Academic Theory And Clinical Experience Of Wang Xixing"Harmonizing" Treatment To Tumors And The Research Of Advanced Gastric Cancer Treatment And Survival Evaluation

Professor Wang Xixing, doctoral tutor, one of the fourth batch of the old Chinese medicine academic experience teachers, middle-aged expert with outstanding contribution to the Ministry of Public Health, enjoys special government al lowances of the state counci1. He has engaged in traditional Chinese medicine clinical practice, teaching, and research work for more than30years, and specialized in the stomach disease and tumor study. He advocates "harmonizing" curative perspectives and has a unique treatment methods and research achievements on functional gastrointestinal disorders. In addition, He has been applying the idea of tradition Chinese "harmonizing" to the western medicinal research results in treating tumor, which successfully lead an innovative development to traditional Chinese medicine.On the base of exploring the professor Wang Xixing academic origin, This thesis summarized the academic thoughts and clinical experience of professor Wang’s "harmonizing"treatment to tumor, summed up the treatment rule of advanced gastric cancer, discussed "harmonizing" concept to advanced gastric cancer survival impact. The thesis is divided into three parts:Part one:Professor Wang Xixing academic overview1、Discussing the formation of professor Wang’s academic thought and clinical experience of "harmonizing" in the treatment of tumors, and seeking the paths of well-known specialists.Tutor Wang became interested in traditional Chinese medicine by chance when he was young, and got further systematic study on traditional Chinese medicine in colleges and practiced a lot clinically. By extensively studying TCM classics, such as the Yellow Emperor’s Internal Classic, Treatise on Febrile Diseases, the Theory of Spleen and Stomach, he paid great attention to spleen and stomach, and made the best use of classical prescriptions in the diagnosis and treatment; By reading widely on the clinical experience from masters of TCM, he developed his own academic thoughts especially grasp the essence of "harmonizing"Professor Wang was learned from famous gastroenterologist Xiao Hanxi, who helped him get deeper understanding and innovative ideas on using "harmonizing" treatment on spleen and stomach diseases. Driven by the strong sense of mission to carryforward TCM, professor Wang set his research target to malignant tumors, a worldwide difficult problem, and brought his long-accumulated "harmonizing" insights into the theory of tumor treatment. Tutor Wang Xixing pointed out that to be a successful doctor, one need to "seize opportunities, read classic books, follow masters, practice more, think much, and focus on innovations"2、Through the summary of the idea on "harmonizing" in ancient TCM classics, we analyze its academic origin and tutor Wang’s inheritance and development on it.In Yellow Emperor’s Internal Classic, the idea of "harmonizing" run all through the book, laying its theoretical basis. The book Treatise on Febrile Diseases reflects the use of "harmonizing" in clinical practice, and make contribution to the formation and development of the "harmonizing" theory. Cheng Wuji, Zhang Jiebin, Cheng Zhongling, Dai Tianzhang and other doctors from late generation’s work about "harmonizing" theory enriched and completed the Chinese medicine theory of "harmonizing". Nowadays,"harmonizing" theory has been widely used in the treatment of digestive disease, gynecological disease, pediatric disease, cardiovascular and cerebrovascular diseases, but it hasn’t largely involved with the treatment of tumor. The treatment of tumor are commonly guided by the principle of Fuzheng Quxie (or dispersing phlegm, removing stasis, detoxifying). Tutor Wang Xixing innovatively brought "harmonizing" concept to the complicated therapy of tumor, which contributed to his unique academic thoughts and clinical experience. This acted as a great contribution to the inheritance and development of the treatment principle of "harmonizing"Part Two:Professor Wang Xinxing’s academic thoughts and clinical experience.1、We summarized tutor Wang’s academic thoughts of "harmonizing" treatment to tumor in six aspects as follows:impacts of Chinese cultural values had on the theory of traditional Chinese medicine, reasons and basic principles of using "harmonizing" treatment to tumor, application of "harmonizing" in treatment of common tumor, and some commonly used tumor drugs and prescriptions clinical practice.