Yurencun Teacher Academic Ideas, Experiences And Spleen And Kidney Method In The Treatment Of Tumor

Professor Yu Rencun, a famous specialist in Oncology with combination of Traditional Chinese Medicine (TCM) and Western Medicine in China, has possessed unique academic ideology and experiences in the treatment of TCM and combination medicine for malignant tumors. I have learned much knowledge from Professor Yu by participating in the fourth experience inheritance activity. During the three years, I summarized his main academic theory, origin and development, inherited his clinical experience and unique treatment for lung cancer, gastric cancer, breast cancer, colon cancer, liver cancer and so on, accumulated a large amount of clinical cases and acquired plenty of firsthand information.I summarized all the cases, with the basis of clinical medicine, analyzed, contrasted and concluded the original prescriptions. Based on the theory of replenishing the spleen and kidney systems form my teacher, I summarized his clinical experiences, medicine regularity, which including the efficacy, nature and pairs of the common herbs, seek his academic thinking, theoretical essence and clinical significance. Besides,32 cases of Leucocytopenia after chemotherapy were treated by tonifying spleen and replenishing kidney method, which has shown significant difference in terms of symptoms alleviation, leukocyte increase and immunologic function improvement, proving the guiding significance of Professor Yu’s theory in clinic.In terms of the etiology of tumors, Professor Yu raised the theory of inner deficiency and imbalance. He treated and prevented tumors based on the theory of balance and the method of tonifying spleen and replenishing kidney. Inner deficiency was considered to be the key reason for the ongoing and development of tumors. For treatment, the functions of Zang Fu organs, Qi and blood, as well as the balance between pathogens and vital energy were the premises with stabilization of the disease. The cardinal principle for treatment was balancing Yin and Yang, replenishing vital energy and expelling pathogens, in order to achieve new balance. Based on the theory of inner deficiency, the method of tonifying spleen and replenishing kidney was the most important principle. By strengthening the spleen and kidney, the source was plenty and Qi and blood was replenished to balance the Qi, blood, Yin and Yang, and eliminate the mass.Professor Yu was the first expert, in the field of combined TCM and Western Medicine, who put forward the replenishing Qi and activating blood circulation methods to treat tumors, and the view had activated the development of theories for the treatment of tumors in TCM. Considering that the syndrome of Qi deficiency and blood stasis was existed among the patients with tumors, the key problem for the method of replenishing Qi and activating blood circulation was the choice of therapeutic opportunity, drugs and dosage. The method could be adopted when syndrome of Qi deficiency and blood stasis, or for the prevention and treatment during radiotherapy or chemotherapy. The herbs, with the function of replenishing Qi, proved to be develop the immunologic function and the visceral function in modern medical research, were utilized as Jun medicine on principle, while those, with the function of activating blood circulation, confirmed to restrain the tumor cells but have little suppression for immune system, were chosen as well. The dosage of herbs for replenishing Qi should more than that for activating blood circulation (7:3-6:4), to satisfy the cardinal purpose of replenishing Qi and activating blood circulation method. When effective treatment for tumors, such as chemotherapy and biologic target therapy, the herbs with the function of expel tumors should be prescribed.For the treatment in integration of TCM and Western Medicine, Professor Yu came up with four principles and three combinations. Four principles meant the combinations of syndrome differentiation and disease differentiation, vital energy strengthening and pathogens eliminating, systemic and local treatment as well as short-term therapy and long-term healthcare, while three combinations referred to Chinese herbs with operation, chemotherapy and radiotherapy.The combination of syndrome differentiation and disease differentiation; Professor Yu always combined syndrome differentiation with the own rule of the tumors. Apart from making sure the syndrome the patient was suffering from to know the Qi, blood, Yin, Yang, the condition of Zang Fu organs and collaterals, the classification, pathological types, stage, location and phase should also be determined. Treatment was performed according to the characteristics in different stage of various diseases. When made prescriptions, attached importance on the double functions of Chinese herbs and chose the ones, which were able to improve the immune system and suppress the tumor, according to the theories of TCM and their pharmacological actions.The combination of vital energy strengthening and pathogens eliminating; in the early stage, when vital energy was not exhausted, the treatment of eliminating pathogens was focused on. All kinds of methods of TCM or Western medicine should be adopted to eliminate tumors and should pay attention to vital energy as well. If vital energy was decreasing, the replenishing and eliminating methods should be utilized. For the patients in the advanced stage, when vital energy was too weak to receive medicine of expelling pathogens, especially for those without effective drugs, the method of replenishing vital energy was in lead, with a small amount of herbs for expelling tumors. The method of replenishing vital energy was mainly relied on for the patients after operation, radiotherapy or chemotherapy, while combined approach of replenishment and expulsion should be given for those with high risk factors, easy to have recurrence or metastasis.The combination of systemic and local treatment; in the early stage, local treatment was focused on while in the advanced stage, systemic treatment was predominant. Local treatment should be performed when the localized tumor could be eliminated and the patient was suitable, while systemic treatment was utilized when the localized tumor was unable to be eliminated or the patient was not suitable. If the localized condition was serious or urgent, local treatment should be performed first.The combination of short-term therapy and long-term healthcare; Methods in Western Medicine had absolute advantage on short-term efficacy while TCM could play a supplementary role. After the complete treatment for tumor by Western Medicine, the application of TCM, which was used to adjust the balance of Yin and Yang, was an effective way to prevent recurrence or metastasis.When TCM was combined with operation, Chinese herbs of replenishing function were mainly prescribed before the operation to