A Case Report: Nourishing Yin and Subduing Fire Rapidly Shrinking a Lung Adenocarcinoma Tumor

The patient, Ren, female, aged 74, presented for treatment of lung adenocarcinoma.

First visit, February 24, 2016. She had undergone targeted therapy for lung cancer. Findings: teeth-marked tongue; chest pain radiating through to the back; dry mouth; bitter taste in the mouth; bone-steaming sensation and tidal fever; deficient panting; inability to breathe normally through the nose, so she had to breathe through the mouth; frequent nosebleeds; drooling while asleep, with blood-tinged saliva. The pulse was deep, fine, and rapid. The larger lung tumor measured a little over 2 cm.

On comprehensive pattern differentiation, I judged the patient to have yin deficiency with effulgent fire, and the treatment principle was to nourish yin and subdue fire. Modified Biejia Qinghao Decoction (Soft-shelled Turtle Shell and Sweet Wormwood Decoction) was used, together with oral Zhi Bai Di Huang Wan (Anemarrhena-Phellodendron Rehmannia Pill) and Xi Huang Wan (Rhinoceros-Bezoar Pill).

Prescription at the first visit:

Qinghao (Artemisiae Annuae Herba) 9 g, Zhimu (Anemarrhenae Rhizoma) 6 g, Sangye (Mori Folium) 6 g, Zhi Biejia (processed Trionycis Carapax) 15 g [decoct first], Danpi (Moutan Cortex) 6 g, Tianhuafen (Trichosanthis Radix) 6 g, Huangjing (Polygonati Rhizoma) 15 g, Maozhaocao (Ranunculus Ternati Radix) 30 g, Banzhilian (Scutellariae Barbatae Herba) 10 g, Baihuasheshecao (Hedyotidis Diffusae Herba) 10 g

Zhi Bai Di Huang Wan, twice a day.

Xi Huang Wan, once a day before bed, 6 g each time, taken with warm water; after taking, cover with a blanket to promote sweating—a slight sweat is best.

Take the medicine for one week, then stop for one week.

After taking the medicine, the patient's various symptoms eased. She later reported that symptoms such as chest pain were hard to control once the medicine was stopped, and she asked to take it continuously; I therefore instructed her to take the medicine for five days and stop for two.

On May 5, at the follow-up visit, the tumor had shrunk from just over 2 cm to 0.9 cm. The bone-steaming, tidal fever, and epistaxis and oral bleeding were gone, but she felt nausea and vomiting when taking Xi Huang Wan. She could now breathe through her nose, and her strength had improved markedly. The pulse was deep and fine, no longer rapid; there was slight inflammation in both lungs, with signs of chronic liver injury caused by the targeted drug.

As the treatment took effect, the patient and her family began to have confidence in my treatment and cooperated closely.

Zhi Bai Di Huang Wan is too bitter and cold to be taken long-term. The tumor was still present, so Xi Huang Wan could not be discontinued. At the second visit, Zhi Bai Di Huang Wan was changed to Liu Wei Di Huang Wan (Rehmannia Six-Ingredient Pill), and the decoction was modified on the basis of the prior formula, focusing on fortifying the spleen and nourishing the kidneys.

Prescription: Sheng Huangqi (raw Astragali Radix) 15 g, Taizishen (Pseudostellariae Radix) 30 g, Fuling (Poria) 15 g, Chao Baizhu (fried Atractylodis Macrocephalae Rhizoma) 10 g, Zhi Gancao (honey-fried Glycyrrhizae Radix) 6 g, Baiji (Bletillae Rhizoma) 15 g, Chaihu (Bupleuri Radix) 10 g, Huangqin (Scutellariae Radix) 10 g, Qinghao (Artemisiae Annuae Herba) 10 g [add later], Zhi Biejia (processed Trionycis Carapax) 15 g [decoct first], Zhimu (Anemarrhenae Rhizoma) 6 g, Sangye (Mori Folium) 6 g, Maozhaocao (Ranunculus Ternati Radix) 30 g, Mudanpi (Moutan Cortex) 6 g, Tusizi (Cuscutae Semen) 10 g, Nüzhenzi (Ligustri Lucidi Fructus) 10 g, Shayuanzi (Astragali Complanati Semen) 10 g, Jinqiaomai (Fagopyri Cymosi Herba) 15 g, Jiaogulan (Gynostemmae Pentaphylli Herba) 15 g, Yuxingcao (Houttuyniae Herba) 6 g, Banzhilian (Scutellariae Barbatae Herba) 10 g, Baihuasheshecao (Hedyotidis Diffusae Herba) 10 g, Jiao Sanxian (charred three digestive-medicines), each 30 g, Pian Jianghuang (curcuma longa slice) 6 g, Jiangcan (Bombyx Batryticatus) 10 g, Chanyi (Cicadae Periostracum) 6 g

Liu Wei Di Huang Wan, twice a day.

Xi Huang Wan, once a day, in the same dose and manner as at the first visit.

The patient was instructed to return for follow-up after two months of treatment, and to call at any time if she felt unwell.

The subsequent outcome is currently being observed.

This patient responded rapidly and clearly to treatment because her symptoms were typical, making it easy to find a corresponding treatment plan. In clinical practice, many patients present atypical symptoms and are far more difficult to treat.