Case Record of Patient Jin Zhuoma from Xi'an with Leiomyosarcoma

Jin Zhuoma, female, 52 years old, from Xi'an, Shaanxi Province. First consultation on December 12, 2015.

Five years earlier, she had undergone total hysterectomy with bilateral adnexectomy for uterine sarcoma. Postoperative pathology showed a well-differentiated leiomyoma, and she had received chemotherapy after surgery. This year the disease recurred and she underwent another surgical resection in November; she is currently receiving chemotherapy. She hoped to use TCM to prevent recurrence and came to Beijing for consultation on December 12.

The left pulse, on both light and medium pressure, was fine and rapid; on heavy pressure it was weak, intermittently breaking and resuming, and choppy. The patient reported that her left atrium was enlarged and she had an irregular heartbeat.

On the right, the cun and guan positions were fine, rapid, soft and weak; the chi position, even pressed deep to the bone, was barely perceptible. She had evening tidal fever each night, especially severe if she went to bed late. While the sarcoma was present, both legs felt cold; now thenar eminences of both hands are red. She speaks rapidly and is irritable; her stools are dry, urine output is scant, and her mouth is dry though she has no desire to drink. The tongue is pale with a red tip, and the sublingual veins are stasis-purple.

I judged the patient to have liver qi stagnation, qi-blood deficiency, yin deficiency with internal heat, and an intermingled yin-yang pattern. I planned treatment with both a decoction and pill medicines.

The decoction was based on Zhonghe Tang (Moderation Decoction): Renshen (Ginseng Root) 6 g, Chenpi (Tangerine Peel) 6 g, Huangqi (Astragalus Root) 5 g, Baizhu (Atractylodes Rhizome) 5 g, Danggui (Angelica Root) 5 g, Baizhi (Angelica Dahurica Root) 5 g, Fuling (Poria) 3 g, Chuanxiong (Sichuan Lovage Rhizome) 3 g, Zaojiaoci (Gleditsia Thorn) 3 g, Ruxiang (Frankincense) 3 g, Moyao (Myrrh) 3 g, Jinyinhua (Honeysuckle Flower) 3 g (added later), Sheng Gancao (Unprepared Licorice Root) 3 g.

Pill medicines: Jiawei Xiaoyao Wan (Modified Free-and-Easy Pill) once in the morning; Huangqi Shengmai Yin (Astragalus Pulse-Generating Drink) once at noon; Zhibai Dihuang Wan (Anemarrhena-Phellodendron Rehmannia Pill) once in the evening.

The decoction and the pills should be taken in alternation. One may take the decoction for a week and then the pills for a week, or take the decoction on odd days and the pills on even days. Medication should be taken in cycles of on-and-off: every five or six days, pause for two days.