Experience in Treating Gastric Bloating, Stomach Pain, Hiccups, Vomiting and Acid Regurgitation Caused by Upper Digestive Tract Cancer
Patients with advanced upper digestive tract cancer (esophageal cancer, cardiac carcinoma or gastric cancer) usually develop, as the disease progresses, symptoms such as gastric bloating, stomach pain, hiccups, vomiting, acid regurgitation and heartburn. By this stage most patients already have distant metastases, and cure by traditional Chinese medicine (TCM) is unlikely. However, TCM pattern differentiation and treatment (symptomatic supportive care) can relieve the suffering brought by the tumor.
The distress of such patients cannot be relieved by a single simple classical formula; treatment must take their many symptoms into account and make use of a large combination formula (da fu fang). The advantage of a large combination formula is that it comprehensively addresses the patient's various complaints, effectively relieves the symptoms and improves quality of life. Such hospice care has real positive meaning.
This year I provided hospice care for a patient from Hebei province with upper digestive tract cancer. The patient presented with stomach pain, gastric bloating, hiccups, vomiting, acid regurgitation, heartburn, dry mouth and loose stools. Previous doctors had mostly treated her with simple prescriptions, which failed to relieve her suffering.
Because the patient had so many symptoms that no single simple prescription could relieve them, I tailored her clinical symptoms by combining and modifying several formulas: Er Chen Tang (Two-Aged Decoction), Xuanfu Daizhe Tang (Inula and Haematite Decoction), Ping Wei San (Stomach-Calming Powder), Si Shen Wan (Four-Miracle Pill), Dingxiang Shidi San (Clove and Persimmon Calyx Powder), Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction), Xiao Luo Wan (Scrofula-Dissolving Pill) and Wu Ji San (Bletilla and Cuttlefish Bone Powder). Er Chen Tang was used to stop vomiting; Xuanfu Daizhe Tang, Dingxiang Shidi San and Jupi Zhuru Tang to treat hiccups; Ping Wei Wan to relieve gastric bloating; Si Shen Wan to relieve loose, watery stools; Wu Ji San to suppress acid and relieve pain; and Xiao Luo Wan to fight cancer and disperse swelling. Additional symptom-specific and anticancer herbs were added, and all were used together.
The prescription was as follows:
Chen Pi (Citrus Reticulata Pericarpium) 10 g, Fa Ban Xia (processed Pinelliae Rhizoma) 10 g, Huo Xiang (Agastachis Herba) 6 g, Pei Lan (Eupatorii Herba) 10 g, Zisugeng (Perillae Caulis) 6 g, Sha Ren (Amomi Fructus) 3 g, Xuanfuhua (Inulae Flos) 10 g (wrapped, decocted first), Daizheshi (Haematitum) 10 g (same wrapping, decocted together), Zhuru (Bambusae Caulis in Taeniam) 10 g, Fuling (Poria) 10 g, Renshen (Ginseng Radix) 6 g, Shidi (Kaki Calyx) 10 g, Dingxiang (Caryophylli Flos) 6 g, Cangzhu (Atractylodis Rhizoma) 6 g, Houpo (Magnoliae Cortex) 10 g, Zhi Pipaye (processed Eriobotryae Folium) 10 g, Caoguo (Tsaoko Fructus) 3 g, Roudoukou (Myristicae Semen) 6 g, Zhuyu (Evodiae Fructus) 3 g, Huanglian (Coptidis Rhizoma) 6 g, Baiji (Bletillae Rhizoma) 10 g, Wuzeigu (Sepiae Endoconcha) 10 g, Danggui (Angelicae Sinensis Radix) 10 g, Zhibiejia (processed Amydae Carapax) 18 g (decocted first), Shengdihuang (Rehmanniae Radix) 15 g, Xuanshen (Scrophulariae Radix) 12 g, Zhe Beimu (Fritillariae thunbergii Bulbus) 12 g, Shengmuli (Ostre Concha) 30 g (decocted first together), Xianhecao (Agrimoniae Herba) 50 g, Banzhilian (Scutellariae barbatae Herba) 30 g, Baihuasheshecao (Hedyotidis Herba) 30 g, Shandougen (Sophorae tonkinensis Radix) 10 g, Jixueteng (Spatholobi Caulis) 30 g, Chaomaiya (fried Hordei Fructus germinatus) 30 g, Shihu (Dendrobii Caulis) 15 g, Xiaoji (Cirsii Herba) 20 g, Shiwei (Pyrrosiae Folium) 30 g, Tengligen (Actinidiae Radix) 30 g.
One dose daily, decocted twice with water, divided into 3-4 portions and drunk, preferably after meals. Take 3-5 doses and observe the effect.
After the very first dose the patient's symptoms already eased; after four doses she no longer had hiccups, vomiting, stomach pain or bloating. However, the patient was already in the terminal stage with numerous metastatic lesions, and she eventually passed away from systemic organ failure because the disease was too severe. During her final days, this formula improved her quality of life and reduced her suffering, meeting the psychological expectations of both the patient and her family.
Many people criticize TCM large combination formulas, yet in the clinical practice of treating advanced cancer patients, large combination formulas often outperform small prescriptions. This is an undeniable fact. However, commanding a large combination formula requires fairly deep TCM grounding and rich clinical experience. TCM practitioners researching cancer must ordinarily study a great deal of formulology and Chinese materia medica; the more they know about the indications of common formulas and herbs, and the more proficiently they apply them, the greater help they can offer patients in clinical practice.