TCM Case: A Patient (A Man) with Skull Base Osteosarcoma

Female, age 46, a resident of Yangzhou, Jiangsu Province; first visit on November 25, 2015.

The left pulse was deep, thin, and slippery; the right pulse was deep and slightly thin.

The patient had undergone surgery in Yangzhou for skull base osteosarcoma, as well as for bile reflux gastritis and cardiac polyp, treated at Yangzhou Hospital of TCM. Now the tumor had recurred and could not be controlled, so she sought TCM treatment. Her tongue deviated, and speech was obstructed; post-surgical trigeminal neuralgia, tinnitus, a blocked sensation in the throat, and headache were present, especially in the afternoon or evening. Her neck was stiff, the ear cartilages were soft, the stomach often felt hungry, and the right lower back ached.

The prescription was drafted as follows:

Sheng Mahuang (Ephedrae Herba) 2 g, Paojiang (Zingiberis Rhizoma Praeparatum) 2 g, Rougui (Cinnamomi Cortex) 4 g (ground, swallowed in suspension), Fabanxia (Pinelliae Rhizoma Praeparatum) 10 g, Baifuzi (Typhonii Rhizoma) 6 g, Dannannan (Arisaema cum Bile) 6 g, Wuzeigu (Sepiae Endoconcha) 15 g, Jiangcan (Bombyx Batryticatus) 10 g, Quanxie (Scorpio) 0.5 g (ground, swallowed in suspension), Wugong (Scolopendra) 0.5 g (ground, swallowed in suspension), Tubeimu (Bolbostemmatis Rhizoma) 10 g, Tengligen (Actinidiae Radicis) 30 g, Baizhi (Angelicae Dahuricae Radix) 6 g

One dose per day, taken all at once one hour after breakfast.

Xihuang Wan: 3 g on day 1, 6 g on day 2, 9 g on day 3, 12 g on day 4, 12 g on day 5, 12 g on day 6, 12 g on day 7.

Xihuang Wan once daily, taken at bedtime with warm yellow wine, all at once.

After taking the medicine, the pain and stiffness disappeared, but the stools became dry and constipated. The formula was too warming and drying.

The prescription was adjusted as follows:

Sheng Mahuang 2 g, Paojiang 2 g, Rougui 4 g (ground, swallowed in suspension), Fabanxia 10 g, Baifuzi 6 g, Dannannan 6 g, Jiangcan 10 g, Quanxie 0.5 g (ground, swallowed in suspension), Wugong 0.5 g (ground, swallowed in suspension), Tubeimu 10 g, Tengligen 30 g, Baizhi 6 g, Jianghuang (Curcumae Longae Rhizoma) 6 g, Shudahuang (Rhei Radix et Rhizoma Praeparatum) 10 g (added in the last five minutes; reduce the dose if diarrhea occurs, or increase the dose or switch to raw Dahuang if the stool remains obstructed), Danggui (Angelicae Sinensis Radix) 10 g, Sangbaipi (Mori Cortex) 15 g, Maidong (Ophiopogonis Radix) 15 g