Experience with Modified Zengye Chengqi Decoction for Acute Intestinal Obstruction as a Cancer Complication
Patient Hairuo developed acute intestinal obstruction due to interventional therapy and tumor effects. At Sichuan Provincial Cancer Hospital, after multiple interventions failed, the patient suffered abdominal distension and pain from the obstruction, gradually intensifying to unbearable agony. The attending physician proposed surgery to resolve the obstruction, but the patient feared surgery and consulted me. I firmly opposed surgery. I prescribed modified Zengye Chengqi Decoction (Fluid-Increasing Purgative Decoction):
Xuanshen (Scrophulariae Radix) 30g, Shengdi (Rehmanniae Radix recens) 24g, Maidong (Ophiopogonis Radix) 24g, Mangxiao (Natrii Sulfas) 30g (taken in two divided doses, dissolved in the decoction), Dahuang (Rhei Radix et Rhizoma) 30g (added later), Danggui (Angelicae Sinensis Radix) 12g, Baishao (Paeoniae Radix alba) 12g
Because this patient was a bleeding patient, this formula was chosen also with the aim of stopping bleeding.
About ten hours after taking the medicine, the patient had five or six severe bowel movements; the intestinal obstruction was resolved, the colicky abdominal pain ceased, strength returned, and the patient could eat.
Western medicine readily resorts to surgery for intestinal obstruction. After an operation, the patient's constitution declines sharply; for late-stage cancer patients this is almost a catastrophe. At such times using Chinese medicine to solve the problem is rapid, safe, and has few side effects. Yet doctors in Western hospitals, when handling such problems, discriminate against TCM treatment recommendations and often refuse to let patients take Chinese medicine, which is deeply regrettable.
During intestinal obstruction, the entire Chengqi (Order-the-Qi) Decoction series may be selected according to the patient's actual condition, and most are markedly effective. Yet clinically many doctors use them without effect. The key lies in using too small a dose of Dahuang; they dare not use 30g. In such cases, only a large dose can solve the problem. But with such doses, one must remember: once the symptoms resolve, immediately stop taking such a harsh formula, lest it injure the patient's body.
Previously, another late-stage intestinal cancer patient developed a similar situation; my prescribing approach was much the same. Not only did the Western doctors at that hospital fail to cooperate, but the TCM doctor the family found to review the prescription, upon seeing it, was frightened and dared not transfer the formula, believing one dose would be enough to kill the patient. The family was terrified and dared not fill the prescription, so the patient finally progressed to an unredeemable state. It is most regrettable.