Qingzao Jiufei Decoction for Adjuvant Treatment of Lung Cancer
Qingzao Jiufei Tang (Dryness-Clearing Lung-Rescuing Decoction) is a celebrated Chinese medicine formula for respiratory diseases. It comes from Yimen Falü (Medical Principles and Laws) by Yu Chang, a famed physician of the early Qing. Yu Chang (style name Jiayan, hao Xichan Laoren) lived from the late Ming into the early Qing. His life was remarkable: he was a gongsheng during the Chongzhen reign of the Ming, became a Buddhist monk after the dynasty fell, then left the order to devote himself to medicine. He attained profound skill, his reputation was unrivaled, and he ranks with Zhang Luoyu and Wu Qian as one of the "Three Great Masters of the Early Qing." His Yiyi Cao and Yimen Falü are recognized classics of Chinese medicine.
Qingzao Jiufei Tang, also called Jiufei Tang, consists of Sangye (mulberry leaf), duan Shigao (calcined gypsum), Maidong (Ophiopogon), Zhi Pipaye (honey-fried loquat leaf), Gancao (licorice), Chao Huziren (fried sesame seed), Ejiao (donkey-hide gelatin), Chao Xingren (fried apricot kernel), and Renshen (ginseng). Traditional Chinese medicine holds that it treats dryness-fire damaging the lung, with chills and fever, rapid wheezing and counterflow qi, incessant cough, blood-streaked sputum, and in severe cases stomach counterflow with vomiting of phlegm-saliva and a restless, rapid pulse.
Professor Yin Huihe, in applying this formula by pattern differentiation, pointed out that cough and wheeze must distinguish phlegm from froth: phlegm is produced by water-dampness, usually comes in clumps, and is relatively easy to expectorate; froth is produced when dryness-heat scorches lung yin, is small in amount, sticky, light as flying catkins, and adheres stubbornly and is hard to bring up. Clinically, whenever a patient—whether with other lung disease or advanced lung cancer—presents with difficult expectoration of white frothy sputum, this formula may be used to relieve the symptom.
The author has used Qingzao Jiufei Tang, following Professor Yin's pattern differentiation, to treat lung-cancer and nasopharyngeal-cancer patients presenting these symptoms, and it indeed relieves symptoms and eases suffering. Building on this approach, combining it with anticancer drugs has helped prolong survival.
Professor Yin once treated a lung-cancer patient after radiotherapy. On presentation the patient was frail, haggard, with paroxysmal spasmodic cough like pertussis, dry mouth, difficult expectoration of light sticky white froth, dry sore throat, a red tongue with scant coating, and a thin rapid pulse. Professor Yin identified this as a Qingzao Jiufei Tang indication and prescribed the modified formula:
Sangye 10 g, Sangbaipi (Morus root bark) 15 g, Xingren (apricot kernel) 10 g, Maidong (Ophiopogon) 12 g, Ejiaozhu (pearl-shaped Ejiao) 10 g, Sheng Shigao (raw gypsum) 30 g (decocted first), Pipaye (loquat leaf, brushed free of hairs) 10 g, Shashen (Glehnia) 15 g, Shihu (Dendrobium) 10 g, Qingdai (indigo) 5 g (wrapped), Hafen (clam shell powder) 15 g (wrapped), Quanxie (scorpion) 5 g, Lugen (reed root) 30 g, Yuxingcao (Houttuynia) 30 g, Baihua Sheshengcao (Oldenlandia) 30 g, Banzhilian (Scutellaria barbata) 18 g.
After seven doses, wheezing settled and cough lessened, and chest oppression was largely relieved. Thereafter Sangye and Yuxingcao were removed and the formula taken for over a month (Professor Yin instructed one dose every other day rather than daily). The patient reported good effect, marked symptom relief, and much improved quality of life.
Professor Yin prescribed frugally for the patient's sake, and in his era many anticancer patent medicines now proven useful were not yet in clinical use, so his formula was relatively simple. His case record only notes symptom improvement; no tumor shrinkage is mentioned.
I believe that, building on Professor Yin's pattern differentiation, simultaneously applying disease differentiation—adding anticancer agents such as Fufang Banmao Capsule and Xihuang Wan—might yield still better results.
Lung cancer is a serious, stubborn disease and hard to treat. In my experience, abandoning pattern differentiation leaves the patient's clinical symptoms unresolved; abandoning disease differentiation makes the tumor hard to eliminate. Combining the two multiplies the therapeutic effect.