My Medical Thoughts 5
Medication should be administered step‑by‑step; drug withdrawal ought to proceed slowly; relapse prevention needs scientific‑based strategies.
I advocate the characteristic therapy of large‑scale compound prescriptions with multi‑target effects. Having practised this therapy clinically for over ten years, I have witnessed its curative effects firsthand and summed up certain medication‑administration rules. Even though I have not yet managed to accelerate research on this therapy via combined large‑scale animal and human trials, clinical practitioners of traditional Chinese medicine (TCM) can still adopt it for disease treatment. Compound prescriptions have long stood at the heart of TCM treatment, and a large‑scale compound prescription is merely a formula containing more medicinal ingredients.
To further refine the theoretical framework of the multi‑target characteristic therapy with large‑scale compound prescriptions, I will elaborate on its medication rules, drug‑withdrawal protocols and follow‑up principles after treatment. These are concisely summed up in the three short sentences of the title: Medication should be administered step‑by‑step; drug withdrawal ought to proceed slowly; relapse prevention needs scientific‑based strategies.
First, let us discuss step‑by‑step medication administration.
When prescribing medicines for patients, practitioners shall follow the principle of starting with fewer herbal ingredients and low doses before making gradual increases. Naturally, once you gain proficient command of this method and verified the high safety profile of your customized large‑scale compound formulas through clinical practice, this procedure may be simplified.
Nevertheless, you must strictly abide by this principle while you are learning and applying the therapy. It serves as the bottom‑line safeguard for both patient safety and the practitioner’s professional safety. Carry out medication adjustments incrementally, closely observe the patient’s reactions to medicines, keep track of their blood routine and biochemical indicators based on patient feedback, and tweak dosages in a timely manner so as to avert severe side‑effects.
During my clinical apprenticeship, my retired‑and‑rehired TCM mentor stressed to me time and again that practitioners stay safe only when their patients stay safe, and medicines must be prescribed with extreme caution. To cultivate my prudent work ethic, she meted out strict penalties for my slightest operational mistakes. She also required me to memorize professional codes for doctors across departments to strengthen my safety awareness. Up to this day, I remain deeply grateful for her rigorous training.
As mentioned in earlier chapters of this book, I recommend pills, powders, ointments and pellets rather than herbal decoctions when deploying the large‑compound multi‑target therapy for intractable illnesses. Pills, powders, ointments and pellets allow for easier dosage control, deliver superior clinical safety and bring greater economic benefits to patients.
Pills are spherical preparations made from processed Chinese herbs. Powders are fine ground herbal particles. In the old days, patients took powders infused in hot water; nowadays, patients may fill the fine powder into empty capsules for oral intake. Ointments are thick extracts simmered from herbal ingredients. Pellets are essentially equivalent to pills, except that ancient pellet‑making included extra heating and refining procedures.
Patients should also start with low doses and raise intake gradually for pills, powders, ointments and pellets.
It is highly necessary to advise patients to pause medication for several days after each course of treatment. For illnesses such as cancer and sequelae of stroke, I generally instruct patients to take medicine for five days and suspend intake for two days, and conduct regular liver‑and‑kidney‑function re‑examinations to guarantee patient safety.
Next comes slow and gradual drug withdrawal.
Patients suitable for this large‑compound multi‑target TCM therapy suffer from intractable diseases, which usually entail long‑term treatment cycles ranging from several months to multiple years. Once treatment yields favourable results, slow‑tapering withdrawal plans should be arranged.
Complete recovery from such conditions, especially cancer, can hardly be confirmed. Medical examinations can only detect the disappearance of tumours and normalised tumour markers. We cannot distinguish whether cancer cells have entered a dormant state or been thoroughly eliminated. Given cancer’s tendency toward recurrence and metastasis, I suggest patients continue medication for a period to consolidate therapeutic effects after tumours vanish and tumour markers return to normal ranges.
During the consolidation phase, medication frequency and dosage shall be lowered little by little. For instance, three daily doses may be gradually reduced to two. After three to six months of consolidated treatment, the dosage frequency can be further cut down to once per day with appropriately lowered intake.
You may then stop medication and launch regular follow‑ups after a period of consolidated therapy. Patients are reminded to receive routine check‑ups throughout follow‑up sessions. All physical indicators require close monitoring; medication shall be resumed once early warning signs of index rebound emerge.
Some of my cancer patients have remained off medication for over five years, and one for as long as a decade, with zero recurrence. A small number of patients experienced a sudden rise in tumour markers after ceasing treatment. Their markers dropped back to normal after resuming the previous medicine, and they then returned to observation status.
These fortunate cases remain rare. Most patients cannot achieve such ideal treatment outcomes. Even so, TCM treatment achieves high success rates in improving patients’ quality of life and extending survival time. This stems from cancer’s unique pathological traits, alongside the common scenario in which most cancer patients seek TCM intervention only in the advanced or terminal stage — groups with inherently low cure rates.
Learners of this large‑compound multi‑target TCM characteristic therapy need to fully grasp its complete set of philosophies. Failure to comprehend its core ideas patiently and comprehensively may trigger unforeseeable clinical risks.