①The theory of traditional Chinese medicine embodies the concept of "harmony". The basic features of traditional Chinese medicine theoretical system could be condensed into a word-"harmony ".②The concept of "harmonizing" is a multifaceted one. The general meaning refers to not only a kind of method, but also the final purpose to this particular method, at the same time it is also an idea.③The reason behind "harmonizing" treatment on the tumor."The pathogenesis of tumor is very complex and only can be moved by’harmonizing’". Combining traditional Chinese medicine with Western medicine is an people-oriented way to increase the survival of patients with tumor.④The concept of "harmonizing" is presented by therapeutic principles and methods. For example, strengthening heal thy qi to eliminate pathogens, treatment focusing both on alleviating symptoms and cursing the cause to improve the whole therapeutic effects, applying a comprehensive treatment of combining the internal with external and combining traditional Chinese medicine with western medicine, and this has brought great advantage to the efficacy of treatment;⑤"harmonizing" treatment for common tumor, for example:digest ive system tumor with spleen-stomach disharmony, liver-spleen disharmony, disharmony between liver and stomach, or incoordination between cold and heat, breast tumor with spleen-stomach disharmony, and genito-urinary system tumor with Yin-yang disharmony.⑥using "harmonizing " prescription flexibly, such as using ease powder、Sini Powder、Bupleurum fruticosum、ZishuiQinggan Decoction、Banxiaxiexin Decoction.2、We comprehensively summarize Professor Wang’s clinical experience of diagnosis and treatment of digestive tumor and spleen-stomach disease from aspects such as the pathogenesis, treatment based on syndrome differentiation, characteristics of his prescription and others.The diagnosis and treatment experience of six kinds of commonly seen digestive system tumor.①Gastric cancer. Gastric cancer is caused by weakness of the spleen and stomach. In order to protect stomach qi, spleen should be treated first.②Colorectal cancer. Colorectal cancer also belongs to the spleen-stomach category, it is better to be treated by regulating Qi and protecting spleen and stomach.③Esophagus cancer. The TCM pathology of Esophagus cancer is the stagnation of spleen Qi and the adverse flow of stomach Qi, and the treatment method is smoothing liver, strengthening spleen and regulating Qi movement.⑤Biliary tract cancer. The TCM pathology of biliary tract cancer lies in the damp heat in liver and gall and disharmony between gall and stomach. Its treatment focuses on smoothing liver and on strengthening spleen and stomach,⑥pancreatic cancer. Pancreatic cancer is closely related with spleen deficiency and liver Qi stagnation, and its treatment is soothing liver and gallbladder. The experience of diagnosis and treatment of three commonly seen spleen and stomach diseases.①Radiation proctitis. The TCM name of the disease is" Chang Pi" and TCM pathogenesis is the poison in intestine collateral. Treatment of it lies in retention enema, and special drug called Intestinal Rui is the our research result.②NSAID-related gastropathy. The TCM pathology of NSAIDs-related gastropathy is that the stomach is hurt by the poison of the drug, excessive heat stagnate the middle, causing irregular descending of stamoch Qi. The treatment is regulating stomach qi.③Functional dyspepsia. Tutor Wang advocated to borrow the TCM treatment of liver impairment, and apply them to digestive system diseases. From TCM perspective, funct ional dyspepsia is rooted in the liver, and it should be treated by regulating qi.Part Three. Professor Wang Xixing’s research on syndromes and treatments of advanced gastric cancer and survival evaluation of the "harmonizing" treatment on advanced gastric cancer.1、We summarized professor Wang Xixing’s TCM rule of treatment on advanced gastric cancer based on syndrome differentiation and followed the line of symptoms, syndrome, treatment principle, and prescriptions. By using research methods like frequency analysis, cluster analysis, principal component analysis and multifactor analysis, we provided objective and scientific basis for TCM treatment on advanced gastric cancer.①Professor Wang Xixing divided advanced gastric cancer into five categories based on the rule of syndrome differentiation:disharmony between the liver and stomach syndrome (36.6%), spleen deficiency and qi stagnation syndrome (27.7%), phlegm stagnation syndrome (22.7%), the cold-heat coexisted syndrome (7.9%), and yin deficiency of liver and stomach syndrome (4.9%).