The Application of Guipi Tang (Spleen-Restoring Decoction) in Cancer Treatment

Guipi Tang is a base formula I am very fond of in treating cancer. When pattern differentiation fits, I prefer it, and it almost always brings surprising results. Especially in patients who have undergone radiation and chemotherapy, as long as differentiation is correct, modified Guipi Tang usually plays a very good adjunctive role.

Guipi Tang is a famous formula that supplements both qi and blood. As a qi-blood tonic alone, Bazhen Tang is better known. But compared with Bazhen Tang, Guipi Tang has the advantage for cancer patients who overthink.

Guipi Tang calms the spirit and nourishes blood, strengthens the spleen and stimulates appetite, and aids sleep. Many cancer patients, upon learning their diagnosis, develop excessive rumination and depression; and cancer itself is a disease that greatly consumes the patient's qi and blood. At such times choosing Guipi Tang is highly appropriate.

But in concrete application, Guipi Tang must be modified according to the patient's own characteristics to avoid side effects and achieve better results.

Guipi Tang comes from Yan Yonghe's Jisheng Fang of the Song dynasty. Yan created it based on the Huangdi Neijing theory that disease of the two yang arises in the heart and spleen. The heart stores the spirit and governs blood; the spleen governs thought and commands blood. Excessive thought taxes the heart and spleen, causing spleen failure to transport and insufficiency of heart blood, presenting as fright palpitations, poor appetite, and bodily fatigue. Many cancer patients show spleen-stomach disharmony, heart-blood insufficiency, restless palpitations, fatigue and lassitude, and loss of appetite; the probability is even higher in patients who have had radiation and chemotherapy. Such conditions are exactly Guipi Tang's indications. At this point, selecting a few additional herbs aimed at symptom and disease differentiation and forming a compound formula usually yields ideal results.

But Guipi Tang tends to support the yang of the heart and spleen; it is not appropriate to use it directly in patients who are constitutionally yin-deficient with internal heat. The original Guipi Tang comprises Renshen, Baizhu, Fuling, Huangqi, Longyanrou (longan aril), Suanzaoren (sour jujube seed), Muxiang, Gancao, ginger, and jujube. The Ming physician Xue Lizhai added Danggui and Yuanzhi (Polygala) to Guipi Tang, two herbs that nourish blood, communicate heart and kidney, and calm the spirit. In clinical use, Guipi Tang may serve as a base, adjusted appropriately to the patient's condition.

Constitutionally yin-deficient, internally hot patients may show similar symptoms, but after taking heat-supporting herbs like ginseng, astragalus, and longan, their lung heat and dryness worsen, clinically presenting as vexing heat and thirst. For such patients, one should follow the design idea of Guipi Tang without being bound by its fixed formula: consider replacing Renshen with Shashen (Glehnia) or Taizishen (pseudostellaria), which nourish yin and generate fluids; remove the heat-supporting Longyanrou; replace warm-dry Danggui with blood-nourishing, yin-nourishing herbs such as Ejiao (donkey-hide gelatin); if necessary add Huangqin and Sangbaipi to clear lung heat, and Maidong, Tiandong, Wuweizi, and Tianhuafen to moisten the lung and treat dryness.

Decoctions based on Guipi Tang also work well in postoperative patients; used properly, the patient's constitution recovers rapidly in a short time. Appropriately assisted by anti-cancer herbs, they can effectively control disease progression. For patients with digestive reactions, I often combine Guipi Tang with Xuanfu Daizhe Tang, or Erchen Tang, or Dingxiang Shidi San, effectively reducing vomiting and other gastrointestinal reactions.

For patients needing long-term regulation, consider the patent medicine Guipi Wan in place of Guipi Tang. This not only reduces the economic burden of taking medicine but also achieves the effect of slow treatment with pills, without over-taxing the stomach with too much herbal decoction.