Zengye Tang And Zengye Chengqi Tang Are Very Useful For Relieving Constipation And Ileus In Cancer Patients

This is another essay I once published under the pen name Huaici Jushi on Sina Blog, recording some of my own past therapeutic experiences.

In clinical practice I often give Zengye Tang, a famous formula of the Warm-Disease school, for constipation and abdominal distension in late-stage cancer patients; sometimes I also give Sanren Tang (I will detail its use another time, when I have the chance). Here I will discuss the use of Zengye Tang.

Zengye Tang is a formula that moistens the intestines and frees the stool, treating dryness. The herbs are extremely simple: 30g Xuanshen (Scrophularia), 24g Maidong (Ophiopogon), 24g Shengdi (Rehmannia glutinosa raw).

When a patient has mild constipation with irritability and thirst, I use half the dose of Zengye Tang to relieve it—namely 15g Xuanshen, 12g Maidong, 12g Shengdi.

When an elderly, weakened patient has dry stool, Zengye Tang may be augmented with Roucongrong (Cistanche). Considering that genuine Roucongrong is expensive, for some patients in financial difficulty I substitute Yuliren (Prunus humilis seed), Huomaren (Cannabis seed) and Baiziren (Biota seed) for Roucongrong. That is: 15g Xuanshen, 12g Maidong, 12g Shengdi, plus 15–60g Roucongrong, or instead use 6–12g Huomaren, 6–12g Yuliren and 6–12g Baiziren to replace Roucongrong.

One can also achieve the goal by increasing the doses of the herbs in Zengye Tang, but if the patient also has cold-deficient stomach, Zengye Tang should include fresh ginger or Guizhi (Cinnamon twig) to warm the stomach, lest the cold herbs damage the patient's appetite.

If none of the above works, consider Zengye Chengqi Tang—Zengye Tang plus Mangxiao (Mirabilite) and Dahuang (Rheum).

If the patient also has difficult urination, appropriately add diuretic herbs such as Fuling (Poria), Zhuling (Polyporus) and Baizhu (Atractylodes).

Zengye Tang is a relatively safe prescription for moving the bowels. When I use it, augmented, for liver-cancer ascites and lung-cancer pleural effusion, it likewise works; it is much safer than Shizao Tang, Tingli Dazao Xiefei Tang and similar formulas, especially for people weakened by prolonged illness. Abusing harsh, aggressive herbs may clear the pleural/ascitic fluid in the morning only for it to return by night. Augmented Zengye Tang is far safer.

There was a late-stage cervical cancer patient from Sichuan with severe ileus, no bowel movement for many days, hospitalized at the Sichuan Provincial Cancer Hospital. The attending physician tried various laxatives without effect and decided to operate. The patient turned to me; I prescribed augmented Zengye Chengqi Tang with Baishao (White Paeonia) and Danggui (Angelica). One dose, and over ten hours later, the patient's bowels moved, the ileus resolved, and she was spared surgery.