The Summary Of Professor Bingkui Piao’s Academic Thoughts And Clinical Study Of Jiedu Xiaozhen Formula’s Efficacy On Rush Induced By Tumor Targeting Drugs

Piao Bingkui,the chief scientist of China Academy of Chinese Medical Science and the capital of the National Medical Master,enjoy the special subsidy of the State Council.He served as vice president of Guang’anmen Hospital and director of the Oncology Department.He is currently director of National Cancer Medical Center and Cancer Profession Committee of World Federation of Chinese Medicine Societies.Professor Piao continues learning and thinking about the treatment of cancer with Chinese medicine through clinical practice and constantly summing up and exploring.He creates a unique academic experience and ideology on the basis of inheriting from Yu Guiqing,Duan Fengwu,Zhang Daizhao and other predecessors.Professor Piao suggested that "visceral imbalance" is the main pathological basis of cancer,advocated "Fuzheng Guben" principle in the prevention and treatment of cancer.He explored the basic treatment model of "Fuzheng Guben" combined with"Quxie detoxification".As the academic successor of Professor Piao,I analyzed and summarized his academic thoughts on the treatment of the side effects of target therapy for lung cancerThis paper mainly discussed academic thoughts of Fuzheng detoxification treatment of tumor,clinical experience of detoxification treatment targeted rash,data mining and application research,and treating rash caused by targeted drugs with Jiedu Xiaozhen Formula.1.The academic sourcesIn the mid-80s of last century,Piao proposed that "poisonous pathogens" is related with pathogenesis of cancer.Deficiency,pathogenic factor,dysfunction of organs is implicated with the development of tumor.He put forward the basic rule of cancer:Fuzheng Guben as the leading,Quxie detoxification as complementary.combined with traditional Chinese and Western medicine.Professor Piao emphasized on distinguishing the priorities of asthenia and sthenia and pathogenic factors,that is the key to achieve good curative effects.2.Discussion on cademic thoughts2.1 Professor Piao proposed "visceral disorders" as the pathogenesis of malignant tumors and advocated strengthening the body resistance in the prevention and treatment of cancer.He also explored the basic treating mode of cancer:Fuzheng Guben" combined with "Quxie detoxification".On the basis of above pathogenesis,Professor Piao stressed that the treatment of cancer should defend the stomach qi;drug compatibility can improve the effects.Regulating activities of Qi is the main therapeutic principles for treatment of the tumor.On the basis of syndrome differentiation and disease diagnosis,different prescriptions should be taken to get better effects.2.2 From the Quxie detoxification theory of the origin,theoretical basis,dialectical points,commonly used law and commonly used drugs to conduct a comprehensive combing study.Professor Piao considered that the cancer toxin is the key to induce the occurrence and development of cancer.Cancer toxin is both exogenous invasion and dysfunction of viscera.The stagnation of cancer toxin,phlegm-turbid,blood-stasis,damp-turbid and heat toxin lead to exhaustion of vital Qi and complicated syndromes.The accumulation of phlegm,dampness combined with toxic factors inside the human body for a long time is the core of cancer pathogenesis.The elimination of blood stasis is the therapeutic principle of cancer.Removing toxic substance,resolving phlegm,dispersing masses,activating blood circulation,clearing heat is also the essential treatment method.Professor Piao stressed that different medicine should be taken to treat different tumor as well as decrease in the toxicity.Reasonable compatibility can reduce the toxicity to get better effects.2.3 Academic Characteristics2.3.1 Disease-syndrome-combined Treatment:Clinically employing modern medicine development,disease differentiation and syndrome differentiation are combined to treat cancer patients.For example,according to disease differentiation,tailored Shashen Maimendong Decoction is always used in lung cancer patients,Xiaoyao San in thyroid cancer/breast cancer/gynecological cancer patients,Sijunzi Decoction plus Shanyao(Chinese yam)in gastric cancer/colorectal cancer patients,Zhuye Shigao Decoction in nasopharyngeal cancer patients in which radiation causes deficiency of Jin and Ye,Liuwei Dihuang Decoction in renal cancer patients,Zhibai Dihuang Pill in prostate cancer patients,Chaihu Shugan San in liver cancer patients,Zhuling Decoction in bladder cancer patients etc..2.3.2 Balance-emphasized Fuzheng Jiedu Theory:Professor Piao has accumulated rich clinical