Veteran Physician Liu Yaxian's Empirical Formula for Chemotherapy-Induced Liver Damage

Cancer patients undergoing chemotherapy, or taking anticancer Chinese herbs or patent medicines, often develop liver-function impairment. In clinical practice, veteran physician Liu Yaxian developed an empirical formula for repairing liver function, which he named Jia Yi Jian.

Jia Yi Jian is composed as follows: Yinchen 10 g, Fuling 15 g, Yiyiren 15 g, Peilan (Eupatorii Herba) 10 g, Zexie 10 g, Yujin 10 g, Chaihu 10 g, Lianqiao (Forsythiae Fructus) 10 g, Sheng Gancao 10 g. These doses are for adults; for pediatric patients, a doctor should adjust the dose according to the child's age and weight.

This formula fortifies the spleen and transforms dampness, and soothes the liver and harmonizes the stomach. It treats not only liver damage caused by chemotherapy in cancer patients but also that caused by other anticancer drugs, and even liver damage from hepatitis A and B. Any such patient presenting with fatigue, poor appetite, possibly rib pain, abdominal distension, nausea, possibly soreness of the lower back, palpitations and shortness of breath, a red tongue with thin white or thin greasy coating, and a wiry, fine, or slippery pulse may use it.

Yinchen in this formula is a key herb for abnormal liver function; I often use Yinchen alone for patients with abnormal liver function and elevated bilirubin. Yinchen drains dampness and reduces jaundice and is a TCM specific for jaundice. Fuling, Yiyiren, and Zexie are all strong spleen-fortifying, damp-transforming, water-draining herbs; pairing Yinchen with them follows the idea of Yinchen Wuling San. Peilan is an aromatic damp-transforming herb that awakens the spleen. Yujin and Chaihu soothe the liver and move qi, also key herbs in TCM treatment of liver disease. Lianqiao clears heat and resolves toxin; Sheng Gancao resolves toxin and repairs liver injury. Combined, these herbs give good results for cancer patients with abnormal liver function.

Yet this formula is not universally applicable to every cancer patient with abnormal liver function. In clinical use, patients should still consult an experienced TCM physician, who decides whether to use it and how to modify it according to the patient's condition.

Veteran physician Liu gave the following modifications: for abdominal distension, add Houpo 10 g; for severe poor appetite, add Jiao Sanxian 10 g each; for bitter mouth and thick greasy coating, add Baimaogen 10 g and Huashi (Talcum) 10 g; for rib pain, add Yanhusuo 10 g and Chuanlianzi 10 g; for nausea, add Zhuru 10 g.

I believe that, if both restoring liver function and anticancer goals are to be served, one may add to this formula anticancer herbs such as Sanleng, Ezhu, Jianghuang, Ruxiang, Moyao, Zhi Biejia (processed Carapax Trionycis), Sheng Muli, and Beimu; but use cautiously the liver-toxic Banzhilian and Banxia.

If the patient's liver damage is very severe, to avoid mishaps during treatment the priority should first be restoring liver function. Along with the above Chinese herbs, liver-protecting Western drugs may be taken. Patients should also be told to stop smoking and drinking; in severe cases, food should as far as possible be restricted or reduced to speed recovery of liver function.