus), Shayuanzi (Astragali Complanati Semen), Tusizi (Cuscutae Semen), Heshouwu (Fallopiae Multiflori Radix), Heizhima (Sesami Nigri Semen), etc. If diarrhea is present, use the patent medicine Si Shen Wan alongside this formula. For qi stagnation and blood stasis, add Chuanxiong (Chuanxiong Rhizoma), Cu Xiangfu (vinegar-processed Cyperi Rhizoma), etc.

Da Bu Yuan Jian is a purely supplementing formula. Besides easing post-chemotherapy side effects, it can also treat chronic physical weakness, anemia, or aplastic anemia. This formula is only suitable for patients with pure deficiency patterns; it is not appropriate for young, robust patients.