experience through 50 years of clinical practice.He thinks the core of Fuzheng Jiedu theory in cancer treatment is to Tiao Qi Bu Ping(which literally means adjusting the uneven condition),and this reflects the idea of Ping Heng Guan Dian(which literally means the idea of balance).The simple materialism and dialectics thought is embodied in his clinical practice.Considering different stages of the disease in patients,different treatment regimens are used so that the balance of human body can be achieved in the end.2.3.3 Integrative Medicine——Western medicine applied in Chinese Medicine:Professor Piao believes we should accept western medicine other than reject it.Clinically we always consider western medicine as Quxie(which literally means expel Evil Qi)treatment.For example,for early-staged patients,as their health is relatively good,surgery is advised to be done,and Chinese medicine can be used after the surgery.For patients in need of radiotherapy or chemotherapy after surgery,we suggest conventional therapy combining Fuzheng Guben(which literally means strengthen Zheng Qi)treatment should be done at the same time.For advanced inoperable cancer patients,taking their specific condition into consideration,proper radiotherapy/chemotherapy or other treatment can be chosen,and this treatment which combines western medicine’s Quxie treatment and Chinese medicine’s Fuzheng Guben treatment can help maintain body balance,release symptoms,and prolong survival time.For patients in terminal stage,Chinese conservative treatment should be done instead of western medicine to prolong survival time.3.Summary of clinical experienceFor the rash caused by lung cancer targeted therapy,Professor Piao proposed the four treatment principles.3.1 Clearing Heat removing Dampness should be taken to get better effects.For the incidence of drug-induced rash,damp heat depression is the internal cause,external cause is toxicity of herbs trespass on body,cause the the abnormal of Qi and Blood and the damp turbidity inside.3.2 Different treatment should be based on syndrome differentiation.In early stage,the rash is limited to the upper body,especially in the head and face.The color of rash is red,but not so brilliant,and itchy.Cooling and stopping the blood in early stage can get better effects.With the aggravation of disease,nourishing Yin and Qi should be taken.3.3 The spleen and the stomach should be taken good care.If the spleen and stomach function is harmed,it’s hard to cure,3.4 If wind-relieving medicine used properly,we will get better effects on rash.4.Data analysis and clinical researchOBJECTIVE:Through the data analysis,we try to analyze the medication rule on targeted therapy of lung cancer,as well as the medication rule on rash caused by targeted therapy.Methods:A total of 46 patients treated by targeted therapy of lung cancer(including 14 patients with rash)were analyzed retrospectively.Results:Through the data analysis,we came to the conclusion:replenishing Qi to invigorate the spleen is the core thought of Professor Piao.We also specify the basic formula on treating rash.Conclusion:The results of data analysis and Professor Piao’s thoughts on treating lung is mutually confirmed.We also confirmed the composition of detoxification rash:white peony,honeysuckle,fructus kochiae,cicada slough.5.Clinical research of Jiedu Xiaozhen Formula on treating rash caused by targeted therapy of lung cancerOBJECTIVE:In this study,the tumor patients with EGFRIs treatment were observed by prospective random trial to specify the effect of Jiedu Xiaozhen Formula,The test group is treated with Jiedu Xiaozhen Formula,while control group is treated with external used medicine.METHODS:72 patients were randomly divided into two groups:the traditional Chinese medicine group and the external control group.Chinese medicine group received Jiedu Xiaozhen Formula and silicone cream emulsion.28 days as one cycle,at least 2 cycles.Control group received silicone cream emulsion.28 days as one cycle,at least 2 cycles.The data were recorded before treatment,2weeks after treatment and the end of treatment(4 weeks),then was evaluated with NCI CTCAE3.0 standard.Also the symptom was quantified at the same time.Results:The effective rate was 81.8%in the treatment group and 38.7%in the control group.As for the symptom improvement,the effective rate of treatment group was 87.1%,42.9%in the control group,The total effective rate of the treatment group was better than the control group(P = 0.000<0.01).Conclusion:Jiedu Xiaozhen Formula is effective for the patients with rash caused by targeted therapy drug EGFRIs.And the longer the time of taking Jiedu Xiaozhen Formula,the higher the therapeutic effect.