②The key for syndrome differentiation. Symptoms such as pain in stomach and lateral side of thorax, taut thready pulse, belching, vomiting pantothenic acid would go to disharmony between the liver and stomach syndrome. Lassitude of the body, bloating belly, anorexia, vomiting would be the symptom of the spleen deficiency and qi stagnation syndrome. Symptoms like chest tightness, epigastric pain, black stool, epigastric fullness and rigidity, darkish complexion and nausea would go to phlegm stagnation syndrome. The cold-heat coexisted syndrome would have symptoms like loose stool, stomach fullness, abdomen pain, sore and yellow tongue. Syndrome of yin deficiency of liver and stomach would have symptoms like gastric heartburn, noisy and uncomfortable feeling after eating, stomach pain, and red tongue with crack coat.③regularity of distribution. TCM pathological factors for advanced gastric cancer mainly lies in the spleen, stomach and liver; syndrome key factors, and is mainly caused by qi stagnation, blood stasis, Qi deficiency, phlegm and poison.④Rule of using drugs. The top10drugs commonly used by Professor Wang Xixing’s prescription of advanced gastric cancer:tuckahoe,liquorice, tangerine peel, dangshen, bupleurum, astragalus root, asarum, diffusa, Rhizoma Atractylodis Macrocephalae, August’s. They are mostly of mild flavor.⑤Commonly used prescriptions:Disharmony between liver and stomach syndrome is treated by modified four inverse powder. Stagnation of Qi due to spleen deficiency syndrome is treated by decoction of six noble drugs. Phlegm stagnation syndrome is treated with Xiao Xianxiong Decoction and Wendan Decoction. The cold-heat coexisted syndrome is treated by Banxia Xiexin Decoction. Liver and stomach yin deficiency is treated with modified Decoction of four inverse powder.Professor Wang Xixing thought that the primary pathological factors for advanced gastric cancer are qi stagnation, blood stasis, deficiency of Qi, phlegm stasis and poison, and they mainly effect spleen and stomach, and the liver is closely related. The basic pathogenesis is spleen and liver dysfunction, with spleen deficiency run through the whole pathologicalprocess. TCM treatment is based on syndrome differentiation, disease differentiation combined with methods to protect spleen and stomach, using prescription properly and effectively, which fully embodies the "harmonizing" thoughts.2、By cohort study, a prospective research method, we observed the survival time and living quality of patients with advanced gastric cancer treated by "harmonizing" treatment and discussed the impact of "harmonizing" treatment on patients with advanced gastric cancer. This research collects diagnosed advanced gastric cancer cases, which are suitable for chemotherapy treatment. Patients in TCM group were only treated tradi t ional Chinese medicine, the experimental group were treated Chinese herbal medicine combined with chemotherapy. The western medicine group was only treated by chemotherapy. All traditional Chinese medicine were prescribed by Professor Wang Xixing. We used product limit method (Kaplan-Meier method) to calculate the survival rate of the three groups, using the logrank test (log-rank) method to compare the survival rate for three groups and drew survival curves. The patients were investigated with a questionnaire designed according to EORTC QLQ-C30and EORTC QLQ-STO22three month before and after the treatment respectively, and repeated measurement was used to process statistics.The median survival time of traditional Chinese medicine treatment group (166cases), traditional Chinese combined with western medicine treatment group (83cases), western medicine treatment group (63cases) were456days (about15months),422days (about14months),324days (aboutll months) respectively. The difference of survival rate of three groups of was significant (p<0.01). After treatment, scoresof function subscale and total health status subscale in EORTC QLQ-C30and EORTC QLQ-STO22in the traditional Chinese medicine treatment groupwere significantly higher than the western medicine treatment group, traditional Chinese combined with western medicine treatment group in the middle; and scores of symptoms subscale decreased in three groups, but the TCM treatment group were significantly lower than thewestern medicine treatment group, integrative group in the middle, showing a statistically significant difference in three groups (p<0.01)."Harmonizing" treatment from Chinese tradi t ional medicine can improve life quality of patients with advanced gastric cancer, prolonging the period of survival, indicating a guidance meaning to the clinical treatment of advanced gastric cancer.