Experience in Treating Poor Appetite in a Gastric Cancer Patient with Modified Guizhi Tang
When Professor Liu Duzhou lectured on the Shanghan Lun (Treatise on Cold Damage), he mentioned that Guizhi Tang (Cinnamon Twig Decoction) can harmonize the nutritive and defensive aspects externally, and harmonize qi and blood, and regulate the spleen and stomach internally. Master Liu said that Guizhi Tang is an acrid-sweet, warm formula that has the action of boosting stomach qi. Therefore this formula is not only a good prescription for treating "Taiyang wind-stroke" among externally-contracted diseases, but also a good prescription for treating poor appetite caused by stomach cold. The author has repeatedly used this formula to treat anorexia that appears in cancer patients after various treatments, and has often achieved surprising results.
The patient introduced in this article, Mr. Liu, is a gastric cancer patient from Dianbai County, Guangdong Province. He developed symptoms of gastric cancer in 2019 but did not pay attention to them. In 2021 his symptoms worsened, and he went to Maoming People's Hospital for examination (patient ID: 589719), where he was diagnosed with poorly differentiated adenocarcinoma. He underwent standard surgery and chemotherapy. On June 19, 2021, he had his first video consultation with the author, seeking a subsequent TCM plan to prevent gastric cancer recurrence; he consulted the author several more times thereafter. Recently, because of poor appetite, he took the Western medicines omeprazole and domperidone (Motilium), with poor effect, and on April 1, 2022, he again sought the author's help via video.
On video, the patient's tongue coating was pale, white, and water-glistening. The patient reported that for the past week his stomach had been uncomfortable, bloated, and vaguely painful. A few days earlier, when symptoms became severe, he switched to eating small, frequent meals (from three meals a day to five), and after taking Motilium and omeprazole he improved slightly, but the effect was unsatisfactory. On the morning of April 1, after eating a little, he felt unbearable gastric distending pain, so he turned to the author. The author judged that this might be inflammation of the anastomosis or residual gastritis.
On inquiry, the patient had no recent cold and no obvious aversion to cold; he dressed about the same as a normal person, but sweated very little. The temperature in Dianbai County, Guangdong, that day was 24°C, with a slight north wind during the Qingming Festival; it felt a little cool but was still fairly warm. Family members reported that after nearly a year of Chinese medicine treatment, the patient's complexion had improved considerably. Recently his stool had been small in amount and rather dry, and his urine was clear in color. His back was numb, and he felt as though there was a foreign object in his stomach that could neither pass downward nor be vomited up.
The author judged that this patient most likely had stomach qi failing to rise and fall normally because the stomach had been attacked by cold. Guizhi Tang could be considered to boost stomach qi, assisted by stomach-warming and food-digesting medicinal herbs.
Prescription: Guizhi (Cinnamomi Ramulus) 10 g, Baishao (Paeoniae Radix Alba) 10 g, Zhigancao (processed Glycyrrhizae Radix) 6 g, Shengjiang (Zingiberis Rhizoma Recens) 7 slices, Dazao (Jujubae Fructus) 7 pieces, Jiaoshanzha (charred Crataegi Fructus) 30 g, Chao Maiya (stir-fried Hordei Fructus Germinatus) 30 g. 2 doses, one dose per day, decocted in water, taken twice daily, once after breakfast and once after dinner. If the above formula is ineffective, the Chinese patent medicine Shugao Hewei Wan (Liver-Smoothing Stomach-Harmonizing Pill) may be tried.
On the morning of April 3, the patient reported that after taking the second dose of medicine he had already improved markedly. From the therapeutic effect in this case we can see that Guizhi Tang indeed has a notable effect in boosting stomach qi and improving appetite.