Xiangsha Yangwei Wan: A Common Spleen-Fortifying, Stomach-Nourishing Medicine for Cancer Patients
Because cancer patients need to take Chinese and Western medicines over a long period, they easily lose their appetite from too much medication and develop a series of symptoms of drug-induced stomach injury. Personally I commonly use three medicines to solve this problem: first, Guizhi Tang, which I have recommended before; second, Xiangsha Liujun Wan; and third, Xiangsha Yangwei Wan. Each medicine has its own indications; today I will introduce the indications for Xiangsha Yangwei Wan.
Xiangsha Yangwei Wan is a Chinese warming-internal formula; it has the effect of warming the middle and harmonizing the stomach. It mainly treats stomachache and glomus-fullness due to insufficiency of stomach yang and dampness obstruction with qi stagnation, presenting as dull stomach pain, stuffy discomfort in the epigastrium, vomiting of acid water, gnawing discomfort, lack of appetite, and fatigue of the limbs.
Both Xiangsha Yangwei Wan and Xiangsha Liujun Wan developed from the famous spleen-fortifying and qi-boosting formula Sijunzi Tang. Xiangsha Yangwei Wan is composed of muxiang (Aucklandia), sharen (Amomum), baizhu (atractylodes macrocephala), chenpi (tangerine peel), fuling (poria), banxia (processed pinellia), vinegar-processed xiangfu (cyperus), zhishi (immature bitter orange, stir-fried), doukou (cardamom, hulled), ginger-processed houpo (magnolia bark), guanghuoxiang (patchouli), and gancao (licorice). It has the effects of fortifying the spleen and moving qi, dispersing distention and fullness, and soothing the liver and relieving pain; it is used for gastrointestinal patients in whom qi deficiency is not marked but qi stagnation is relatively severe.
In the formula, baizhu boosts the middle qi; TCM holds that the spleen is the central earth, which likes dryness and dislikes dampness, and baizhu has the function of fortifying the spleen and transforming dampness, so it can awaken the spleen and open the appetite. Banxia dries dampness and fortifies the spleen. Fuling promotes urination and seeps dampness, and is also a commonly used spleen-fortifying and middle-boosting herb. Xiangfu, muxiang, chenpi, houpo, sharen, and doukou all belong to the qi-moving herbs; they soothe and free the qi dynamic, transform dampness, warm the middle, and also relieve pain. Xiangfu additionally soothes the liver and resolves constraint. Zhishi additionally resolves stagnation and disperses accumulation. Licorice harmonizes the various herbs and also boosts qi and fortifies the middle. Thus the combined herbs warm the middle and harmonize the stomach.
Patients taking targeted drugs or Chinese "poison-to-attack-poison" anti-cancer medicines often develop poor appetite. Some heat-clearing, toxicity-resolving, swelling-dispersing Chinese patent medicines, such as Xihuang Wan and Kushen Pian, also cause the side effects of acid regurgitation, heartburn, epigastric pain, and vomiting of acid water. All of these result from the adverse irritation of the digestive tract by the medicines, so such patients, when taking the above drugs, had better take them together with Xiangsha Yangwei Wan to reduce the side effects.
There are also some cancer patients with diabetes who frequently take metformin and other hypoglycemic drugs; these medicines also have the side effect of irritating the digestive tract, and long-term use causes epigastric pain and acid regurgitation with heartburn. I also often use Xiangsha Yangwei Wan together with them, with good results. This medicine is also used today to treat chronic superficial gastritis or atrophic gastritis presenting with the above symptoms.
But the key to stomach disease still lies in nourishing it. Patients with poor stomach health must rest properly, must not stay up late, must not binge eat, must not drink alcohol or crave spicy, irritating, or pickled foods; in addition, they must pay attention to how they take their medicine.
When I personally prescribe medicine for patients, I advise non-emergency patients to take medicine for five days and rest for two; maintenance-phase patients may even take medicine for three or four days and stop for three or four days. This can reduce the damage the drugs do to the patient's body and avoid serious side effects.
Xiangsha Yangwei Wan itself also has certain side effects; a few patients develop allergic reactions such as urticaria after taking it, so if an allergic reaction appears, the medicine should be stopped and the patient should contact a doctor. One must not be careless merely because one believes Chinese medicine has no side effects.
By the way, patients who develop skin allergic reactions while taking medicine may have a kidney connection.
In 2019 I (the author) encountered a patient prone to severe skin allergies after medication. Whether she received chemotherapy or took stimulating Chinese medicines, she developed very severe skin allergies, such that neither Chinese nor Western physicians dared to give her drugs.
I suspected that the patient's skin allergy might be related to impaired kidney function; after giving her yimucao (motherwort) granules to improve her renal function, her kidney function improved markedly, and she no longer developed allergies when taking Chinese and Western medicines. However, this is only an isolated case, insufficient to prove the point; I offer this case for the reader's reference only.