strengthen Qi, nourish blood, tonify spleen and replenish kidney to strengthen the constitution, improve the patient’s nutritional status and make the operation perform smoothly. While postoperative treatment principles with Chinese herbs focused on sooner recovery. When TCM was combined with radiotherapy, the radiation was considered to be heat toxin, which would be harmful to Yin, Qi and the transportation and transformation function of spleen and stomach. Meanwhile, Yin deficiency and blood stasis caused the syndrome of Qi deficiency and blood stasis. So the principles were tonifying Qi, nourishing Yin, promoting fluid, relieving dryness, adjusting spleen and stomach, removing heat, eliminating toxin, activating blood circulation and so on. Besides, treatments were performed according to the location of the disease and the syndromes. When TCM was combined with chemotherapy, Professor Yu held the view that the formula of tonifying spleen and replenishing kidney had the best efficacy, because the inborn and acquired state could be strengthened respectively by the method, which would improve the medullary hematopoiesis function and the immune function. In addition, empirical formula and effective commonly used Chinese herbs were concluded for the treatment of aglobulia, leucocytopenia and thrombocytopenia.The 668 original formulas prescribed by Professor Yu in clinic were analyzed and contrasted in different angles. The rules prescribed according to the syndrome were concluded below; first, the formula of strengthening spleen and kidney should be applied all over, while the exact Chinese herbs, the dosage could be varied in terms of the conditions of the patient and the course of the disease. Second, based on the balance theory, the focus on replenishing vital energy or defending tumors was different due to the various stages. Third,19 Chinese herbs were summarized and reorganized in light of the frequency among the 179 Chinese herbs prescribed in the formulas, the intension of which could fully embody his academic theory of replenishing vital energy and defending tumors at the same time, as well as paying attention on strengthening spleen and kidney. Fourth, according to the analyses for the 19 usually used Chinese herbs, the ones with warm, moderate and sweet nature accounted for great percentage, which meant the core concept of Professor Yu was invigorating and moderate medicine. Moreover, herbs with bitter and cold nature were less commonly applied, illustrating that the method of removing heat and eliminating toxin was usually used, which was coincided with the principle of tonification and purgation in combination. Fifth, the herbs of tonification were mainly utilized, while the ones of removing heat, eliminating toxin, activating blood circulation regulating Qi were applied as assistance. Treatments performed in various aspects at the same time, such as soothing the liver, resolving hard lump, dissolving dampness and phlegm, implied the orderliness of the prescriptions. Sixth, the application of couple herbs was the essence in formulas. Seventh, the advantage in the prevention and treatment for tumors in TCM and Western Medicine could be shown in the double functions of the herbs and their widely-used values, in the evidence of TCM theory, combined with the development of pharmacological research.Professor Yu has been engaged in clinical research on Oncology in combination of TCM and Western Medicine for more than 50 years. His academic theories and treacherous experiences about the treatment for tumors in combination of TCM and Western Medicine have been gradually formed in practice. He has been one of the founders and pacemakers on Oncology in in combination of TCM and Western Medicine, who is famous for profound knowledge, combined medicine, plenty experience and obvious efficacy home and abroad. Objective:First, to observe the clinical efficacy for leucocytopenia, caused by chemotherapy, by the formula of tonifying spleen and replenishing kidney, prescribed by Professor Yu; second, to discuss the advantage of tonifying spleen and replenishing kidney method for the treatment of leucocytopenia, according to the alleviation of clinical symptoms, qualities of life and T-lymphocyte subgroups, providing evidence for further study on the application of tonifying spleen and replenishing kidney method during chemotherapy.Methods:The random, control and prospective trials were adopted. The qualified cases were divided into treatment group and control group by the proportion of 1:1. In treatment group, the formula of tonifying spleen and replenishing kidney by Professor Yu was prescribed, while Leucogen were given in control group and the course of both treatments was two weeks. The exact efficacy of the treatment for leucocytopenia by the formula of tonifying spleen and replenishing kidney, and the alleviation of spleen deficiency syndrome and quality of life, were then evaluated, in terms of leucocyte count, integration for deficiency syndrome of spleen, scores of quality of life and T-lymphocyte subgroups.Results:First, the effective rates of leucocytopenia were 91% and 70% respectively in treatment group and in control group, and the difference between the groups was significant according to statistical analysis (P<0.05). Besides, the increasing range of leucocytes in treatment group was higher than that in control group, showing significant difference (P<0.05).Second, so far as the symptom integration of spleen deficiency syndrome was concerned, the total points was decreased after treatment in both groups, showing significant difference (P<0.05). The total points after treatment and the difference value between the total points before and after treatment in the two groups was significant (P<0.05). Meanwhile, the improvement of anorexia, fatigue, abdominal distension in treatment group, was greater than that in control group.Third, after treatment, the average KPS was higher than that in treatment group, showing statistical difference, while there was no statistical difference of the average KPS before and after treatment in control group. The improve rates of KPS were 84.4% and 53.3% respectively in treatment group and control group, showing significant difference. Fourth, concerning T-lymphocyte subgroups, the results of CD3, CD4 and CD4/CD8 were improved after treatment in treatment group, but the difference was not significant. And there was little improvement in control group.Fifth, in terms of side effects, the impairment of heart, liver or kidney was not observed in both groups after treatment.Conclusions:First, Leucocytopenia after chemotherapy can be effectively alleviated, by the method of tonifying spleen and replenishing kidney, without toxic or side effects.Second, the symptoms of spleen deficiency syndrome after chemotherapy can be improved, and the qualities of life can be developed by the method of tonifying spleen and replenishing kidney.