TCM Emergency Hemostasis for Gastric Bleeding in Gastric Cancer Patients
Gastric bleeding is a common complication of gastric cancer. When the gastric tumor reaches a certain size, tumor ulceration or rupture of gastric vessels caused by the large tumor frequently leads to this complication.
In most gastric cancer patients, gastric bleeding is a gradual process. At the onset the patient hardly notices it, merely feeling fatigue and cold aversion, with darker stools; in severe cases the stool is black (like the stool the day after eating pig or duck blood). When bleeding is heavy, the patient vomits coffee-ground/bituminous vomitus, with fatigue, cold limbs, sweating, fright palpitations, or restlessness. Some gastric cancer patients have long-term slight gastric bleeding without knowing it, and over time become anemic.
Severe gastric bleeding requires urgent hospital emergency care, but when emergency care is unavailable, or when the patient's bleeding is not severe but has dragged on, family members may use some home measures to relieve the patient's suffering.
When bleeding is heavy and the patient shows collapse, use Renshen Tang (decoct Renshen alone into a strong concentrated broth, 10–50g; or grind into powder and take 2–3g frequently with water) as emergency aid, or take the patent medicine Shengmai Yin (Renshen formula). Once the patient's spirit has somewhat recovered, use Zhixue Fumai Heji (hemostasis and pulse-restoring mixture; ingredients: Ejiao,附子 Aconiti Lateralis Praeparata, Chuanxiong, Dahuang) to stop bleeding, or frequently take Yunnan Baiyao to stop bleeding. In addition, the patent medicine Sanqi Pian (made from Sanqi, Radix Notoginseng) or Sanqi Xuening Jiaonang (made from Sanqi, Chonglou Rhizoma Paridis, processed Caowu, Daye Zizhu Folium Callicarpae, Shanyao, Heizui Lilu, and Bingpian Borneolum) has similar hemostatic action.
When gastric bleeding is severe, the usage and dosage of hemostatics should not follow the package insert. For example, using Yunnan Baiyao to stop gastric bleeding may be given every 15–30 minutes, 1–2 capsules each time. If Yunnan Baiyao is taken only four times a day, each dose may be 4–8 capsules.
The Chinese herb Baiji (Bletilla striata tuber) has excellent hemostatic action on gastric bleeding. One may use 30–60g Baiji alone, decocted for oral hemostasis, or grind Baiji into powder and take 2–3g every 15–30 minutes. The common rural herb Fengweicao (Pteris multifida) is also a fine hemostatic; it treats gastric bleeding and also relieves pain, suiting patients with gastric bleeding plus stomach pain. The patent medicine Zhixue Dingtong Pian (hemostatic, pain-relieving tablets; made from Sanqi, calcined Huaruishi, Haipiaoxiao cuttlebone, and Gancao) can both stop bleeding and relieve pain.
Gastric cancer patients must long watch their stool color. When stools are the normal yellow, gastric bleeding has generally not occurred; when stools are very dark or black stools appear, one must be alert. After treatment one should also watch stool color; a change from black to yellow indicates the bleeding has been fairly well controlled. Of course, the more scientific method is to go to the hospital and test for fecal occult blood. During treatment one should also check fecal occult blood weekly; if it turns negative, the bleeding has basically stopped; if blood persists in the stool, the problem has not been resolved.