Ermiao Wan and Erzhi Wan Combined with Endocrine Therapy for Breast Cancer
Ermiao Wan and Erzhi Wan are two commonly used TCM pills; their formulas are extremely simple, yet their therapeutic effects are outstanding. Ermiao Wan is composed of equal parts of Huangbo (Phellodendri Cortex) and Cangzhu (Atractylodis Rhizoma); Erzhi Wan is composed of equal parts of Mohanlian (Ecliptae Herba) and Nüzhenzi (Ligustri Lucidi Fructus). Both are produced as finished patent medicines by pharmaceutical factories, so patients can directly buy the ready-made patent products when using them.
Ermiao Wan has the function of clearing heat and drying dampness, and can be used for the syndrome of damp-heat pouring downward, presenting as pain in the sinews and bones, or weakness and flaccidity of the two legs, or redness, swelling, heat and pain of the feet and knees, or damp sores in the lower part of the body, scanty and dark urine, or vaginal discharge due to damp-heat, with a yellow greasy tongue coating. Ermiao Wan can be used to treat dermatological diseases described in modern medicine such as lower-leg erysipelas, erythema nodosum, chronic eczema, dermatitis, tinea pedis, and impetigo; it can also be used for rheumatic arthritis, rheumatoid arthritis, gouty arthritis, thrombophlebitis, ankylosing spondylitis, poliomyelitis, lumbar and knee osteoarthritis, osteoporosis, and gastrocnemius spasm, when these belong to damp-heat impediment; it can further be used for acute glomerulonephritis, chronic prostatitis, vaginitis, pelvic inflammatory disease, scrotitis, and scrotal eczema, when these patterns belong to damp-heat pouring downward.
Erzhi Wan has the effects of tonifying the kidney and nourishing the liver, and nourishing yin to stop bleeding; it is used for liver-kidney yin deficiency syndrome, presenting as dizziness and tinnitus, a bitter taste and dry throat, lightheadedness and dim eyesight, insomnia and profuse dreaming, soreness and weakness of the waist and knees, flaccidity and weakness of the lower limbs, seminal emission, early graying of hair and beard, and heavy menstrual bleeding, with a red tongue, little coating, and a thin or thin rapid pulse. Erzhi Wan is often used to treat heavy, incessant menstrual bleeding in women; it can also treat a variety of chronic kidney diseases (such as chronic glomerulonephritis, latent nephritis, purpura nephritis, nephrotic syndrome, chronic renal failure, and chronic pyelonephritis); it can also treat white hair and hair loss. The author himself has on several occasions suffered alopecia areata due to excessive stress, and was cured each time by taking Erzhi Wan. Ermiao Wan can also be used for leukopenia, functional uterine bleeding, and fundus hemorrhage, when these patterns fit.
Ermiao Wan may cause constipation, while Erzhi Wan may cause loose stools; when the two are used together, their side effects just cancel each other out. Combining Ermiao Wan and Erzhi Wan with endocrine therapy for breast cancer can exert two major effects.
Ermiao Wan can relieve the osteoporosis caused by endocrine drugs, reducing the side effects of endocrine therapy in patients. Many patients develop joint pain while taking endocrine drugs for breast cancer, and this is precisely what Ermiao Wan treats. Of course, while taking Ermiao Wan, it is best also to supplement calcium tablets and get sunlight.
Erzhi Wan, for its part, can assist endocrine therapy by inhibiting estrogen. The author has used Ermiao Wan alone to treat breast cancer patients with elevated CA125, and this one drug alone could lower CA125 in some estrogen- and progesterone-receptor-positive patients. In addition, Erzhi Wan has a liver-protective effect and provides some protection against liver injury during endocrine therapy for breast cancer. Erzhi Wan can also improve the hot flashes, profuse sweating, dry throat and mouth, irritability and insomnia that frequently occur in breast cancer patients receiving endocrine therapy. If the profuse sweating is not sufficiently resolved by Erzhi Wan alone, Baihe Gujin Wan can be added.
Therefore, pairing Ermiao Wan and Erzhi Wan with endocrine drugs to treat breast cancer is an economical, cost-effective, and well-targeted regimen. However, the number of cases the author has treated with this regimen so far is still small; only a few patients have indeed achieved symptomatic relief, which is not yet enough to demonstrate the universal applicability of this regimen. It is hoped that interested colleagues can carry out further clinical research on this approach.