TCM Case: Mr. Zhu with Pancreatic Cancer and Diffuse Hepatic Metastases
Mr. Zhu, male, 70 years old, a resident of Kaifeng, Henan Province. A patient with pancreatic cancer and multiple diffuse hepatic metastases; he had recently undergone CAR-T bio-immunotherapy at the 301 Hospital, which failed. The disease progressed rapidly, with progressive weight loss; six metastatic lesions appeared in the liver. He hoped to maintain quality of life and reduce suffering through TCM treatment.
He first visited in early November 2015; the pulse record is lost. His main complaint was abdominal discomfort. Based on the original prescription records provided by the family, the first formula was as follows:
Chaihu (Bupleuri Radix) 9 g, Huangqin (Scutellariae Radix) 9 g, Chenpi (Citri Reticulatae Pericarpium) 6 g, Houpo (Magnoliae Cortex) 6 g, Fabanxia (Pinelliae Rhizoma Praeparatum) 15 g, Dangshen (Codonopsis Radix) 15 g, Tusizi (Cuscutae Semen) 9 g, Shayuanzi (Astragali Complanati Semen) 9 g, Nvzhenzi (Ligustri Lucidi Fructus) 12 g, Mohanlian (Ecliptae Herba) 12 g, Maidong (Ophiopogonis Radix) 12 g, Shengdi (Rehmanniae Radix) 15 g, Xuanshen (Scrophulariae Radix) 12 g, Zhebeimu (Fritillariae Thunbergii Bulbus) 12 g, Sheng Muli (Ostreae Concha) 30 g, Haizao (Sargassum) 15 g, Kunbu (Eckloniae Thallus) 15 g, Jianghuang (Curcumae Longae Rhizoma) 6 g, Jiangcan (Bombyx Batryticatus) 10 g, Chanyi (Cicadae Periostracum) 6 g, Lingzhi (Ganoderma) 30 g, Huangjing (Polygonati Rhizoma) 10 g, Yuzhu (Polygonati Odorati Rhizoma) 10 g, Sheng Huangqi (Astragali Radix) 30 g, Baishao (Paeoniae Radix Alba) 12 g, Chishao (Paeoniae Radix Rubra) 12 g, Zhigancao (Glycyrrhizae Radix Praeparata) 6 g, Danggui (Angelicae Sinensis Radix) 12 g, Baihuasheshecao (Oldenlandiae Herba) 30 g, Qiancao (Rubiae Radix) 12 g
Initially take one dose every two days, gradually increasing to one dose daily, taken twice a day.
Patent medicines: Ruimusheng (Lactasin), Gancaoxin (licorice zinc), Pingxiao Pian.
After taking the medicine, the patient's symptoms improved markedly, but there was slight nausea. The formula was changed to:
Shengshen (Ginseng Radix, sun-dried) 6 g (decocted separately and added, or ground and swallowed), Daizheshi (Haematitum) 6 g, Xuanfuhua (Inulae Flos) 10 g (wrapped), Fabanxia 10 g, Zhigancao 6 g, Jianghuang 6 g, Jiangcan 10 g, Chanyi 6 g, Shudahuang (Rhei Radix et Rhizoma Praeparatum) 3 g, Zhi Biejia (Testudinis Carapax Praeparatum) 15 g, Banzhilian (Scutellariae Barbatae Herba) 10 g, Baihuasheshecao 10 g, Dazao (Jujubae Fructus) 7 (crushed), Shengjiang (Zingiberis Rhizoma Recens) 5 slices; one dose daily, divided into three doses, taken one hour after meals. Xihuang Wan twice daily, 3 g each time.
After taking the above, the patient felt it was inferior to the previous formula, so it was changed again:
Sheng Huangqi 30 g, Dangshen 15 g, Fuling 10 g, Baizhu 10 g, Chaihu 10 g, Houpo 10 g, Zhishi 10 g, Baishao 10 g, Chishao 10 g, Fabanxia 10 g, Huangqin 10 g, Sheng Gancao (Glycyrrhizae Radix) 6 g, Jianghuang 10 g, Jiangcan 10 g, Banzhilian 20 g, Baihuasheshecao 20 g, Huzhang (Polygoni Cuspidati Rhizoma) 15 g, Jiao Sanxian (each) 10 g, Tengligen (Actinidiae Radicis) 20 g, Zhongjiefeng (Sarcandrae Herba) 20 g
One dose every two days, taken twice daily. Take Xihuang Wan 6 g at bedtime; after every six days of dosing, rest two days. Xihuang Wan: take five days, then rest three days.
After taking this formula, the patient's condition was very good: weight stopped falling, and he could live normally. He is still under continued treatment and observation.