Cancer of digestive tract includes the malignant tumor such as esophageal cancer, gastric cancer, carcinoma of colon and rectal cancer, the clinical symptoms of which are related to the position of the tumor. The tumor is removed or controlled by means of the antitumor treatment. However, the healthy qi of the human body is often impaired to various degrees because of the operation, chemotherapy and radiotherapy. As a result, the healthy qi is consumed and becomes deficient. In addition, the operational complications or the reactions of chemotherapy and radiotherapy are again related to qi stagnation, blood stasis and the unsmooth circulation of qi and blood. These form the pathogenesis of asthenia in origin and sthenia in superficiality.

Syndrome differentiation and treatment

Blood stasis due to qi stagnation

It manifests stabbing pain with distenison of esophageal, epigastric and abdominal regions, of which the painful sites mostly correspond to the pathological sites, thoracic and abdominal hardness or hard massees, or occasional eructation, blackish stool, deep red tongue or with ecchymoses, thready and unsmooth pulse. It is advisable to promote blood circulation to remove blood stasis. The prescription used is the modified Xuefu Zhuyu

Decoction (Decoction for Removing Blood Stasis in the Chest) or Gexia Zhuyu Decoction (Decoction for Dissipating Blood Stasis under Diaphram). In the case of severe qi stagnation, add Yujin (Radix Curcumae), Quangualou (Fructus Trichosanthis ) , Muxiang ( Radix Aucklandiae ) and Sharenke (Pericarpium Amomi); in the case of severe blood stasis, add Zhechong (Eupolyhage seu Steleophaga ), Oianglangchong ( Catharsius ), Jixingzi ( Semen Impatientis ) , Zicao (Radix Arnebiae seu Lithospermi ) and Danshen (Radix Salviae Mittiorrhizae ) .

Internal accumulation of dampness and heat

It manifests thoracic and epigastric calor and discomfort worsened by ingestion, concurrent pain, thirst, red tongue, yellowish and greasy fur, taut and rapid or taut and slippery pulse, congestion of fistulous mouth with pain or oozing of liquid when it is pressed after fistulation due to carcinoma of colon. It is advisable to clear away heat and dry dampness.

The prescription used is the modified Huanglian Jiedu Decoction (Antidotal Decoction of Coptis). In the case of consumption of yin and body fluids due to dampness and heat, add Shengdihuang (Radix Rehmanniae), Xuanshen (Radix Scrophutariae), Maimendong (Radix Ophiopogonis ) and Tianhuafen ( Radix Trichosanthis); in the case of concurrent qi stagnation, add Qingpi (Pericarpium Citri Reticulatae Viride ), Chenpi (Pericarpium Citri Reticulatae ), Chaihu ( Radix Bupleuri ), Zhike ( Fructus Aurantii ) and Baishaoyao (Radix Paeoniae Alba ); in the case of excessive heat, add Baihuasheshecao ( Herba Hedyotis Diffusae ), Longkui ( Herba Solani Nigri ), Banzhilian ( Herba Scuteltariae Barbatae ) and Shemei ( Herba Duchesneae Indicae); in the case of profuse fluid oozing from the fistulous mouth of carcinoma of colon, add Ermiao Powder (Two Wonderful Drugs Powder).

Incoordination between the liver and stomach

It manifests dysphagia, epigastric tightness and fullness, frequent vomiting and regurgitation or eructation, occasional inclination to sigh, distending pain of hypochondriac regions, vexation, irascibility, thin fur and taut pulse. It is advisable to disperse the liver and regulate the stomach. The prescription used is the modified Chaihu Shugan Decoction (Bupleurum Decoction for Dispersing the Liver). In the case of severe adversely rising gastric qi and lingering vomiting and nausea, add Xuanfuhua ( Flos Inulae ), Daizheshi ( Haematitum ), Zhuru ( Caulis Bambusae in Taeniam), Huanglian ( Rhizoma Coptidis), Wuzhuyu ( Fructus Euodiae) and Jiangbanxia (prepared Rhizoma Pinelliae ).

Obstruction of phlegm stagnation intermingled with blood stasis

It manifests hardness and pain of thoracic, epigastric and abdominal tumorous regions, pain with definite site or lumps, thoracic and diaphragmatic distension and tightness, vomiting of sputum and saliva, or blackish stool, dyschezia or stool with pus and blood as well as foul odor, dark red tongue with purple spots or ecchymoses, thready and unsmooth, or thready, slippery and rapid pulse. It is advisable to resolve phlegm and remove blood stasis. In the case of esophageal carcinoma, use the modified Qige Powder in combination with Taohong Decoction; in the case of gastric carcinoma, use the modified Haizao Yuhu Decoction; in the case of colonic carcinoma and rectal carcinoma, use the modified Yiyi Fuzi Baijiang Powder (Powder of Semen Coicis, Radix Aconiti Praeparata and Herba Patriniae) in combination with Rhubark Powder. In the case of severe vomiting of sputum and saliva, add Quanguanlou ( Fructus Trichosanthis ), Fabanxia (Rhizoma Pinellinae Praeparata ) , Baijiezi (Semen Sinapis Albae ) and Daizheshi ( Ochra Haematitum ); in the case of vomiting like red bean juice or in the case of blackish stool, add Xianhecao (Herba Agrimoniae), Baiji (Rhizoma Bletillae ) and Shensanqi (Radix Notoginseng); in the case of lump in the affected part or subcutaneous phlegm nodules, add Longkui (Herba Solani Nigri), Zhongjiefeng (Folium et Ramulus Sarcandrae ),Tieshuye (Folium Cycadis Revolutae) and Baqia (Rhizoma Smilacts Chinensis ).

Yin consumption of the lung and stomach

It manifests emaciation, dry mouth and throat, thirst with inclination to drink, or foul breath, dysphoria with feverish sensation of the chest, palms and soles, thoracic, dorsal and epigastric burning pain, constipation, uncoated and smooth tongue, thready and rapid pulse. It is advisable to nourish yin and fluid of the lung and stomach. In the case of esophageal carcinoma, use the modified Shashen Maidong Decoction (Decoction of Glehnia and Ophiopogon); in the case of gastric carcinoma, use the modified Zhuye Shigao Decoction (Lophatherum and Gypsum Decoction). In the case of yin consumption and severe heat, add Shandougen ( Radix Sophoare Subprostratae ), Pugongying ( Herba Taraxaci ), Jinyinhua ( Flos Lonicerae ), Baihuasheshecao ( Herba Hedyotis Diffusae) and Banzhilian (Herba Scutellariae Barbatae). In the case of consumption involving hepatorenal yin, use the modified Yiguan Decoction (An Ever Effective Decoction for Nourishing the Liver and Kidney) or Pulsation-Promo-ting Decoction.